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GOVERNMENT COLLEGE OF NURSING, RAIPUR (C.G.) Subject: Nursing Education DEMONSTRATION ON
NEUROLOGICAL EXAMINATION
Submitted To
Submitted By
Mrs. Mamta Naik Demonstrator
Deepa Mishra M.Sc. Nsg. 1st Year
LESSON PLAN
NAME OF THE TEACHER
: Mrs. Mamta Naik
NAME OF THE STUDENT TEACHER: Ms. Deepa Mishra NAME OF THE SUBJECT
: Nursing Education
NAME OF THE UNIT
: Introduction of Nursing Education (I)
NAME OF THE TOPIC
: Neurological Examination
CLASS/GROUP/BATCH
: M.Sc. Nsg. 1st Year
SIZE OF THE CLASS
: 20
DATE & TIME
: 24/10/2013 between 11:00 AM to 01:00 PM
VENUE
: M.Sc. Nsg. 1st year Classroom
PREVIOUS KNOWLEDGE
: The group will be having some knowledge about Professional Education.
METHODS OF TEACHING
: Demonstration
MEDIA OF TEACHING
: L.C.D., Blackboard, O.H.P., Flash Cards, Handouts
GENERAL OBJECTIVE: After the completion of lecture, the group will be able to know about professional education and will be able to understand the development of professional education.
SPECIFIC OBJECTIVES : After the completion of lecture, the group will be able to : 1. To introduce the Professional Education. 2. To define professional education. 3. To explain responsibilities of professional education. 4. To describe the fundamentals of professional education. 5. To enumerate the historical perspectives of professional education. 6. To explain the development of professional education during first period. 7. To enlist the developments in medicine. 8. To list down developments in law. 9. To explain developments in engineering. 10. To enumerate other forms of vocational education. 11. To describe the development of professional education during second period. 12. To enlist educational means in law. 13. To describe progress of medicine in second period. 14. To list down the progress in engineering. 15. To describe the development in agriculture. 16. To explain the development in commercial education. 17. To explain the miscellaneous progress. 18. To narrate the development of professional education during third period. 19. To describe the development in law during the third period. 20. To explain the progress in the field of medicine. 21. To enumerate the progress in agricultural field. 22. To enlist the commercial development. 23. To describe the miscellaneous development. 24. To narrate the development of the professional education during third period. 25. To explain the development of agricultural and allied personnel during fourth period. 26. To tell about the management strategies. 27. To describe the nursing and nursing education in India. 28. To explain the Dufferin fund. 29. To tell about the educational courses. 30. To describe the auxiliary nursing.
S.NO
TIME
SPECIFIC OBJECTIVE
CONTENTS
TEACHING A.V. LEARNING AIDS ACTIVITY
EVALUATION
NEUROLOGICAL ASSESSMENT 1.
2 min.
To introduce the Professional Education.
2.
2 min.
To define professional education.
INTRODUCTION A neurological examination is a physical examination conducted by a health care provider which is focused on the nervous system. It is a common part of a complete neurological assessment as may be conducted by various physicians, most commonly a neurologist or neurosurgeon. The goal of the examination is to detect any signs or symptoms related to the nervous systems & its functioning. The neurological examination can be conducted by anyone, including primary care providers such as family practitioner & internal medicine, doctors. However, it is most commonly part of a neurological evaluation by a physician specializing in diseases of the nervous system, such as a neurologist or a neurosurgeon.
LCD
How will you introduce professional education?
L.C.D What is the definition of Professional education?
DEFINITION
3.
2 min.
To explain responsibilities of professional education.
L.C.D What are the responsibilities of professional education?
4.
2 min.
5.
1 min.
6.
2 min.
7.
2 min.
PARTS OF A TYPICAL NEUROLOGICAL EXAMINATION To describe Behavioral, Cognitive & Mental Status: the This is a part of the neurological evaluation helps to fundamentals determine the higher functioning of a patient’s brain. It is an of professional assessment of their mental status, or level of alertness & education. consciousness, as well as their higher functions of memory, reasoning, logic & general behavior. While some of this overlaps with a psychological assessment. It is at least in part, a part of the complete neurological examination. Head & Neck Examination Since the brain and the spinal cord are in the head & neck, a general examination of the head and neck for malformations, abnormal anatomy, mass & other findings is often undertaken.
L.C.D What are the fundamentals of professional education?
To enumerate the historical perspectives of Cranial Nerve Examination professional There are 12 cranial nerve which are nerves that education. originate in the head, coming off the brain and brain stem. The examination of these nerves and the functions is complex but includes areas such as smell, vision & eye movements, facial sensation, reflexes & movement, hearing taste, tongue & palate To explain the movements & even movements of the head, neck & shoulders. development of professional Motor Examination education This part of the examination tests the motor function, or during first movement of the major muscle groups most notably in the period. shoulders, arms, hips & legs. The muscles are tested for mass, muscle tone & strength.
O.H.P What are the historical perspectives of professional education?
To enlist the developments in medicine.
O.H.P List down the development in medicine?
Reflex Examination Various reflexes are tested throughout the body. While these can indicate problems with sensation and /or motor
Flash cards
How will you describe the development of professional education during first period?
function, they can also reveal other aspects of other aspects of nervous system dysfunctions as well.
8.
1 min.
To list down developments in law.
9.
2 min
To explain developments in engineering.
10.
1 min.
To enumerate other forms of vocational education.
11.
2 min.
To describe the development of professional education during second period.
12.
1 min
To enlist educational
Coordination & Gait Coordination testing & evaluating a patient’s gait reveal much about various aspects of their nervous system while they involve motor functions they also reveal aspects of other more subtle components of brain function which control these things.
O.H.P What are the . developmental facts in law?
Sensory Examination Finally, the sensory examination part of the neurological examination evaluates the sensation of the patient this includes not just normal touch but also pain & temperature & sensation of limb position and movement.
O.H.P How will you explain the development in engineering?
ASSESSING THE NEUROLOGICAL SYSTEM Begin by asking about the patient’s chief complaint. Then gather details about his current illness, Past illnesses, family history & social history. Also perform a system review. If possible include the patient’s family members or close friends when taking the history. Don’t assume that the patient remembers accurately to collaborate the details with others to get a better picture. Chief Complaints The most common complaints about the neurologic system include headache, dizziness, faintness, confusion, impaired mental status disturbances in balance and gait, changes in loss of consciousness. When documenting the chief complaints, record the information in the patient’s own words. Ask about onset and frequency, what precipitates or
O.H.P What is the progress in other forms of education?
L.C.D What is the development in professional education during second period?
L.C.D List down the educational
means in law.
13.
14.
15.
2 min.
1 min.
2 min.
To describe progress of medicine in second period.
To list down the progress in engineering.
To describe the development in agriculture.
exacerbates it, what alleviates it, and if other symptoms accompany it. Headache, dizziness or faintness, confusion or impaired mental status, balance & gait disturbances, level of consciousness changes. Current Health History Reveals headache, dizziness, numbness, tingling, seizures, tremors, weakness or paralysis. Detects impairment of memory and concentration. Evaluates speech, comprehension, reading or writing skills. Identifies interference with ADL’s. Special Points Children and Headache Suspect headache in child who bangs or holds his head. In an infant, a shrill cry or bulging fontanels may indicate increased intracranial pressure and headache. In children older than 3 years, headache is the most common symptom of brain tumor. Neurologic changes with aging Note that not all neurologic changes in elderly patients are caused by aging & that certain drugs can also cause changes. Past Health History Previous major illness, recurrent minor illnesses, accidents or injuries, surgical procedures and allergies. Health and dietary habits and drug use.
means in law?
L.C.D What is the progress in medicine during second period?
L.C.D What was the progress in engineering?
L.C.D What was the progress in the field of agriculture?
16.
17.
18.
19.
1 min.
2 min.
3 min.
2 min.
To explain the development in commercial education. To explain the miscellaneous progress.
To narrate the development of professional education during third period.
To describe the development in law during the third period.
Family History Diabetes Cardiac or Renal diseases High blood pressure or stroke Cancer Bleeding or mental disorders Psychosocial History Reveals occupation, home environment religion & hobbies. Assess patient’s self-image Check the Vital Signs It is controlled by central nervous system Involves body temperature, heart rate and rhythm, blood pressure & respiratory rate. Normal range- 96.7 F to 100.5 F Ability to maintain a constant temperature can be impaired due to hypothalamus or upper brain stem damage. Controlled by Autonomic nervous system. Slows due to pressure on brain stem & cranial nerves. Abnormal Findings Bradycardia Tachycardia Blood Pressure Continuously monitored by pressure receptors in the medulla. Abnormal Findings Rising systolic blood pressure in a patient with no history of hypertension may signal rising Intracranial pressure. Respiration Respiratory centers in medulla & pons regulate
L.C.D What was the developmental steps in commerce ? L.C.D Explain the miscellaneous progress?
L.C.D How will you narrate the development during third period ?
Hand Outs/ Black board
What were the developmental steps in law during third period?
20.
3 min.
To explain the progress in the field of medicine.
21.
1 min.
To enumerate the progress in agricultural field.
22.
2 min.
To enlist the commercial development.
rate, depth & pattern of respiration. Neurologic dysfunction alters respirations. Uncovers a central nervous system lesion’s site and severity. Abnormal Findings Cheyne-strokes respiration Central neurogenic hyperventilations. Apneustic & Biot’s respirations. Impaired respiration ASSESSING MENTAL STATUS & SPEECH Begins during health history. Gives clue to orientation & memory, guides physical assessment. Assess level of consciousness, appearance, behavior, communication, cognitive function, constructional ability. Level of Consciousness Assessment order can be changed, depending on patient’s state. Tactile stimulus can be used if there is no response. Painful stimuli can be used to assess unconscious patient or patient with markedly decreased level of consciousness who doesn’t respond to other stimuli. Other Methods to Assess Level of Consciousness Squeeze trapezius muscle. Apply supraorbital pressure. Apply mandibular pressure Perform a sternal rub. Apply nail bed pressure. CHECKING MENTAL STATUS To screen patient for disordered thought processes, ask these questions, an incorrect answer to any question may indicate
Hand Outs/ black board
What was the progress in medicine ?
LCD
How will you describe the progress in agricultural field?
LCD
How will you enlist the commercial development?
23.
2 min.
To describe the miscellaneous development.
24.
4 min.
To narrate the development of professional education during third period.
the need for a complete mental status examination. Question Function screened What is your name? Orientation to person What is your mother’s name? Orientation to other person What is today’s date? Orientation to time Where are you now? Orientation to place How old are you? Memory Where were you born? Remote Memory What you have taken in Recent Memory breakfast? Who is the president of India? General Knowledge Can you count backward from Attention and calculation 20 to 1? skill. Noting Trends in Level of Consciousness Compare findings after assessing patient’s level of arousal, with results of previous assessments. Describe patient’s responsiveness objectively. Use clear terms to describe level of consciousness, such as alertness, lethargic, stuporous or comatose. Alerts ! If patient with a skull fracture appears lucid & later has decreased level of consciousness, suspect arterial epidural bleeding. Rapid deterioration of level of consciousness indicates an acute disorder.. Generally decreasing level of consciousness reflects a progressive or degenerative disorder. Toxic encephalopathy, hemorrhage, generalized cortical atrophy (extensive), tumor or intracranial hemorrhage. About Orientation Measures ability of cerebral cortex to receive and accurately interpret sensory stimuli.
LCD
What was the miscellaneous development during third period ?
LCD, OHP
What was the development in professional education during fourth period ?
25.
26.
4 min
2 min.
To explain the development of agricultural and allied personnel during fourth period.
To tell about the management strategies.
Includes orientation to person, place and time. Glasgow Coma Scale Minimize level of consciousness subjectivity. Establishes greater degree of reliability. Describes patient’s baseline mental status. Detects & interprets changes from baseline findings. Evaluate patient’s level of consciousness according to eye opening, verbal and motor responsiveness. Using the Glasgow Coma Scale The Glasgow coma scale describes a patient’s baseline mental status and helps to detect & interpret changes from baseline findings When using the Glasgow coma scale, test the patient’s ability to respond to verbal, motor & sensory stimulation. Grade your findings according to the scale. A score of 15 indicates that the patient is alert can follow simple commands and is oriented to person, place and time. A decreased score in one or more categories may signal an impending neurologic crisis. A score of 7 or less indicates severe neurologic damage. S.No Test Score Patient Response 1. Eye Opening Response Spontaneously 4 Open eye spontaneously To Speech 3 Opens eyes when told to To pain 2 Opens eyes only to painful stimulus None 1 Doesn’t open eyes in response to 2. Motor Response Obeys 6 Shows two fingers when asked
OHP
How will you explain the development in agricultural and allied personnel’s?
OHP
What were the management strategies for development of professional education ?
27.
4 min.
To describe the nursing and nursing education in India.
Localizes
5
Withdraws
4
Abnormal Flexion Abnormal Extension None
3 2 1
Reaches toward towards painful stimulus & tries to remove it. Moves away from painful stimulus. Assumes a decorticate posture (Shown below) Assumes a decerebrate posture (shown below) No response; just lies flaccid (an ominous sign).
Verbal Response (To question, ”What is today’s Date?”) S.No Test Score Patient Response 1. Oriented 5 Tells correct data. 2. Confused 4 Tells incorrect date 3. Inappropriate 3 Replies randomly with words incorrect words 4. Incomprehensible 2 Moans or screams 5. No response 1 No response Detecting Increased Intracranial Pressure The earlier you can recognize the signs of increased intracranial pressure (ICP), the more quickly you can intervene & improve the patient’s chance of recovery. By the time late signs appear, interventions may be useless. Test Early Signs Late Signs Level of Requires increased Unarousable consciousness stimulation Subtle Orientation loss Restlessness & anxiety Sudden Quietness
LCD/ Flash cards
What was nursing and nursing education in India in earlier times ?
28.
29.
2 min.
2 min.
To explain the Dufferin fund.
Pupils
Pupil changes on side Pupils fixed and of lesion. dilated ‘or blown’ One pupil constricts but then dilates. (unilateral hippus) Sluggish reaction of both pupils. Unequal pupils
Motor response
Sudden weakness. Profound Motor changes on side Weakness opposite the lesion. Positive pronator drift with palms up, one hand pronates.
Vital Signs
LCD
What is Dufferin fund ?
LCD
Tell about the educational courses in nursing ?
Intermittent increases Increased systolic in blood pressure. pressure profound Bradycardia, abnormal respirations (cushing’s syndrome)
To tell about the educational Abnormal Findings courses. Orientation to Person: Inability of patient to remember his name. Self-identity usually remains intact until late in decreasing level of consciousness. Abnormal Findings Orientation to Place: A hospitalized patient may confuse health care facility with home.
A non-hospitalized patient (such as with Alzheimer’s disease) may fail to recognize familiar home surroundings & wander.
30.
1 min.
To describe the auxiliary nursing.
Orientation to Time: Disorientation to time may be first indicator of decreasing level of consciousness. Facts about Appearance: Reveals patient’s behavior, dress & group Evaluates coloring, facial expressions, mobility deformities & nutritional state. Detects impairments in gait, posture & ability to rise.
LCD
How will you describe the auxiliary nursing?
Abnormal Findings Subtle changes in patient’s behavior (new onset of chronic disease or more acute change, involving frontal lobe). Reccon eyes (Bleeding into peri-orbital tissue) Otorrhea (Basilar Skull Fracture) Facts about Behavior
SUMMARY Historically, Only medicine, law and the ministry were accepted as professions. Today, professional is a term commonly used to identify many types of people ranging from wrestlers and rock stars, cricketers to college professors and archeologists. RECAPITUALISATION
How will you introduce professional education? What is the definition of Professional education? What are the responsibilities of professional education? What are the fundamentals of professional education? What are the historical perspectives of professional education? How will you describe the development of professional education during first period? List down the development in medicine? What are the developmental facts in law? How will you explain the development in engineering? What is the progress in other forms of education? What is the development in professional education during second period? List down the educational means in law? What is the progress in medicine during second period? What was the progress in engineering? What was the progress in the field of agriculture? What was the developmental steps in commerce ? Explain the miscellaneous progress? How will you narrate the development during third period ? What were the developmental steps in law during third period? What was the progress in medicine ? How will you describe the progress in agricultural field? How will you enlist the commercial development? What was the miscellaneous development during third period ? What was the development in professional education during fourth period ? How will you explain the development in agricultural and allied personnel’s? What were the management strategies for development of professional education ? What was nursing and nursing education in India in earlier times ? What is Dufferin fund ? Tell about the educational courses in nursing ? How will you describe the auxiliary nursing?
BIBLIOGRAPHY 1. Sudha R. “Nursing Education Principles and Concepts”, Jaypee Brothers Medical Publisher (P) Ltd, 2013, Pg.300 2. Basavanthappa B.T. “Nursing Education”, 1st Edition, Jaypee Brothers Medical Publisher (P) Ltd, 2003, Pg.106-115. 3. Sharma Suresh K. & Reena Sharma “Communication and Education Technology in Nursing”, Chennai, Elsevier Publications, 2012, Pg. 126-146. 4. Neeraja K.P. “Textbook of Nursing Education”, 1st Edition, Jaypee Brothers Medical Publisher (P) Ltd, Pg.211-219. 5. “Professional Education”. By Gauri Doshi, 9 Jan 2012, https://www.preservearticles.com 6. “Professional Education”. https://www.ehow.com 7. Professional Education”. https://www.en.wikipedia.org. 8. “Professional Education”. https://rana03458622422.blogspot.com
9. Professional Education”. https://www.pregi.com
10.“Professional Education”.https://www.sites.google.com
NEUROLOGICAL EXAMINATION
Submitted To
Submitted By
Mrs. Mamta Naik Demonstrator
Deepa Mishra M.Sc. Nsg. 1st Year
LESSON PLAN
NAME OF THE TEACHER
: Mrs. Mamta Naik
NAME OF THE STUDENT TEACHER: Ms. Deepa Mishra NAME OF THE SUBJECT
: Nursing Education
NAME OF THE UNIT
: Introduction of Nursing Education (I)
NAME OF THE TOPIC
: Neurological Examination
CLASS/GROUP/BATCH
: M.Sc. Nsg. 1st Year
SIZE OF THE CLASS
: 20
DATE & TIME
: 24/10/2013 between 11:00 AM to 01:00 PM
VENUE
: M.Sc. Nsg. 1st year Classroom
PREVIOUS KNOWLEDGE
: The group will be having some knowledge about Professional Education.
METHODS OF TEACHING
: Demonstration
MEDIA OF TEACHING
: L.C.D., Blackboard, O.H.P., Flash Cards, Handouts
GENERAL OBJECTIVE: After the completion of lecture, the group will be able to know about professional education and will be able to understand the development of professional education.
SPECIFIC OBJECTIVES : After the completion of lecture, the group will be able to : 1. To introduce the Professional Education. 2. To define professional education. 3. To explain responsibilities of professional education. 4. To describe the fundamentals of professional education. 5. To enumerate the historical perspectives of professional education. 6. To explain the development of professional education during first period. 7. To enlist the developments in medicine. 8. To list down developments in law. 9. To explain developments in engineering. 10. To enumerate other forms of vocational education. 11. To describe the development of professional education during second period. 12. To enlist educational means in law. 13. To describe progress of medicine in second period. 14. To list down the progress in engineering. 15. To describe the development in agriculture. 16. To explain the development in commercial education. 17. To explain the miscellaneous progress. 18. To narrate the development of professional education during third period. 19. To describe the development in law during the third period. 20. To explain the progress in the field of medicine. 21. To enumerate the progress in agricultural field. 22. To enlist the commercial development. 23. To describe the miscellaneous development. 24. To narrate the development of the professional education during third period. 25. To explain the development of agricultural and allied personnel during fourth period. 26. To tell about the management strategies. 27. To describe the nursing and nursing education in India. 28. To explain the Dufferin fund. 29. To tell about the educational courses. 30. To describe the auxiliary nursing.
S.NO
TIME
SPECIFIC OBJECTIVE
CONTENTS
TEACHING A.V. LEARNING AIDS ACTIVITY
EVALUATION
NEUROLOGICAL ASSESSMENT 1.
2 min.
To introduce the Professional Education.
2.
2 min.
To define professional education.
INTRODUCTION A neurological examination is a physical examination conducted by a health care provider which is focused on the nervous system. It is a common part of a complete neurological assessment as may be conducted by various physicians, most commonly a neurologist or neurosurgeon. The goal of the examination is to detect any signs or symptoms related to the nervous systems & its functioning. The neurological examination can be conducted by anyone, including primary care providers such as family practitioner & internal medicine, doctors. However, it is most commonly part of a neurological evaluation by a physician specializing in diseases of the nervous system, such as a neurologist or a neurosurgeon.
LCD
How will you introduce professional education?
L.C.D What is the definition of Professional education?
DEFINITION
3.
2 min.
To explain responsibilities of professional education.
L.C.D What are the responsibilities of professional education?
4.
2 min.
5.
1 min.
6.
2 min.
7.
2 min.
PARTS OF A TYPICAL NEUROLOGICAL EXAMINATION To describe Behavioral, Cognitive & Mental Status: the This is a part of the neurological evaluation helps to fundamentals determine the higher functioning of a patient’s brain. It is an of professional assessment of their mental status, or level of alertness & education. consciousness, as well as their higher functions of memory, reasoning, logic & general behavior. While some of this overlaps with a psychological assessment. It is at least in part, a part of the complete neurological examination. Head & Neck Examination Since the brain and the spinal cord are in the head & neck, a general examination of the head and neck for malformations, abnormal anatomy, mass & other findings is often undertaken.
L.C.D What are the fundamentals of professional education?
To enumerate the historical perspectives of Cranial Nerve Examination professional There are 12 cranial nerve which are nerves that education. originate in the head, coming off the brain and brain stem. The examination of these nerves and the functions is complex but includes areas such as smell, vision & eye movements, facial sensation, reflexes & movement, hearing taste, tongue & palate To explain the movements & even movements of the head, neck & shoulders. development of professional Motor Examination education This part of the examination tests the motor function, or during first movement of the major muscle groups most notably in the period. shoulders, arms, hips & legs. The muscles are tested for mass, muscle tone & strength.
O.H.P What are the historical perspectives of professional education?
To enlist the developments in medicine.
O.H.P List down the development in medicine?
Reflex Examination Various reflexes are tested throughout the body. While these can indicate problems with sensation and /or motor
Flash cards
How will you describe the development of professional education during first period?
function, they can also reveal other aspects of other aspects of nervous system dysfunctions as well.
8.
1 min.
To list down developments in law.
9.
2 min
To explain developments in engineering.
10.
1 min.
To enumerate other forms of vocational education.
11.
2 min.
To describe the development of professional education during second period.
12.
1 min
To enlist educational
Coordination & Gait Coordination testing & evaluating a patient’s gait reveal much about various aspects of their nervous system while they involve motor functions they also reveal aspects of other more subtle components of brain function which control these things.
O.H.P What are the . developmental facts in law?
Sensory Examination Finally, the sensory examination part of the neurological examination evaluates the sensation of the patient this includes not just normal touch but also pain & temperature & sensation of limb position and movement.
O.H.P How will you explain the development in engineering?
ASSESSING THE NEUROLOGICAL SYSTEM Begin by asking about the patient’s chief complaint. Then gather details about his current illness, Past illnesses, family history & social history. Also perform a system review. If possible include the patient’s family members or close friends when taking the history. Don’t assume that the patient remembers accurately to collaborate the details with others to get a better picture. Chief Complaints The most common complaints about the neurologic system include headache, dizziness, faintness, confusion, impaired mental status disturbances in balance and gait, changes in loss of consciousness. When documenting the chief complaints, record the information in the patient’s own words. Ask about onset and frequency, what precipitates or
O.H.P What is the progress in other forms of education?
L.C.D What is the development in professional education during second period?
L.C.D List down the educational
means in law.
13.
14.
15.
2 min.
1 min.
2 min.
To describe progress of medicine in second period.
To list down the progress in engineering.
To describe the development in agriculture.
exacerbates it, what alleviates it, and if other symptoms accompany it. Headache, dizziness or faintness, confusion or impaired mental status, balance & gait disturbances, level of consciousness changes. Current Health History Reveals headache, dizziness, numbness, tingling, seizures, tremors, weakness or paralysis. Detects impairment of memory and concentration. Evaluates speech, comprehension, reading or writing skills. Identifies interference with ADL’s. Special Points Children and Headache Suspect headache in child who bangs or holds his head. In an infant, a shrill cry or bulging fontanels may indicate increased intracranial pressure and headache. In children older than 3 years, headache is the most common symptom of brain tumor. Neurologic changes with aging Note that not all neurologic changes in elderly patients are caused by aging & that certain drugs can also cause changes. Past Health History Previous major illness, recurrent minor illnesses, accidents or injuries, surgical procedures and allergies. Health and dietary habits and drug use.
means in law?
L.C.D What is the progress in medicine during second period?
L.C.D What was the progress in engineering?
L.C.D What was the progress in the field of agriculture?
16.
17.
18.
19.
1 min.
2 min.
3 min.
2 min.
To explain the development in commercial education. To explain the miscellaneous progress.
To narrate the development of professional education during third period.
To describe the development in law during the third period.
Family History Diabetes Cardiac or Renal diseases High blood pressure or stroke Cancer Bleeding or mental disorders Psychosocial History Reveals occupation, home environment religion & hobbies. Assess patient’s self-image Check the Vital Signs It is controlled by central nervous system Involves body temperature, heart rate and rhythm, blood pressure & respiratory rate. Normal range- 96.7 F to 100.5 F Ability to maintain a constant temperature can be impaired due to hypothalamus or upper brain stem damage. Controlled by Autonomic nervous system. Slows due to pressure on brain stem & cranial nerves. Abnormal Findings Bradycardia Tachycardia Blood Pressure Continuously monitored by pressure receptors in the medulla. Abnormal Findings Rising systolic blood pressure in a patient with no history of hypertension may signal rising Intracranial pressure. Respiration Respiratory centers in medulla & pons regulate
L.C.D What was the developmental steps in commerce ? L.C.D Explain the miscellaneous progress?
L.C.D How will you narrate the development during third period ?
Hand Outs/ Black board
What were the developmental steps in law during third period?
20.
3 min.
To explain the progress in the field of medicine.
21.
1 min.
To enumerate the progress in agricultural field.
22.
2 min.
To enlist the commercial development.
rate, depth & pattern of respiration. Neurologic dysfunction alters respirations. Uncovers a central nervous system lesion’s site and severity. Abnormal Findings Cheyne-strokes respiration Central neurogenic hyperventilations. Apneustic & Biot’s respirations. Impaired respiration ASSESSING MENTAL STATUS & SPEECH Begins during health history. Gives clue to orientation & memory, guides physical assessment. Assess level of consciousness, appearance, behavior, communication, cognitive function, constructional ability. Level of Consciousness Assessment order can be changed, depending on patient’s state. Tactile stimulus can be used if there is no response. Painful stimuli can be used to assess unconscious patient or patient with markedly decreased level of consciousness who doesn’t respond to other stimuli. Other Methods to Assess Level of Consciousness Squeeze trapezius muscle. Apply supraorbital pressure. Apply mandibular pressure Perform a sternal rub. Apply nail bed pressure. CHECKING MENTAL STATUS To screen patient for disordered thought processes, ask these questions, an incorrect answer to any question may indicate
Hand Outs/ black board
What was the progress in medicine ?
LCD
How will you describe the progress in agricultural field?
LCD
How will you enlist the commercial development?
23.
2 min.
To describe the miscellaneous development.
24.
4 min.
To narrate the development of professional education during third period.
the need for a complete mental status examination. Question Function screened What is your name? Orientation to person What is your mother’s name? Orientation to other person What is today’s date? Orientation to time Where are you now? Orientation to place How old are you? Memory Where were you born? Remote Memory What you have taken in Recent Memory breakfast? Who is the president of India? General Knowledge Can you count backward from Attention and calculation 20 to 1? skill. Noting Trends in Level of Consciousness Compare findings after assessing patient’s level of arousal, with results of previous assessments. Describe patient’s responsiveness objectively. Use clear terms to describe level of consciousness, such as alertness, lethargic, stuporous or comatose. Alerts ! If patient with a skull fracture appears lucid & later has decreased level of consciousness, suspect arterial epidural bleeding. Rapid deterioration of level of consciousness indicates an acute disorder.. Generally decreasing level of consciousness reflects a progressive or degenerative disorder. Toxic encephalopathy, hemorrhage, generalized cortical atrophy (extensive), tumor or intracranial hemorrhage. About Orientation Measures ability of cerebral cortex to receive and accurately interpret sensory stimuli.
LCD
What was the miscellaneous development during third period ?
LCD, OHP
What was the development in professional education during fourth period ?
25.
26.
4 min
2 min.
To explain the development of agricultural and allied personnel during fourth period.
To tell about the management strategies.
Includes orientation to person, place and time. Glasgow Coma Scale Minimize level of consciousness subjectivity. Establishes greater degree of reliability. Describes patient’s baseline mental status. Detects & interprets changes from baseline findings. Evaluate patient’s level of consciousness according to eye opening, verbal and motor responsiveness. Using the Glasgow Coma Scale The Glasgow coma scale describes a patient’s baseline mental status and helps to detect & interpret changes from baseline findings When using the Glasgow coma scale, test the patient’s ability to respond to verbal, motor & sensory stimulation. Grade your findings according to the scale. A score of 15 indicates that the patient is alert can follow simple commands and is oriented to person, place and time. A decreased score in one or more categories may signal an impending neurologic crisis. A score of 7 or less indicates severe neurologic damage. S.No Test Score Patient Response 1. Eye Opening Response Spontaneously 4 Open eye spontaneously To Speech 3 Opens eyes when told to To pain 2 Opens eyes only to painful stimulus None 1 Doesn’t open eyes in response to 2. Motor Response Obeys 6 Shows two fingers when asked
OHP
How will you explain the development in agricultural and allied personnel’s?
OHP
What were the management strategies for development of professional education ?
27.
4 min.
To describe the nursing and nursing education in India.
Localizes
5
Withdraws
4
Abnormal Flexion Abnormal Extension None
3 2 1
Reaches toward towards painful stimulus & tries to remove it. Moves away from painful stimulus. Assumes a decorticate posture (Shown below) Assumes a decerebrate posture (shown below) No response; just lies flaccid (an ominous sign).
Verbal Response (To question, ”What is today’s Date?”) S.No Test Score Patient Response 1. Oriented 5 Tells correct data. 2. Confused 4 Tells incorrect date 3. Inappropriate 3 Replies randomly with words incorrect words 4. Incomprehensible 2 Moans or screams 5. No response 1 No response Detecting Increased Intracranial Pressure The earlier you can recognize the signs of increased intracranial pressure (ICP), the more quickly you can intervene & improve the patient’s chance of recovery. By the time late signs appear, interventions may be useless. Test Early Signs Late Signs Level of Requires increased Unarousable consciousness stimulation Subtle Orientation loss Restlessness & anxiety Sudden Quietness
LCD/ Flash cards
What was nursing and nursing education in India in earlier times ?
28.
29.
2 min.
2 min.
To explain the Dufferin fund.
Pupils
Pupil changes on side Pupils fixed and of lesion. dilated ‘or blown’ One pupil constricts but then dilates. (unilateral hippus) Sluggish reaction of both pupils. Unequal pupils
Motor response
Sudden weakness. Profound Motor changes on side Weakness opposite the lesion. Positive pronator drift with palms up, one hand pronates.
Vital Signs
LCD
What is Dufferin fund ?
LCD
Tell about the educational courses in nursing ?
Intermittent increases Increased systolic in blood pressure. pressure profound Bradycardia, abnormal respirations (cushing’s syndrome)
To tell about the educational Abnormal Findings courses. Orientation to Person: Inability of patient to remember his name. Self-identity usually remains intact until late in decreasing level of consciousness. Abnormal Findings Orientation to Place: A hospitalized patient may confuse health care facility with home.
A non-hospitalized patient (such as with Alzheimer’s disease) may fail to recognize familiar home surroundings & wander.
30.
1 min.
To describe the auxiliary nursing.
Orientation to Time: Disorientation to time may be first indicator of decreasing level of consciousness. Facts about Appearance: Reveals patient’s behavior, dress & group Evaluates coloring, facial expressions, mobility deformities & nutritional state. Detects impairments in gait, posture & ability to rise.
LCD
How will you describe the auxiliary nursing?
Abnormal Findings Subtle changes in patient’s behavior (new onset of chronic disease or more acute change, involving frontal lobe). Reccon eyes (Bleeding into peri-orbital tissue) Otorrhea (Basilar Skull Fracture) Facts about Behavior
SUMMARY Historically, Only medicine, law and the ministry were accepted as professions. Today, professional is a term commonly used to identify many types of people ranging from wrestlers and rock stars, cricketers to college professors and archeologists. RECAPITUALISATION
How will you introduce professional education? What is the definition of Professional education? What are the responsibilities of professional education? What are the fundamentals of professional education? What are the historical perspectives of professional education? How will you describe the development of professional education during first period? List down the development in medicine? What are the developmental facts in law? How will you explain the development in engineering? What is the progress in other forms of education? What is the development in professional education during second period? List down the educational means in law? What is the progress in medicine during second period? What was the progress in engineering? What was the progress in the field of agriculture? What was the developmental steps in commerce ? Explain the miscellaneous progress? How will you narrate the development during third period ? What were the developmental steps in law during third period? What was the progress in medicine ? How will you describe the progress in agricultural field? How will you enlist the commercial development? What was the miscellaneous development during third period ? What was the development in professional education during fourth period ? How will you explain the development in agricultural and allied personnel’s? What were the management strategies for development of professional education ? What was nursing and nursing education in India in earlier times ? What is Dufferin fund ? Tell about the educational courses in nursing ? How will you describe the auxiliary nursing?
BIBLIOGRAPHY 1. Sudha R. “Nursing Education Principles and Concepts”, Jaypee Brothers Medical Publisher (P) Ltd, 2013, Pg.300 2. Basavanthappa B.T. “Nursing Education”, 1st Edition, Jaypee Brothers Medical Publisher (P) Ltd, 2003, Pg.106-115. 3. Sharma Suresh K. & Reena Sharma “Communication and Education Technology in Nursing”, Chennai, Elsevier Publications, 2012, Pg. 126-146. 4. Neeraja K.P. “Textbook of Nursing Education”, 1st Edition, Jaypee Brothers Medical Publisher (P) Ltd, Pg.211-219. 5. “Professional Education”. By Gauri Doshi, 9 Jan 2012, https://www.preservearticles.com 6. “Professional Education”. https://www.ehow.com 7. Professional Education”. https://www.en.wikipedia.org. 8. “Professional Education”. https://rana03458622422.blogspot.com
9. Professional Education”. https://www.pregi.com
10.“Professional Education”.https://www.sites.google.com
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