Page 262 - Critical Care Nursing Demystified

Chapter 5 CARE OF THE PATIENT WITH NEUROLOGICAL NEEDS 247

TABLE 5–7 Medications Used to Treat Stroke Victims
Medication Action Use
Nimodipine Calcium channel blocker Improves neurologic deficits due
(Nimotop) that crosses the blood- to spasm following subarachnoid
brain barrier and acts as a hemorrhage. Also used to treat
potent peripheral vasodila- migraine headaches and isch-
tor. Binds with cerebral tis- emic seizures. Use with care with
sue and has a high lipid liver impairment.
solubility.
Labetalol Beta-blocker effects. Reduces blood pressure. Take
(Normodyne Reduces BP through vaso- apical pulse prior to giving and
and Trandate) dilation, decreases periph- withhold if <60. Baseline VS
eral resistance. and laboratory evaluation of liver
and kidney function. Monitor for
skin rash, edema, and tachycar-
dia. Assess for dizziness and
hypotension.
Naloxone Narcotic antagonist Reverses CNS and respiratory
(Narcan) reverses effects of opiates depression. Used for narcotic
overdosage or when nature of
respiratory depression is
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Adderall XR Amphetamines that func- Stimulates respirations and the
tion as the brainʼs main CNS by direct action on the cere-
excitatory neurotransmit- bral cortex and the RAS. Results
ter. Increases synaptic in increased motor activity, less
release of norepinephrine fatigue, mood elevation, alert-
and dopamine in the brain. ness, and wakefulness. Useful to
Releases norepinephrine treat narcolepsy.
from nerve endings

of a cerebral aneurysm or an AVM (arteriovenous malformation). Hypertension,
smoking, alcohol, and stimulants are risk factors. An SAH may result in coma
or death. A cerebral aneurysm is a weakened outpouching of a blood vessel wall
that can be congenital or a result of a traumatic injury that stretches and tears
the middle layer of an artery. An AVM is a tangled mass of arterial and venous
blood vessels that become connected and “shunts” blood away from normal
cerebral circulation from the arterial side to the venous side and bypasses the
capillary system. AVMs are primarily congenital and can also be found in the
GI tract, spinal cord, and renal and integumentary systems. On the skin, it is
seen as a small port-wine stain. AVM is supplied by “feeders” of one or more
cerebral arteries. These feeders enlarge over time, become engorged, and tend