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29 Cards in this Set
- Front
- Back
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ALS patho
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overstimulation of glutamate leads to cell injury is the current theory
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hallmark signs of ALS
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weakess of upper extremities
dysarthria - difficulty w/ speech dysphagia - difficulty w/ swallowing deep tendon reflexes brisk/overactive |
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post op nursing for crainiotomy patients
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monitor respiratory status q1hr
permissive hypercapnia may be necessary assess for Cushing's Triad monitor for hypothermia |
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management of cerebral edema - post op
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IV Decadron
osmotic diuretics Dilantin avoid excessive stimulation |
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monitor these post op for crainiotomy
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urine/serum osmolality daily
urine specific gravity q2h |
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standard fluids post op for crainiotomy
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D5 1/2 NS @ 75 mL/hr
watch for SIADH |
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Migraine
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results from vasodilation
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tension headache
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skeletal muscle tension
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Tx for migraine & cluster headache
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serotonin receptor antagonist
Imitrex |
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Stages of a seizure
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prodromal - signs & activity preceding a seizure
aural - any sensory warning ictal - full seizure postictal - recovery |
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Partial seizure types
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focal - one area or hemisphere
jacksonian - no loss of consciousness complex partial - altered LOC |
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Generalized seizure types
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tonic-clonic - grand mal
absence - petit mal; staring spells myoclonic - "drop attack" |
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most common side effect of dilantin (anti-seizure med)
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gingival hypertrophy
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patho for Multiple Sclerosis
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destruction of myelin sheath leading to poor nerve transmission
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primary progressive MS
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continual decline with development of quadreparesis, cognitive dysfunction & vision loss
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S/S of Multiple Sclerosis
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coordination problems - loss of balance
vision difficulties - diplopia, patchy or total blindness bowel/bladder dysfunction symptoms improve during pregnancy |
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med's for Multiple Sclerosis
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ABC & R
Avonex, Betaseron, Copaxone, Rebif |
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nursing interventions for MS patients
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mobility exercises
teach wide gait stance don't raise body temp too much ROM exercises |
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myasthenia gravis patho
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autoimmune disorder of the myoneural junction; characterized by weakness of voluntary muscles
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S/S of myasthenia gravis
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diplopia & ptosis
weakness of facial, throat, ocular muscles respiratory muscle effect - decreased vital capacity purely motor - no affect on sensation or coordination |
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Tensilon Test
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anticholinesterase test
facial muscle weakness resolves for about 5 min positive test for MG |
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myasthenia gravis med's
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pyridostimine bromide
prostigmin plan meals around med admin time |
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med's that can worsen MG
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antibiotics
CV med's (b-blockers) antisezure med's psychotropics morphine novacaine |
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S/S of myasthenia crisis
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respiratory muscle fatigue
dysphagia inadequate cough impaired gag reflex decreased vital capacity |
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S/S of cholinergic crisis
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mimic myasthenic crisis
respiratory muscle fatigue dysphagia inadequate cough decreased vital capacity & decreased inspiratory force from overmedication; tx is to hold all med's and give atropine |
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used to control side effects of Tensilon
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atropine
keep at bedside |
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interventions for myasthenia gravis
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mobility:plan adequate rest during the day
time activity with peak med effects conserve energy Communication: allow pt time to speak, yes/no questions Eye care: patch 1 eye if diplopia, sunglasses |
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secondary progressive pattern of MS
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progresses between relapses
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relapse-remission pattern of MS
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periods of symptoms followed by periods of complete recovery
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