INSTITUTO DE CIENCIAS HUMANAS
PROCESO ENFERMERO:
ANEURISMA CEREBRAL
NOMBRE DEL ALUMNO:
MIGUEL IVAN DORTA MALDONADO PRACTICAS DE MEDICO QUIRURGICO 2 GRADO Y GRUPO: 5 A FECHA: 18/12/14
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INDICE INTRODUCCION………………………………………….……..3 OBJETIVO…………………………………………………..…….3 JUSTIFICACION……………………………………… JUSTIFICACION…………… ……………………………....……4 …....……4 ANATOMIA ANATOMIA Y FISIOLOGIA DEL CEREBRO……………..…..5 CEREBRO……………..…..5 CONCEPTO ANEURISMA CEREBRAL………………………7 FISIOPATOLOGIA………………………………………………10 EPIDEMIOLOGIA……………………………………………….12 ETIOLOGIA- CAUSAS…………………… CAUSAS………………………………………….13 …………………….13 CUADRO CLINICO…………………………………………… CLINICO……………………………………………...14 ...14 DIAGNOSTICO…………………………………………………..15 TRATAMIENTO………………………………………………….1 OBJETIVO DEL PLAN DE CUIDADOS………………………23 CUADRO DE JERAR!UI"ACION………… JERAR!UI"ACION……………………………24 …………………24 PLACE……………………………………………………………25 BIBLIOGRAFIA………………………………………………….2#
INTRODUCCION 2
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
OBJETIVO
P*$$*+$'&* )+&$% &/ &+('( *(%($ & %) &$/$8&9 (' %) (%&'+& ('*$ (/ ;$%+&/9 &*& /$% )+&$% '$% &$&*(,$% (' (/ /+*$ ( '&&9 '+9 '$. P*$$*+$'&* /$% )+&$% ;$%+&/&*+$% '((%&*+$%9 &*& %) ,(>$*8&. D&* )'& $,$+& (' %) ('$*'$ (/ &+('(. S&(* ( /& &$/$8& (/ &+('( *(%($ & (%$ ;&(* +'(*?('+$'(% &*& %) ,(>$*8&. M(>$*&* %) &/+& ( ?+&.
JUSTIFICACION 3
S&*(,$% :)( /$% &'()*+%,&% (*(*&/(% +'/)(' &'$ <&$*(% ;(*(+&*+$% $,$ &,+('&/(%. C$,/+&+$'(% ( /$% &'()*+%,&% - A+('( (*(*$?&%)/&* ;(,$**&+$ - D&$ '(*?+$%$ (*,&'('( - +*$(<&/+&
Planteamiento del problema L& *) *))* )*& & ( &'()* &'()*+% +%,& ,&%% (*( (*(*& *&/( /(%% (% /& *+' *+'+ +& &// &)% &)%& & ( ;(,$ ;(,$** **&+ &+& & %)&*&'$+(& ( &)(*$ & /&% (%&8%+&% ,)'+&/(% $* /$ :)( %( ;&( $'?('+('( *(?+%&* /$% &?&'(% ='+$% :)+*6*+$%. D(+$ & /& &/& +'+('+& ( %()(/&% ,$*+,$*&/+& (' ')(%*$ &8% (% ,(>$* *($'$(* /&% ,(>$*(% $+$'(% ( *&&,+('$ $'//(?&' & ,(>$*&* /& %$*(?+& /& &/+& ( ?+&.
ANATOMIA ANATOMIA Y FISIOLOGIA DEL CEREBRO 4
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
Partes del cerebro:
Cerebro. L& %)%&'+& *+% (/ (*(*$ %( +?+( (' ?&*+&% $*+$'(% $ @*(&% )&% '()*$'&% (>()&' <)'+$'(% (%(8<+&%9 ( ,&'(*& :)( && <)'+' (*(*&/ %( /$&/+& (' )' @*(& ((*,+'&&. S(/(+$'( )' @*(& (/ *@<+$ &*& ?(* /& (/+&+'. Corteza cerebral. C&& ((*'& ( )'$% 3 ,, ( (%(%$*. E% (/ ('*$ ( +'(**(&+' ( /& +'<$*,&+' %('%$*+&/9 /& $'+('+&9 /& ,(,$*+& (/ &*('+&>(9 /$% ,$?+,+('$% /&'+<+&$%. Lóbulo prefrontal. C('*$ ( /& (*%$'&/+& (/&$*&+' (/ ('%&,+('$. Lóbulo frontal. C('*$ (/ ,$?+,+('$ $,/(>$. Corteza motora. C('*$ (/ ,$?+,+('$. P/&'+<+& (/ ,$?+,+('$ (/ )(*$. Corteza somatosensorial. B&'&% ( $*(& *(%$'%&/(% (/ &'@/+%+% /& (*(+' (/ %('+$ (/ &$. C&& /&$ (/ (*(*$ %( ('&*& ( /$% %('+$% (/ /&$ $)(%$ (/ )(*$. Lóbulo parietal. C('*$ ( +'(**(&+' ('(*&/.
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Lóbulo temporal. C('*$ ( /& &%$+&+' ( /& &)++'. Lóbulo occipital. C('*$ ( &%$+&+' ?+%)&/. P*$(%& /& +'<$*,&+' ?+%)&/. Cerebelo. C$$*+'& $*&'+& /&% &+$'(% ,)%)/&*(% /$% *($%9 *(+( &/)'&% %(&/(% %('%$*+&/(%. Cuerpo calloso. P)('( ( '()*$'&% :)( $'(& /&% ,+&(% ( /& $*(& ( ,&'(*& :)(9 /+(*&/,('(9 /& ,&'$ (*(;& %&( /$ :)( ;&( /& +:)+(*&. Tálamo. R(+' $'($*& :)( &6& & ,$$ ( (%&+' *(*&'%,+%$*& ('*( /& $*(& (/ *(%$ (/ (*(*$. Hipotálamo. A)& & *()/&* (/ ;&,*(9 /& %(9 /$% /&+$% (/ $*&'9 /& *(%+*&+'9 /& *(%+' %&')8'(&9 /& (,(*&)*& $*$*&/ /& &+?+& %()&/. Médula. C$$*+'& &+?+&(% $,$ /$% /&+$% (/ $*&'9 /& *(%+*&+' /& ,&%+&+' %+' :)( ('&,$% :)( ('%&* (' (//&%. C$'+('( ,);&% '()*$'&% :)( %( $'(&' $' /& ,=)/& (%+'&/ $* /$ &'$ $' (/ *(%$ (/ )(*$.
CONCEPTO DE ANEURISMA CEREBRAL
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
TIPOS DE ANEURISMAS ANEURISMAS LOS VAMOS A CLASIFICARPOR 2.1. SU FORMA.
2.2. TAMAO 2.3. LOCALI"ACIN
2.1. CLASIFICACIN POR SU FORMA A A'()*+%,&% A'()*+%,&% ?(*&(*$%. U' &'()*+%,& ?(*&(*$ $,*('( /&% *(% &&% ( /& &*( (/ ?&%$ %&')8'($. L& && &*(*+&/ (' $'&$ +*($ $' (/ $ %&')8'($ %( //&,& túnica íntimaK (%& && (%@ túnica media9 $,)(%& *+'+&/,('( $* =/)/&% ('$(/+&/(% ('$(/+&/(%.. L& && %+)+('( & =%& (% /& túnica $,)(%& $* =/)/&% ,)%)/&*(% /+%&% /+%&% <+*&% (/@%+&%. L& && ,@% ((*+$* /& ,@% &/(>&& ( adventicia9 /& )&/ (%@ $,)(%& $* (>+$ /& $**+('( %&')8'(& %( $'$( $,$ túnica adventicia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
2.2. CLASIFICACIN POR SU TAMAO TAMAO A ANEURISMAS PE!UEOS T+('(' ,('$% ( ( 11 ,+/8,(*$% $,$ )'& $,& ( $**&* ( )' /@+.
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B ANEURISMAS GRANDES T+('(' ( 11 & 25 ,+/8,(*$% $,$ )'& ,$'(& ( 10 ='+,$%. C ANEURISMAS GIGANTES T+('(' ,@% ( 25 ,+/8,(*$% ( +@,(*$% ,@% ( )'& ,$'(& 20 ='+,$% L$% &'()*+%,&% &'()*+%,&% +('(' +('(' & *((* & )' *+,$ *+,$ ( 3 ,, & ,, &/ &$K /& *$&+/+& *$&+/+& ( *$)*& *$)*& &),('& $'<$*,( (/ &'()*+%,& %( (&'(. A ,(+& :)( (/ &'()*+%,& *((9 +,$'( && ?( ,@% *(%+' $'*& (/ (>+$ (*(*&/ +*)'?(+'$9 )(( &* $* *(%)/&$ $,/+&+$'(% (' $('+& /(&/(%.
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
FISIOPATOLOGIA
!
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
&%$+& $' ('<(*,(& *('&/ $/+:)8%+& &)$%,+& $,+'&'(. E%( +$ ( &'()*+%,& /)&*(% *(%+' %$*( (/ (>+$ (*(*&/ +*)'&'(9 &)%&'$ %) ,&/ <)' <)'+$ +$'& '&,+ ,+(' ('$. $. U'& U'& *) *))* )*& & ( (%( (%( (>+ (>+$ $ (*( (*(*& *&// (*(* (*(*$9 $9 $*8 $*8& & &)% &)%&* &* %&'*& %&'*&$ $ ((%+ ((%+?$ ?$ :)( *$(& *$(& (/ (*(*$9 (*(*$9 //&,& //&,&$ $ ;(,$**& ;(,$**&+& +& %)&*& %)&*&'$+ '$+(& (&.. (,$**& (,$**&+& +& %(?(*& %(?(*& )(( )(( &)%&* &)%&* &$% &$% (*(*&/ (*(*&/(% (% *$?$&* *$?$&* +%& +%&&+ &+& & (*,&'('(.
EPIDEMIOLOGIA
11
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
ETIOLOGIA CAUSAS 12
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CUADRO CLINICO 13
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22
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23
Plan de cuidados de enfermer!a aneurisma cerebral D+&'$%+$ NANDA
/&%+<+&+' ( *(%)/&$% NOC
Dominio:4 actividad/reposo RESULTADOS Clase: 4 respuesta cardio Vascular/ Vascular/ pulmonar
E cardiopulmonar Perfusión tisular cerebral 0406
Presión intracraneal 040602 Presión arterial media 040617 Hallazgos en el angiograma cerebral 040615 Dx riesgo de perfusión tisular cerebral ineficaz r/c aneurisma cerebral
!"#$%&%'('%)* pre+enir una lesión en el estado neurológico del pte,
24
C/&%+<+&+' +'(*?('+$'(% NIC C&,$ 3 fisiológico comple4o /&%( I $'*$/ '()*$/+$
%nter,ención: ,(>$*& ( /& (*<)%+' (*(*&/ 2550 1. 2. 3. 4. 5. .
V++/ V++/&* &* (/ (%&$ (%&$ '()*$/ '()*$/+ +$ $ C$'*$/&* C$'*$/&* /& /& *(%+' *(%+' &*(*+& &*(*+&// ,(+& ,(+& PA PAM M M$'+$ M$'+$*+& *+&** /& *(%+' *(%+' ?('$%& ?('$%& ('*&/ ('*&/ PVC PVC V++/&* V++/&* (/ (%&$ (%&$ *(%+*&$ *(%+*&$*+$ *+$ <*()('+& <*()('+&99 *+,$ 9 *$<)'+& *$<)'+& C&/)/&* C&/)/&* ,$'+$*+ ,$'+$*+&* &* /& *(%+' *(%+' ( (*<)%+' (*<)%+' (*(*&/ (*(*&/ CPP A,+'+%*&* A,+'+%*&* <@*,&$% <@*,&$% &'&/=%+$%9 &'&/=%+$%9 %+ *$((.
Plan de cuidados de enfermer!a aneurisma cerebral D+&'$%+$ NANDA
/&%+<+&+' ( *(%)/&$% NOC
Domi. ! con"ort RESULTADOS # conducta de salud 'ontrol de n.useas +ómitos 161
Clase: 1 confort f-sico
"tiliza medidas pre+enti+as 16105 "tilizar medicaciones antiemticas si est.n recomendadas 1610 %nformar los efectos secundarios molestos de los antiemticos 16110
utiliza un diario para controlar los s-ntomas 16104 Dx0014 nauseas r/c dolor m/p sensación nauseosa O$%etivo: mane3ar los s-ntomas e las n.useas por medio de &.rmacos antiemticos
!"#$%&%'('%)* ali+iar las n.useas +ómitos por medio de f.rmacos indicados
25
C/&%+<+&+' +'(*?('+$'(% NIC C&,$ 1 <+%+$/+$ @%+$ /&%( E <$,('$ ( /& $,$+& <8%+& <8%+&
%nter,ención: ,&'(>$ (/ ?$,+$ 1570 1 A%()*&* A%()*&* ( :)( %( ;&' &,+'+%*& &,+'+%*&$ $ &'+(,=+ &'+(,=+$% $% (<+&(% (<+&(% &*& *(?('+* *(?('+* (/ ?,+$ %+(,*( :)( ;&& %+$ $%+/( 2 R()+* $ (/+,+'&* (/+,+'&* <&$*(% <&$*(% (*%$'&/ (*%$'&/(% (% :)( (%('&('(' (%('&('(' $ &),('(' &),('(' (/ ?,+$ ?,+$ &'%+(&9 ,+($ &)%('+& ( $'$+,+('$ 3 P(%&* P(%&* &/ &+( &+('( '( $' $' *()/ *()/&*+ &*+& &
Plan de cuidados de enfermer!a aneurisma cerebral D+&'$%+$ NANDA
/&%+<+&+' ( *(%)/&$% NOC
Dominio:! con"ort Clase: 1 confort f-sico
RESULTADOS tolerancia a la actividad &&&'
#aturación de oigeno 000501 &,, &,, en respuesta de la acti+idad 00050 Habilidad para ablar durante el e3ercicio 000514 Dx dolor agudo r/c agentes 8esi+os 9biológicos: m/p informe +erbal de dolor conducta epresi+a
O$%etivo: acer un ce;ueo aud.ndolo a +er ;ue ocasiona dico dolor +er si es gra+e
!"#$%&%'('%)* ali+iar el dolor ;ue presenta o refiere el pte,,
26
C/&%+<+&+' +'(*?('+$'(% NIC C&,$ 5 fisiológico básico /&%( E <$,('$ ( /& $,$+& @%+&
%nter,ención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
BIBLIOGRAFIA
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