Neurologic Diagnostics in Patients with Eclampsia

“pregnant” by il-young-ko

In 2013, Jindal, Gained, Hasija, & Vani published the results of their observational study titled “Comparison of neuroimaging by CT and MRI and correlation with neurological presentation in eclampsia” in the International Journal of Reproduction, Contraception, Obstetrics, and Gynecology. The researchers used Fisher’s exact and the chi square test to statistically analyze 25 antepartum/intrapartum patients with eclampsia. All of the patients experienced neurological symptoms including headache, blurred vision, loss of vision, altered level of consciousness, and/or coma. Neuroimaging with magnetic resonance imaging (MRI) provided diagnostic confirmation of cerebral cortex/subcortical edema and transient high T2 signal intensity along with generalized vasospasm. The researchers concluded that MRI correlated better to clinical findings than computed topography and is a preferred imaging modality for eclamptic patients.

Jindal, M., Gaikwad, H., Hasija, B., & Vani, K. (2013). Comparison of neuroimaging by CT and MRI and correlation with neurological presentation in eclampsia. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2(1), 83-87. doi:10.5455/2320-1770.ijrcog20130215


Trends in aging

With the baby boomers starting to age and retire, we will see an explosion of aging adults that will require care. This is concerning especially since our health infrastructure has not grown to keep up with the amount of people will who require care in the near future. As a result, I predict that we will see a shift in the healthcare of prevention of diseases and health maintenance to reserve healthcare resources for people who need it. Unfortunately, many aging Americans today are a lot more unhealthier than their parents. We are seeing an increase in rates of diabetes, obesity, hypertension, and many other chronic diseases. In the next 5-10 years, I expect to see more patients with these chronic diseases and the lack of resources to treat them. I expect that the role of nurse will evolve to accommodate the increasing needs of the aging adult. My main concern is that the rate at which change is currently occurring will not be enough to meet the needs of the baby boomers in the future.


Aging Population

As future nurses, it is very important to be aware of the population that we will be caring for. Whether we care for the aging population directly or indirectly we will all be affected by the aging population. I found an article that talks about the changes nurses will have to make with the increase of people dying at a very old age. The article mentions the importance of nurses being trained and supported in caring for patients nearing end of life that might require additional care for conditions such as dementia. It emphasizes the importance of being skilled in communication, holistic assessment , care planning and being able to support people with declined cognitive ability. This is a very important component especially when nurses and healthcare providers are trying to uncover the patient’s wishes and preferences regarding life-prolonging treatments and preferred place of care and death.

As a caregiver, I work with an elderly woman who has dementia. I could only imagine how hard it would be to decide on life-prolonging treatments or trying to decide where her preferred place of care and death would be. As mentioned in another post, it is important to have these conversations before these situations happen.



The Road Map to a Healthy Brain

The Alzheimer’s Association and the CDC have worked together to develop a road map that utilizes the strengths of public health and government to promote cognitive health. Officially, it was named The Healthy Brain Initiative for 2013-2018 and its action components are based on the Essential Services of public health.

  1. Monitor and evaluate – surveillance data to inform public, identify disparities and needs of caregivers and those with dementia
  2. Develop policies and mobilize partnerships – collaboration between state and local government, incorporate Healthy People 2020 objectives
  3. Assure a competent workforce – continuing education
  4. Educate and empower the nation – disseminate evidenced-based messages, strategies to promote availability of services

Aging is something we cannot prevent and it is the greatest risk factor in developing Alzheimer’s disease (Alzheimer’s, 2013). The trend in healthcare is prevention, and this includes the aging population who are already affected by chronic diseases such as dementia and Alzheimer’s. We can anticipate needs for long term care of these individuals and concerns arise in providing support for their caregivers and family. Another concern is quality of life and the end-of-life wishes of the individual with dementia or Alzheimer’s.

Read it here: The Healthy Brain Initiative

Alzheimer’s Association and Centers for Disease Control and Prevention. The Healthy Brain Initiative: The Public Health Road Map for State and National Partnerships, 2013–2018: Chicago, IL: Alzheimer’s Association; 2013.


Death and Dying

I think the most significant trend in the care for the aging in my lifetime has simply been the fact that our critical care has become so much more sophisticated and effective, at least in terms of prolonging and maintaining life at all costs. This brings up a whole new need that our aging population perhaps never needed in the past, which is that health care providers and families be educated and familiar with the process of dying, not simply as something to avoid but as something that will happen to everyone! It’s crazy to me that we fight off dying with everything we have, because what are we hoping to gain? And it just causes people to have messy and sad deaths.

This is an opinion that I think is held by many people, and definitely by health care professionals, but it’s hard to act accordingly because so many people, in and out of the health field, simply don’t know the ins and outs of death and what it looks like and what to expect. My concern is that lack of education and willingness to discuss death has caused our society to harm elderly people and cheat them of the peaceful death that they desire and deserve.


World’s First Head Transplant

View this article and video to learn about the plan for the world’s first head transplant. A 30 year old Russian man with terminal muscular atrophy has volunteered to be the first human to receive this procedure. The goal is that he receives a new body from a donor through a very intricate and involved procedure. Now think about all the neurological involvement with this one…




Caring for the Aging Population

The culture in America allows for much different practices in caring for the aging population than many other countries. Oftentimes when people are ill, we put them in a nursing home or assisted living, paying strangers thousands of dollars a month to take care of our loved ones. Others pay home health nurses to visit the person in the home; bathing them, giving them medicine, cooking for them. These care tasks are the things our loved ones did for us as children, yet when they are in need of care at an advanced age, it seems to be the norm to have someone else do it for us. In the next 5-10 years, the “baby boomers” are going to be coming into a time where they will likely need advanced care and support. For us to meet the growing needs of this population at the current standard, there will need to be an increase in nursing homes, assisted living, and home health services. However, it is likely those will simply raise their prices in the newly competitive market, making 24/7 care for the elderly a very costly and exclusive. Low income and lower middle class families may have to choose between their job and caring for their loved one due to the lack of services currently for low income families and adult care.

Another major issue we have discussed in class is that of life and death. An aging population means more patients with chronic, life threatening diseases and in turn, ICU patient, ventilator patients, and more talk of extraordinary measures. The time to start advocating for patients and talking to families is now, not once their loved one is dying. To reduce healthcare costs and Medicare spending, it is important for families to understand the concept of life support and the appropriate time to use extraordinary measures so that they can make informed decisions on care in the future. As healthcare professionals, we are responsible for educating patients and families and, in a compassionate way, talk to them about their wishes in tough situations.