Neurologic System
Neurologic System
Neurologic conditions, evidence, coding, tests, medications, and related nursing diagnoses.
Major neurology conditions
CVA
Ischemic stroke is sudden focal neurologic deficit from arterial occlusion. 87% of strokes. Time-critical: IV tPA within 4.5 hours, mechanical thrombectomy up to 24 hours. BEFAST assessment.
ICH/SAH
Hemorrhagic stroke includes intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH). ICH from HTN/amyloid. SAH from ruptured aneurysm — worst headache of life.
TIA
TIA is transient focal neurologic deficit resolving within 24 hours (usually <1 hour) with no infarction on imaging. High early stroke risk (ABCD2 score). Urgent workup and secondary prevention.
Seizure
Seizure is abnormal electrical brain activity. Epilepsy = 2 unprovoked seizures. Types: focal (aware/impaired awareness), generalized (tonic-clonic, absence). First seizure requires full workup.
Status Epi
Status epilepticus (SE) is seizure activity ≥5 minutes or ≥2 seizures without return to baseline. Time-critical — each minute without treatment increases mortality. Follow ACEP/AAN protocol.
TBI
TBI ranges from mild concussion (GCS 13-15) to severe (GCS ≤8). Primary injury from impact; secondary injury from edema, hypoxia, hypotension. Neuroprotective care targets ICP <20, CPP >60.
Elevated ICP
Normal ICP: 5-15 mmHg. Elevated ICP (>20 mmHg) from TBI, stroke, hydrocephalus, tumor. Cushing triad: hypertension + bradycardia + irregular respirations = impending herniation.
GBS
GBS is acute ascending demyelinating polyneuropathy, often post-infectious (Campylobacter, CMV). Ascending weakness peaking at 4 weeks. 25% require mechanical ventilation. IVIG or plasmapheresis.
Meningitis
Meningitis is inflammation of meninges. Bacterial meningitis (N. meningitidis, S. pneumoniae) is a medical emergency — antibiotics within 1 hour of presentation. Classic triad: fever, neck stiffness, photophobia.
Encephalitis
Encephalitis is inflammation of brain parenchyma. Causes: HSV (most common — treatable), autoimmune (anti-NMDAR), arboviral. Presents with altered mental status, fever, seizures.
PD
Parkinson's disease is progressive neurodegeneration (dopaminergic neurons). Motor triad: tremor at rest, rigidity, bradykinesia. Falls, dysphagia, autonomic dysfunction, dementia (later).
MS
MS is an autoimmune demyelinating CNS disease. RRMS (most common): relapsing-remitting. Presents with optic neuritis, sensory/motor deficits, bladder dysfunction. DMTs reduce relapse rate.
ALS
ALS (Lou Gehrig's disease) is fatal progressive motor neuron disease affecting upper and lower motor neurons. Median survival 3-5 years. Riluzole and Edaravone slow progression modestly.
MG
MG is an autoimmune neuromuscular junction disorder (AChR antibodies). Fatigable weakness worsening with activity. Myasthenic crisis (respiratory failure) is a life-threatening emergency.
SCI
SCI results in motor/sensory deficits below the level of injury. ASIA classification A-E. Neurogenic shock (T6 and above): hypotension + bradycardia. Autonomic dysreflexia: life-threatening.
Related nursing diagnoses
Nursing Diagnoses & Care Plans
Open the NANDA tool to review nursing diagnoses and care-plan concepts related to neurology conditions.