Medical Surgical Nursing

(Tina Sui) #1

  • Two subdivisions of ANS:

    • The sympathetic system (activated by stress, prepares body for ―fight or flight‖
      response).

    • The parasympathetic system (conserves, restores, and maintains vital body
      functions, slowing heart rate, increasing gastrointestinal activity, and activating
      bowel and bladder evacuation).




Neurologic Assessment: Health History



  • Pain

  • Seizures

  • Dizziness (abnormal sensation of imbalance or movement) and vertigo (illusion of


movement, usually rotation)



  • Visual disturbances

  • Weakness

  • Abnormal sensations


Neurologic Assessment



  • Cerebral function; mental status, intellectual function thought content, emotional


status, perception, motor ability, and language ability



  • Note the impact of any neurologic impairment on lifestyle and patient abilities and


limitations



  • Agnosia is the inability to interpret or recognize objects seen through the special
    senses.

  • Motor system; posture, gait, muscle tone and strength, coordination and balance,


Romberg test



  • Sensory system; tactile sensation, superficial pain, vibration and position sense

  • Reflexes; DTRs, abdominal, and plantar (Babinski)


 The Romberg test is a screening test for balance. The patient stands with feet


together and arms at the side, first with eyes open and then with both eyes closed for
20 to 30 seconds. The examiner stands close to reassure the patient of support if he
or she begins to fall. Slight swaying is normal, but a loss of balance is abnormal and
is considered a positive Romberg test.
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