Tuesday, March 23, 2010
9:55–10:45 am
(330) Aging and Head Injury: Considerations, Care, and Case Studies
Rose Rossi Schwartz, PhD RN
The growth of the elderly population has increased dramatically and with the "Baby Boomer Generation" reaching the age of 65, the numbers will continue to expand exponentially. The shear numbers coupled with an increasingly active lifestyle, chronic health conditions, impaired motor and cognitive function, and extended life expectancy place this population at an increased risk for head injury. Care of the elderly patient who has sustained a head injury, requires an aggressive approach of managing both the acute injury as well as the chronic conditions that contribute to the health status of the individual. The paper will discuss the epidemiology of head injury in the elderly, risk factors for head injury, and treatment options. Several case studies will be presented with CAT scans images. Understanding early management as well as prevention of secondary complications is essential for the patient's survival and recovery of this insult to the brain.
(331) Adjuvant Therapies for Spinal Cord Tumors
Nancy Villanueva, PhD CRNP BC CNRN
Tumors that arise from the spinal cord, spinal nerve roots and dura are rare compared to intracranial tumors. The overall prevalence is estimated at one spinal tumor for every four intracranial lesions. This ratio results in approximately 10,000 Americans developing primary or metastatic spinal cord tumors per year. Similar to persons with intracranial tumors, surgery, radiation therapy, and chemotherapy are potential treatment options. A variety of factors must be taken into consideration when designing a treatment plan. The nurse caring for the patient with a spinal tumor must understand the treatment options available and related nursing care while undergoing treatment. Case studies with a variety of tumor presentations will be used to illustrate the treatment decisions, therapies employed and nursing care requirements.
(332) Migraine Headache Management: a Case Study Approach* **
Amy Larson,RN APRN BC CNRN
Migraine headache is a very common medical condition seen in outpatient neurology clinics. The nonpharmacologic and pharmacologic management of migraine headaches requires knowledge of current treatment options as well as the ability to engage the patient in active participation in their headache management plan. Current treatment options for migraine headache prevention as well as headache abortion will be outlined and teaching points will be reviewed. A case study format will be utilized to illustrate the decision making points in designing a migraine headache management plan and the role of the advanced practice nurse will be highlighted.
(333) Evidence-Based Care for Patients with Transient Ischemic Attacks
Janice Hinkle, RN PhD CNRN
It is estimated that between two and five hundred thousand people have a transient ischemic attack (TIA) each year in the United States. A TIA is now defined as a transient episode of neurological dysfunction caused by focal brain, spinal cord or retinal ischemia without acute infaction. Neuroscienc nurses are undoubtedly seeing more of these patients as a more intensive evidence based diagnostic work-up is recommended to look for a probable cause. Risk stratification and implementation of prevention strategies is essential as approximately 10% to 15% of patients who have a TIA go on to have a stroke within 3 months, half of these within 48 hours. This presentation will address the important implications of the evidence based changes in definition and patient work-up as they relate to nursing care and patient advocacy. How current nursing research findings can inhance patient and family teaching will also be discussed.
11-11:50 am
(334) The Future of Alzheimer's Disease: Improving Outcomes
Laura Mcilvoy, PhD RN CCRN CNRN
Currently over 4 million Americans have been diagnosed with Alzheimer's disease (AD). After the age of 65, the prevalence of AD is expected to double every 5 years. With AD becoming more widespread, the public will seek reliable sources of information and education on AD and neuroscience nurses need to position themselves to be the primary source. We need to provide accurate and scientific knowledge on AD as we continue to deliver compassionate, evidence-based physical and emotional care to patients and families. This session will present diagnostic criteria for AD, the latest evidence on risk factors and genetic predisposition, along with the current theories on the physiological changes in the brain that result in the hallmark cognitive decline. The degree of success in treating AD with the available pharmaceutical and behavioral interventions as well as the exciting direction new research is taking will be presented.
(335) Oh My Aching Back: Lumbar Degenerative Disk Disease and Lumbar Fusion
Susan Ware, RN MSN CCRN CNRN FNP-C ACNP-C
It is estimated that 10% of chronic low back pain is from age related degenerative changes of the lumbar spine. Currently total direct and indirect costs for low back pain treatment are estimated at $100 billion annually. The incidence of chronic low back pain will only grow as twenty percent of the US population will reach 65 years of age by 2030. Lumbar fusion has become an increasing popular method to treat degenerative disk disease and advances in technology have provided numerous surgical methods to accomplish fusion. This presentation will review the most common degenerative disk disease conditions. A case study approach will be used to present a variety of degenerative conditions, including physical exam findings, radiographic imaging, conservative treatment and lumbar fusion techniques. A variety of surgical approaches for interbody fusion including anterior, posterior, transforaminal and newer minimally invasive approaches will be presented.
(336) Cryptogenic Stroke in Young Adults with a Patent Foramen Ovale
Vince Vacca, RN MSN CCRN
Cryptogenic ischemic strokes, caused by a paradoxical embolus (PDE), can result from a patent foramen ovale (PFO). PFO is a common cause of intracardiac shunt allowing direct communication between the right and left atria. PFO is estimated to be present in 25-35% of young adults less than 30 years of age. A PDE is an embolus that travels from the right side venous circulation to the left side arterial circulation through a PFO, and can then lead to an ischemic stroke. Typically, verification of a venous or pulmonary thrombus/embolus, is necessary for the diagnosis of cryptogenic ischemic stroke. Annually, between 50,000 and 100,000 Americans present with both a PFO and an ischemic stroke of undetermined (cryptogenic) etiology. Studies reveal the annual incidence of first cryptogenic ischemic stroke with PFO is approximately 70,000, making cryptogenic ischemic stroke secondary to PFO and PDE a significant health concern.