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15 Cards in this Set

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  • Back
Cardinal symptoms of Parkinson's
1. Muscle Rigidity
2. Bradykinesia (slow mocements)
3. Tremor
Assessments and Tests for Parkinson's
No specific diagnostic test. Diagnosis made on the basis of rule out of other neurological diseases. CSF may show adecrease in dopamine levels.
Parkinson's Treatment
1. Electrical stimulation for tremor suppression (pacemaker in thalamus that interferes with tremor cells)
2. Stereotactic Pallidotomy - destruction of involved tissue within the basal ganglia
3. Thalamotomy - thermocoagulation of brain cells involved in tremor
4. Autologous adrenal medullary transplant - transplant from left adrenal to the head of the right caudate nucleus
5. Senemet - precursor for dopamine; used for controlling bradykinesia and rigidity
6. Anticholinergics - used when main symptom is tremor
Nursing considerations in Parkinson's
1. Falls
2. Aspiration
3. Malnutrition
4. Impaired communication
5. Infection - pneumonia is #1 cause of death
6. malcutrition
7. skin breakdown
8. depression/ isolation
Myasthenia Gravis
Automimmune disease in which antibodies are formed against ACh and also reduce ACh receptors at neuromuscular junctions - nerve impulses are not transmitted to skeletal muscles

thought to be a genetic component, precipitating event unknown (thymic tumor? viral infection?
Manifestations of MG
1. Easy fatigueability of skeletal muscles during physical activity
2. Common muscles affected: eyes and eyelids, chewing, swallowing, speaking, and breathing
3. Fluctuating weakness: usually strong in the am and weaker with activity
4. No sensory or reflex loss
Assessments and tests for MG
Tensilon Tests - cholinesterase inhibitor given to pts. with suspected MG. Immediate muscle imrovement confirms diagnosis
Treatment of MG
1. Anticholinesterases (Mestinon, Regonol)
2. Corticosteroids (Predisone) - symptom management
3. Immunosuppressant
4. Thymectomy - within the first 2 years of myasthenic symptoms
5. Plasmapheresis - method by which antibodies are removed from the plasma
Nursing Considerations for MG
1. Monitor Respirations
2. Aspirations precautions
3. Myasthenic Crisis vs. Cholinergic crisis
4. Small frequent meals
5. rest periods
6. Med alert bracelet
7. family education - CPR
Pathophysiology of ALS
Progressive disease characterized by loss of motor neurons.

Motor neurons degenerate and leave dead tissue which is unable to transmit signals.
Manifestations of ALS
1. Weakness of upper extremities
2. Dysarthria
3. Dysphagia
4. Muscle wasting
5. Death usually by respiratory arrest, diaphragm is affected
Assessments and Tests for ALS
1. No definitive test, diagnosis made by rule out of other similar neurologic disorders (EMG and nerve conduction studies)
*Patient maintain cognitive abilities
Treatment of ALS
1. Riluzole - decreases glutamate levels - delays progression; does not cure.
Nursing Considerations in ALS
1. Emotional and cognitive support
2. Facilitate communication
3. Provide diversional activities
4. Provide companionship
5. Help family and patient with advanced planning
Pathophysiology of Guillan-Barre'
Autoimmune disease in which the immune system destroys the myelin sheaths along the axons