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15 Cards in this Set
- Front
- Back
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Cardinal symptoms of Parkinson's
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1. Muscle Rigidity
2. Bradykinesia (slow mocements) 3. Tremor |
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Assessments and Tests for Parkinson's
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No specific diagnostic test. Diagnosis made on the basis of rule out of other neurological diseases. CSF may show adecrease in dopamine levels.
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Parkinson's Treatment
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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 |
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Nursing considerations in Parkinson's
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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 |
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Myasthenia Gravis
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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? |
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Manifestations of MG
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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 |
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Assessments and tests for MG
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Tensilon Tests - cholinesterase inhibitor given to pts. with suspected MG. Immediate muscle imrovement confirms diagnosis
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Treatment of MG
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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 |
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Nursing Considerations for MG
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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 |
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Pathophysiology of ALS
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Progressive disease characterized by loss of motor neurons.
Motor neurons degenerate and leave dead tissue which is unable to transmit signals. |
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Manifestations of ALS
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1. Weakness of upper extremities
2. Dysarthria 3. Dysphagia 4. Muscle wasting 5. Death usually by respiratory arrest, diaphragm is affected |
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Assessments and Tests for ALS
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1. No definitive test, diagnosis made by rule out of other similar neurologic disorders (EMG and nerve conduction studies)
*Patient maintain cognitive abilities |
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Treatment of ALS
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1. Riluzole - decreases glutamate levels - delays progression; does not cure.
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Nursing Considerations in ALS
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1. Emotional and cognitive support
2. Facilitate communication 3. Provide diversional activities 4. Provide companionship 5. Help family and patient with advanced planning |
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Pathophysiology of Guillan-Barre'
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Autoimmune disease in which the immune system destroys the myelin sheaths along the axons
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