This document outlines various nursing diagnoses and interventions for patients with several different neurological conditions and injuries. It covers patients with altered levels of consciousness, increased intracranial pressure, brain injuries, spinal cord injuries, strokes, seizures, Parkinson's disease, multiple sclerosis, Guillain-Barré syndrome, brain tumors, and those undergoing cervical disc surgery. For each condition, it lists common nursing diagnoses related to issues like impaired mobility, respiratory function, cognition, and self-care as well as interventions to address these concerns.

2. THE PATIENT WITH AN ALTERED LEVEL
OF CONSCIOUSNESS
 Ineffective airway clearance related to altered level of consciousness
 Risk of injury related to decreased level of consciousness
 Deficient fluid volume related to inability to take in fluids by mouth
 Impaired oral mucous membranes related to mouth breathing, absence
of pharyngeal reflex, and altered fluid intake
 Risk for impaired skin integrity related to immobility
 Impaired tissue integrity of cornea related to diminished or absent
corneal reflex
 Ineffective thermoregulation related to damage to hypothalamic center

3.  Impaired urinary elimination (incontinence or retention) related to
impairment in neurologic sensing and control
 Bowel incontinence related to impairment in neurologic sensing and
control and also related to transitions in nutritional delivery methods
 Disturbed sensory perception related to neurologic impairment
 Interrupted family processes related to health crisis

4. Nursing Interventions
 Maintaining the airway
 Protecting the patient
 Maintaining fluid balance and managing nutritional needs
 Providing mouth care
 Maintaining skin and joint integrity
 Preserving corneal integrity
 Achieving thermoregulation
 Preventing urinary retention

5.  Promoting bowel function
 Providing sensory stimulation
 Meeting families’ needs

6. NURSING PROCESS:
THE PATIENT WITH INCREASED ICP
 Ineffective airway clearance related to diminished protective reflexes (cough,
gag)
 Ineffective breathing patterns related to neurologic dysfunction (brain stem
compression, structural displacement)
 Ineffective cerebral tissue perfusion related to the effects of increased ICP
 Deficient fluid volume related to fluid restriction
 Risk for infection related to ICP monitoring system (fiberoptic or
intraventricular catheter)
 Other relevant nursing diagnoses are included in the section on caring for
patients with altered LOC.

7. Nursing Interventions
 Maintaining a patent airway
 Achieving an adequate breathing pattern
 Optimizing cerebral tissue perfusion
 Maintaining negative fluid balance
 Preventing infection

8. NURSING PROCESS:
THE PATIENT UNDERGOING
INTRACRANIAL SURGERY
 Ineffective cerebral tissue perfusion related to cerebral edema
 Potential for ineffective thermoregulation related to damage to the
hypothalamus, dehydration, and infection
 Potential for impaired gas exchange related to hypoventilation,
aspiration, and immobility
 Disturbed sensory perception related to periorbital edema, head
dressing, endotracheal tube, and effects of ICP
 Body image disturbance related to change in appearance or physical
disabilities

9. Nursing Interventions
 Maintaining cerebral tissue perfusion
 Regulating temperature
 Improving gas exchange
 Managing sensory deprivation
 Enhancing self-image

10. NURSING PROCESS:
THE PATIENT WITH EPILEPSY
 Risk for injury related to seizure activity
 Fear related to the possibility of seizures
 Ineffective individual coping related to stresses imposed by epilepsy
 Deficient knowledge related to epilepsy and its control

11. Nursing Interventions
 Preventing injury
 Reducing fear of seizures
 Improving coping mechanisms
 Providing patient and family education

12. NURSING PROCESS:
THE PATIENT RECOVERING
FROM AN ISCHEMIC STROKE
 Impaired physical mobility related to hemiparesis, loss of balance and
coordination, spasticity, and brain injury
 Acute pain (painful shoulder) related to hemiplegia and disuse
 Self-care deficits (hygiene, toileting, grooming, and feeding) related to
stroke sequelae
 Disturbed sensory perception related to altered sensory reception,
transmission, and/or integration
 Impaired swallowing
 Incontinence related to flaccid bladder, detrusor instability, confusion,
or difficulty in communicating

13.  Disturbed thought processes related to brain damage, confusion, or
inability to follow instructions
 Impaired verbal communication related to brain damage
 Risk for impaired skin integrity related to hemiparesis/ hemiplegia, or
decreased mobility
 Interrupted family processes related to catastrophic illness and
caregiving burdens
 Sexual dysfunction related to neurologic deficits or fear of failure

14. Nursing Interventions
 Improving mobility and preventing joint deformities
 Preventing shoulder adduction
 Positioning the hand and fingers
 Changing positions
 Establishing an exercise program
 Preparing for ambulation
 Managing sensory-perceptual difficulties
 Managing dysphagia

15.  Managing Tube Feedings
 Attaining bowel and bladder control
 Improving communication
 Improving thought processes
 Maintaining skin integrity
 Improving family coping
 Helping the patient cope with sexual dysfunction

16. NURSING PROCESS:
THE PATIENT WITH A
HEMORRHAGIC STROKE
 Ineffective cerebral tissue perfusion related to bleeding
 Disturbed sensory perception related to medically imposed restrictions
(aneurysm precautions)
 Anxiety related to illness and/or medically imposed restrictions
(aneurysm precautions)

17. Nursing Interventions
 Optimizing cerebral tissue perfusion
 Implementing aneurysm precautions
 Relieving sensory deprivation and anxiety

18. NURSING PROCESS:
THE PATIENT WITH A BRAIN INJURY
• Ineffective airway clearance and impaired gas exchange related to brain injury
• Ineffective cerebral tissue perfusion related to increased ICP and decreased
CPP
• Deficient fluid volume related to decreased LOC and hormonal dysfunction
• Imbalanced nutrition, less than body requirements, related to metabolic
changes, fluid restriction, and inadequate intake
• Risk for injury (self-directed and directed at others) related to seizures,
disorientation, restlessness, or brain damage
• Risk for imbalanced (increased) body temperature related to damaged
temperature-regulating mechanism

19. • Potential for impaired skin integrity related to bed rest, hemiparesis,
hemiplegia, and immobility
• Disturbed thought processes (deficits in intellectual function,
communication, memory, information processing) related to brain injury
• Potential for disturbed sleep pattern related to brain injury and frequent
neurologic checks
• Potential for compromised family coping related to unresponsiveness of
patient, unpredictability of outcome, prolonged recovery period, and the
patient’s residual physical and emotional deficit
• Deficient knowledge about recovery and the rehabilitation process

20. Nursing interventions
 Maintaining the airway
 Monitoring fluid and electrolyte balance
 Promoting adequate nutrition
 Preventing injury
 Maintaining body temperature
 Maintaining skin integrity
 Improving cognitive functioning
 Preventing sleep pattern disturbance
 Supporting family coping

21. NURSING PROCESS:
THE PATIENT WITH ACUTE
SPINAL CORD INJURY
• Ineffective breathing patterns related to weakness or paralysis of abdominal
and intercostal muscles and inability to clear secretions
• Ineffective airway clearance related to weakness of intercostal muscles
• Impaired physical mobility related to motor and sensory impairment
• Disturbed sensory perception related to motor and sensory impairment
• Risk for impaired skin integrity related to immobility and sensory loss
• Urinary retention related to inability to void spontaneously
• Constipation related to presence of atonic bowel as a result of autonomic
disruption
• Acute pain and discomfort related to treatment and prolonged immobility

22. Nursing Interventions
 Promoting adequate breathing and airway clearance
 Improving mobility
 Promoting adaptation to sensory and perceptual alterations
 Maintaining skin integrity
 Maintaining urinary elimination
 Improving bowel function
 Providing comfort measures

23. NURSING PROCESS:
THE PATIENT WITH QUADRIPLEGIA
OR PARAPLEGIA
 Impaired physical mobility related to loss of motor function
 Risk for disuse syndrome
 Risk for impaired skin integrity related to permanent sensory loss and
immobility
 Urinary retention related to level of injury
 Constipation related to effects of spinal cord disruption
 Sexual dysfunction related to neurologic dysfunction
 Ineffective coping related to impact of dysfunction on daily living
 Deficient knowledge about requirements for long-term management

24. Nursing Interventions
 Increasing mobility
 Exercise programs
 Mobilization
 Preventing disuse syndrome
 Promoting skin integrity
 Improving bladder management
 Establishing bowel control
 Counseling on sexual expression
 Enhancing coping mechanisms

25. NURSING PROCESS:
THE PATIENT WITH MULTIPLE SCLEROSIS
 Impaired physical mobility related to weakness, muscle paresis,
spasticity
 Risk for injury related to sensory and visual impairment
 Impaired urinary and bowel elimination (urgency, frequency,
incontinence, constipation) related to nervous system dysfunction
 Impaired speech and swallowing related to cranial nerve involvement
 Disturbed thought processes (loss of memory, dementia, euphoria)
related to cerebral dysfunction

26.  Ineffective individual coping related to uncertainty of course of MS
 Impaired home maintenance management related to physical,
psychological, and social limits imposed by MS
 Potential for sexual dysfunction related to spinal cord involvement or
psychological reactions to condition

27. Nursing Interventions
 Promoting physical mobility
 Exercises, minimizing spasticity and contractures, activity and rest,
minimizing effects of immobility, preventing injury, enhancing
bladder and bowel control, managing speech and swallowing
difficulties
 Improving sensory and cognitive function, vision, cognition and
emotional responses, strengthening coping mechanisms, improving
self-care abilities, promoting sexual functioning

28. NURSING PROCESS:
THE PATIENT WITH
GUILLAIN-BARRÉ SYNDROME
 Ineffective breathing pattern and impaired gas exchange related to
rapidly progressive weakness and impending respiratory failure
 Impaired physical mobility related to paralysis
 Imbalanced nutrition, less than body requirements, related to inability
to swallow
 Impaired verbal communication related to cranial nerve dysfunction
 Fear and anxiety related to loss of control and paralysis

29. Nursing Interventions
 Maintaining respiratory function
 Enhancing physical mobility
 Providing adequate nutrition
 Improving communication
 Decreasing fear and anxiety
 Monitoring and managing potential complications

30. NURSING PROCESS:
THE PATIENT WITH CEREBRAL
METASTASES OR INCURABLE
BRAIN TUMOR
 loss or impairment of motor and sensory function and decreased
cognitive abilities
 Imbalanced nutrition, less than body requirements, related to cachexia
due to treatment and tumor effects, decreased nutritional intake, and
malabsorption
 Anxiety related to fear of dying, uncertainty, change in appearance,
altered lifestyle
 Interrupted family processes related to anticipatory grief and the
burdens imposed by the care of the person with a terminal illness

31. Nursing Interventions
 Compensating for self-care deficits
 Improving nutrition
 Relieving anxiety
 Enhancing family processes

32. NURSING PROCESS:
THE PATIENT WITH PARKINSON’S DISEASE
 Impaired physical mobility related to muscle rigidity and motor weakness
 Self-care deficits (feeding, dressing, hygiene, and toileting) related to tremor
and motor disturbance
 Constipation related to medication and reduced activity
 Imbalanced nutrition, less than body requirements, related to tremor,
slowness in eating, difficulty in chewing and swallowing
 Impaired verbal communication related to decreased speech volume,
slowness of speech, inability to move facial muscles
 Ineffective coping related to depression and dysfunction due to disease
progression

33. Nursing Interventions
 Improving mobility
 Enhancing self-care activities
 Improving bowel elimination
 Improving nutrition
 Enhancing swallowing
 Encouraging the use of assistive devices
 Improving communication
 Supporting coping abilities

34. NURSING PROCESS:
THE PATIENT UNDERGOING
A CERVICAL DISCECTOMY
 Acute pain related to the surgical procedure
 Impaired physical mobility related to the postoperative surgical
regimen
 Deficient knowledge about the postoperative course and home care
management
 Nursing Interventions
 Relieving pain, improving mobility, monitoring and managing
potential complications
 Thanking you.