Neurological Disorders, Stroke, & Spinal Injury — NCLEX Neurological Nursing Review | Chapter 55: Saunders NCLEX-PN

Neurological Disorders, Stroke, & Spinal Injury — NCLEX Neurological Nursing Review | Chapter 55: Saunders NCLEX-PN

Chapter 55 of Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri delivers a comprehensive review of the neurological system, from anatomy and physiology to diagnostics, disorders, injuries, and NCLEX-priority interventions. This chapter builds the knowledge base needed for safe, effective neurological nursing care and exam success.

Watch the lecture above and review the detailed notes below to strengthen your neurological nursing skills for both clinical and NCLEX performance.

Saunders NCLEX-PN Examination Review book cover

Neurological Anatomy & Physiology

  • Brain structures: cerebrum, brainstem, cerebellum, meninges.
  • CSF circulation and the role of the blood-brain barrier.
  • Neurotransmitters: dopamine, acetylcholine, serotonin, norepinephrine.
  • Spinal cord anatomy: ascending/descending tracts, nerve roots.

Neurological Assessment

  • Level of consciousness, pupil response, motor strength, reflexes.
  • Glasgow Coma Scale: scoring for eye, verbal, and motor responses.
  • Meningeal signs: Brudzinski’s and Kernig’s tests.

Neurological Diagnostics

  • Imaging: CT, MRI, cerebral angiography — safety & prep.
  • Electrophysiology: EEG, evoked potentials, caloric testing.
  • Procedures: lumbar puncture — positioning, post-procedure care.

Key Neurological Disorders

  • Increased ICP: Cushing’s triad, positioning, seizure precautions, osmotic diuretics.
  • Seizures: tonic-clonic, absence, partial — safety during episodes, status epilepticus care.
  • Stroke: ischemic vs hemorrhagic, NIH Stroke Scale, acute and postacute management, communication strategies for aphasia.
  • Parkinson’s disease: dopamine deficiency, tremor, rigidity, bradykinesia.
  • Multiple sclerosis: demyelination, visual/motor deficits, energy conservation.
  • Myasthenia gravis: cholinergic vs myasthenic crisis, edrophonium test.
  • Guillain-Barré syndrome: ascending paralysis, respiratory monitoring.
  • ALS: progressive motor neuron loss, respiratory decline.
  • Meningitis: bacterial vs viral, isolation, CSF findings.
  • Encephalitis: viral inflammation, antiviral therapy.
  • West Nile virus: vector transmission, neurological effects.
  • Trigeminal neuralgia & Bell’s palsy: facial nerve care, pain control.

Spinal Cord Injuries & Care

  • Injury levels: C1–L4 — motor/sensory loss patterns.
  • Complete vs incomplete: total vs partial function preservation.
  • Autonomic dysreflexia: triggers (bladder, bowel), emergency antihypertensive treatment.
  • Halo device & spinal traction: pin site care, infection prevention.

Post-Surgical Neurological Care

  • Craniotomy positioning: supratentorial vs infratentorial approaches.
  • Monitor for CSF leaks, infection, increased ICP.
  • Fluid balance and temperature regulation.

NCLEX Nursing Priorities

  • Maintain airway and breathing, especially in acute neuro conditions.
  • Implement seizure precautions when indicated.
  • Control ICP with positioning, meds, and monitoring.
  • Provide safety measures for mobility, sensory loss, and confusion.
  • Educate clients and families about condition, prevention, and recovery expectations.

Conclusion

Neurological nursing care demands rapid assessment, decisive action, and precise interventions. Chapter 55 equips you with the knowledge to recognize life-threatening neuro changes, apply critical thinking, and deliver safe, effective care for a wide range of neurological disorders and injuries.

Subscribe to Last Minute Lecture for more NCLEX-focused lectures and nursing exam preparation tips.

View the complete Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) playlist here: Complete NCLEX-PN Review Playlist

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