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Hospital Corpsman 1 & C - Advanced Navy Nursing manual for hospital training purposes | Next
PSYCHIATRIC DISORDERS |
aspiration of saliva and mucus. After the attack,
administer anticonvulsants, such as barbiturates
or Dilantin®. The objective of drug therapy is
complete suppression of symptoms. Refer the
patient for evaluation.
l Petit Mal Seizure—This type of seizure is
characterized by myoclonic jerks (shocklike
contractions of all or a part of a muscle or group
of muscles), akinetic seizures (abnormal absence
of muscular movement or loss of muscle tone),
and sudden clouding of consciousness for a few
seconds. Also, the patient will normally not fall
down. The classical symptoms of a sudden vacant
expression, cessation of motor activity, and loss
of muscle tone are almost always present. This
condition is very common in children but almost
never occurs after the age of 20. Activity will
resume abruptly. The patient may experience as
many as 100 attacks per day.
TREATMENT—Administer phenobarbital or
other anticonvulsants. Refer the patient for
evaluation.
Cerebrovascular Accident
Strokes are caused by destruction of brain
matter by intracerebral hemorrhage, thrombosis,
embolism, or vacular insufficiency.
SYMPTOMS—They include headache, nau-
sea, vomiting, convulsions, and coma. Conscious-
ness may not always be altered. The patient
may experience speech disturbances, confusion,
loss of memory, reduction of sensation, and
paralysis of extremities or of a complete side of
the body. The onset may be sudden and violent,
with the patient falling into an immediate coma
and exhibiting stertorous breathing, Death from
serious strokes may result in a few minutes to a
few days.
TREATMENT—Administer IV fluids, and
place the patient on immediate and strict bed rest.
Evacuate the patient for hospitalization
immediately.
Subarachnoid Hemorrhage
This is characterized by sudden bleeding into
the subarachnoid space that maybe the result of
trauma or a ruptured aneurysm.
SYMPTOMS—Before the aneurysm ruptures,
it may apply pressure to nerves that will manifest
as headaches, ocular palsies, diplopia, squint and
facial pain, and a diminished visual field. After
rupture, severe headache, nausea, vomiting,
stiffness of the neck, positive Kernig’s sign, and
bilateral Babinski’s reflex are usually present. The
consciousness of the patient may or may not be
affected, and the blood pressure is often elevated.
TREATMENT—Keep the patient at rest and
maintain a fluid balance, avoid opiates and
anticoagulants,
and evacuate the patient
immediately.
TRAUMATIC CONDITIONS
OF THE CENTRAL NERVOUS
SYSTEM (CNS)
Head Injuries
Head injury is the most common of the
traumatic conditions of the CNS. These may be
open or closed, and in each case of head injury,
a neurological evaluation should be performed.
l Concussion—This is the most common
form of head injury and maybe diagnosed by an
altered state of consciousness; abnormal vital
signs; bleeding from the ears and nose; con-
vulsions; and altered pupillary reactions. The
patient normally recovers with no permanent
darnage; however, recurrent concussion may cause
permanent damage.
Extramural hematoma is hemorrhage into the
extramural spaces. This condition is a rare
occurrence. The patient will suffer a loss of
consciousness at the time of the injury and
eventual coma with several hours of lucidity in
between. While lucid, the patient will exhibit signs
of increased intracranial pressure, such as
headache, irritability and mental confusion,
variations in level of consciousness, and
hemiplegia (paralysis on one side of the body).
The condition will deteriorate and death will result
if the problem if not corrected.
Subdural hematoma is caused by the rupture
of a cerebral vein. There will normally be a loss of
consciousness at the time of the injury followed
by an asyrnptomatic period that may last for
several days or weeks. Later the patient may have
symptoms of increased intracranial pressure as
described above. About one half of all persons
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