NAME : Darenz Gajete

SEMESTER : 2nd SEMESTER,2023
COURSE : Advanced Medical Surgical (NURSING 213) 
 

Neurologic Monitoring in Medical-Surgical Nursing

I. Introduction

Neurologic monitoring is an essential aspect of medical-surgical nursing, particularly in patients

with conditions or diseases affecting the central nervous system. This type of monitoring
involves the continuous or intermittent assessment of a patient's neurologic function to detect
changes and complications early on. The goal of neurologic monitoring is to prevent or mitigate
potential neurologic damage, optimize patient outcomes, and ensure timely intervention. This
study guide will provide an overview of neurologic monitoring in medical-surgical nursing,
including neurologic assessment, indications for monitoring, types of monitoring, nursing
considerations, collaborative care, and future directions.

II. Neurologic Assessment

Neurologic assessment is a critical component of neurologic monitoring in medical-surgical

nursing. A comprehensive assessment involves the evaluation of the patient's neuroanatomy and
physiology, including the brain, spinal cord, and peripheral nervous system. The assessment can
help detect changes in neurologic function and identify potential complications that require
prompt intervention.

Components of neurologic assessment include:

1. Level of consciousness: The patient's level of consciousness is assessed using the

Glasgow Coma Scale (GCS) or other standardized tools. This includes evaluating the
patient's response to verbal and physical stimuli and the ability to follow commands.
2. Motor function: Motor function is assessed by evaluating the patient's muscle strength,
tone, and coordination. This includes assessing reflexes, gait, and the presence of
abnormal movements.
3. Sensory function: Sensory function is assessed by evaluating the patient's ability to sense
touch, temperature, and pain. This includes assessing the patient's response to stimuli and
the presence of numbness or tingling.
4. Cranial nerve function: Cranial nerve function is assessed by evaluating the patient's
ability to see, hear, smell, taste, and speak. This includes assessing the patient's pupillary
response, facial movements, and ability to swallow.

Assessment tools and techniques used in neurologic monitoring may include imaging studies,
such as computed tomography (CT) or magnetic resonance imaging (MRI), and laboratory tests,
such as electroencephalogram (EEG) or lumbar puncture. The assessment should be performed
regularly and documented accurately to track changes in neurologic function over time.
 NAME : Darenz Gajete
SEMESTER : 2nd SEMESTER,2023
COURSE : Advanced Medical Surgical (NURSING 213) 
 

III. Indications for Neurologic Monitoring

Neurologic monitoring is indicated for various medical-surgical conditions and diseases that can
affect the central nervous system. The following are some of the indications for neurologic
monitoring:

1. Traumatic brain injury: Patients with traumatic brain injury require neurologic
monitoring to detect changes in neurologic function, including intracranial pressure,
cerebral blood flow, and oxygenation.
2. Stroke: Patients with stroke require neurologic monitoring to detect changes in
neurologic function, including motor deficits, speech impairment, and cognitive decline.
3. Seizure disorders: Patients with seizure disorders require neurologic monitoring to detect
seizure activity and assess their response to treatment.
4. Neuromuscular disorders: Patients with neuromuscular disorders, such as myasthenia
gravis or muscular dystrophy, require neurologic monitoring to detect changes in muscle
strength, tone, and coordination.
5. Spinal cord injuries: Patients with spinal cord injuries require neurologic monitoring to
detect changes in neurologic function, including sensory and motor deficits, autonomic
dysfunction, and bowel and bladder function.
6. Neurosurgical procedures: Patients undergoing neurosurgical procedures require
neurologic monitoring to detect changes in neurologic function, including intracranial
pressure and cerebral blood flow.
7. Infections of the central nervous system: Patients with infections of the central nervous
system, such as meningitis or encephalitis, require neurologic monitoring to detect
changes in neurologic function, including altered mental status and seizures.

Early detection of changes in neurologic function can prevent or minimize potential neurologic
damage and optimize patient outcomes.

IV. Types of Neurologic Monitoring

Neurologic monitoring can be performed using various techniques, including continuous or

intermittent monitoring and invasive or non-invasive monitoring. The type of monitoring
selected depends on the patient's condition and the goals of the monitoring.

1. Continuous monitoring: Continuous monitoring involves the continuous monitoring of

neurologic function over an extended period. This type of monitoring is typically used in
critically ill patients and can be performed using various techniques, such as
electroencephalography (EEG), transcranial Doppler (TCD), and cerebral oximetry.
 NAME : Darenz Gajete
SEMESTER : 2nd SEMESTER,2023
COURSE : Advanced Medical Surgical (NURSING 213) 
 

2. Intermittent monitoring: Intermittent monitoring involves periodic assessments of

neurologic function over time. This type of monitoring is typically used in stable patients
and can be performed using various techniques, such as neurologic examination, imaging
studies, and laboratory tests.
3. Invasive monitoring: Invasive monitoring involves the insertion of a device or sensor into
the body to measure neurologic function. This type of monitoring is typically used in
critically ill patients and can be performed using techniques such as intracranial pressure
(ICP) monitoring or cerebral microdialysis.
4. Non-invasive monitoring: Non-invasive monitoring involves the use of external devices
or sensors to measure neurologic function. This type of monitoring is typically used in
stable patients and can be performed using techniques such as EEG, TCD, or cerebral
oximetry.

The selection of the type of monitoring depends on the patient's condition, the risks and benefits
of the monitoring technique, and the goals of the monitoring.

V. Nursing Considerations

Nurses play a critical role in neurologic monitoring in medical-surgical nursing. The following
are some nursing considerations when performing neurologic monitoring:

1. Establish a baseline: Establish a baseline of the patient's neurologic function through a

comprehensive neurologic assessment. Document the baseline assessment findings to
track changes in neurologic function over time.
2. Implement neurologic monitoring: Implement neurologic monitoring based on the
patient's condition and the type of monitoring selected. Ensure that monitoring devices
and equipment are functioning correctly and are accurately calibrated.
3. Assess and document findings: regularly assess and document neurologic monitoring
findings to track changes in neurologic function over time. Notify the healthcare provider
of any significant changes in neurologic function.
4. Manage intracranial pressure: In patients with elevated intracranial pressure, position the
patient appropriately, ensure adequate oxygenation and ventilation, and administer
medications as prescribed to manage intracranial pressure.
5. Provide support and education: Provide emotional support and education to the patient
and family members regarding neurologic monitoring and its importance in preventing or
minimizing potential neurologic damage.
6. Monitor for potential complications: Monitor for potential complications associated with
neurologic monitoring, such as infection, bleeding, or allergic reactions to monitoring
equipment or medication.
 NAME : Darenz Gajete
SEMESTER : 2nd SEMESTER,2023
COURSE : Advanced Medical Surgical (NURSING 213) 
 

7. Collaborate with the healthcare team: Collaborate with the healthcare team to ensure
effective communication and coordination of care for patients undergoing neurologic
monitoring. Work closely with the healthcare provider to implement appropriate
interventions based on the patient's neurologic monitoring findings.

Effective neurologic monitoring requires careful attention to detail, accurate documentation, and
timely communication and collaboration with the healthcare team.

VI. Collaborative Care

Neurologic monitoring requires a multidisciplinary approach involving healthcare providers

from various disciplines. The following are some healthcare providers who may be involved in
collaborative care for neurologic monitoring:

1. Neurologist: A neurologist is a doctor who specializes in the diagnosis and treatment of

nervous system problems. Neurologists are crucial in the diagnosis and care of patients who are
under neurologic surveillance.

2. Neurosurgeon: A neurosurgeon is a doctor who specializes in the surgical treatment of

nervous system problems. Neurosurgeons may be engaged in the insertion of invasive neurologic
monitoring devices as well as patient care during neurosurgical operations.

3. A critical care physician is a doctor who specializes in the treatment of critically sick patients.
Patients with traumatic brain damage, stroke, or other serious neurologic diseases may be
managed by critical care doctors.

4. Nurse practitioner/physician assistant: Under the supervision of a physician, nurse

practitioners and physician assistants may be engaged in the evaluation and care of patients
receiving neurologic monitoring.

5. A radiologist is a doctor who specializes in the interpretation of imaging investigations. To

measure changes in neurologic function, radiologists may be engaged in the interpretation of
imaging investigations such as CT scans or MRIs.

6. Physical, occupational, or speech therapists: Physical, occupational, and speech therapists may
be involved in the management of patients with neurologic conditions, including those
undergoing neurologic monitoring, to help improve function and promote recovery.
 NAME : Darenz Gajete
SEMESTER : 2nd SEMESTER,2023
COURSE : Advanced Medical Surgical (NURSING 213) 
 

Collaborative care is essential in the management of patients undergoing neurologic monitoring.

Effective communication and coordination among healthcare providers from various disciplines
can optimize patient outcomes and prevent or minimize potential neurologic damage.

VII. Conclusion

Neurologic monitoring is an essential component of medical-surgical nursing care. It involves

the continuous or intermittent assessment of neurologic function in patients with acute or chronic
neurologic conditions. The selection of the type of monitoring depends on the patient's condition,
the risks and benefits of the monitoring technique, and the goals of the monitoring. Nurses play a
critical role in neurologic monitoring, including the establishment of a baseline, implementation
of monitoring, assessment and documentation of findings, management of intracranial pressure,
provision of support and education, monitoring for potential complications, and collaboration
with the healthcare team. Collaborative care involving healthcare providers from various
disciplines is essential for the effective management of patients undergoing neurologic
monitoring. By working together, healthcare providers can optimize patient outcomes and
prevent or minimize potential neurologic damage.