You are on page 1of 3

Neuro – Nursing Diagnosis

Nursing Diagnosis for 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 (bathing, hygiene, toileting, dressing, grooming, and feeding) related to stroke sequelae Disturbed sensory perception related to altered sensory reception, transmission, and/or integration Impaired swallowing Total urinary incontinence related to flaccid bladder, detrusor instability, confusion, or difficulty in communicating 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

 

 

Nursing Diagnosis for Hemorrhagic Stroke:
 

Ineffective tissue perfusion (cerebral) related to bleeding or vasospasm Disturbed sensory perception related to medically imposed restrictions (aneurysm precautions) Anxiety related to illness and/or medically imposed restrictions (aneurysm precautions)

Nursing Diagnosis for Altered Level of Consciousness
  

Ineffective airway clearance related to altered LOC Risk of injury related to decreased LOC Deficient fluid volume related to inability to take fluids by mouth

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 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 changes in nutritional delivery methods Disturbed sensory perception related to neurologic impairment Interrupted family processes related to health crisis Nursing Diagnosis for Patient with Increased Intracranial Pressure     Ineffective airway clearance related to diminished protective reflexes (cough. aspiration. 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) Nursing Diagnosis for Craniotomy    Ineffective cerebral tissue perfusion related to cerebral edema Risk for imbalanced body temperature related to damage to the hypothalamus. and immobility  Disturbed sensory perception related to periorbital edema. and infection Potential for impaired gas exchange related to hypoventilation. and effects of ICP  Body image disturbance related to change in appearance or physical disabilities Nursing Diagnosis for Epilepsy   Risk for injury related to seizure activity Fear related to the possibility of seizures . head dressing. endotracheal tube. dehydration.        Impaired oral mucous membrane related to mouth-breathing.

unpredictability of outcome. decreased CPP. communication. memory. and the rehabilitation process        . recovery. hemiplegia. and the patient’s residual physical disability and emotional deficit Deficient knowledge about brain injury. hemiparesis. or restlessness Disturbed thought processes (deficits in intellectual function. information processing) related to brain injury Disturbed sleep pattern related to brain injury and frequent neurologic checks Interrupted family processes related to unresponsiveness of patient. prolonged recovery period. or brain damage Risk for imbalanced body temperature related to damaged temperature-regulating mechanisms in the brain Risk for impaired skin integrity related to bed rest.Ineffective individual coping related to stresses imposed by epilepsy  Deficient knowledge related to epilepsy and its control Nursing Diagnosis for Brain Injury      Ineffective airway clearance and impaired gas exchange related to brain injury Ineffective cerebral tissue perfusion related to increased ICP. restlessness. less than body requirements. related to increased metabolic demands. disorientation. and inadequate intake Risk for injury (self-directed and directed at others) related to seizures. immobility. fluid restriction. and possible seizures Deficient fluid volume related to decreased LOC and hormonal dysfunction Imbalanced nutrition.