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146 Cards in this Set

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WHAT 2 THINGS MAKE UP THE CENTRAL NERVOUS SYSTEM?
1.BRAIN
2.SPINAL CORD
WHAT IS THE BASIC CELL OF THE NERVOUS SYSTEM AND IS MADE UP OF A DENDRITE, CELL BODY, AND AN AXON?
NEURON
THE CONTROL CENTER OF THE NERVOUS SYSTEM.
BRAIN
LARGEST AREA OF THE BRAIN AND IS DIVIDED INTO A RIGHT AND LEFT HEMISPHERE.
CEREBRUM
WHAT IS THE LEFT HEMISPHERE RESPONSIBLE FOR?
SPEECH,PROBLEM SOLVING,REASONING, AND CALCULATIONS
WHAT IS THE RIGHT HEMISPHERE RESPONSIBLE FOR?
VISUAL-SPATIAL INFORMATIONS SUCH AS ART, MUSIC, AND THE SURROUNDING PHYSICAL ENVIRONMENT.
CONTAINS THE THALAMUS AND HYPOTHALMUS
DIENCEPHALON
RELAYS ALL SENSORY INFORMATION INTO THE CORTEX
THALAMUS
REGULATES TEMP., FLUID BALANCE, THIRST, APPETITE, EMOTIONS, AND THE SLEEP WAKE CYCLE
HYPOTHALAMUS
CONSISTS OF THE MIDBRAIN, PONS, AND MEDULLA OBLONGATA
BRAIN STEM
CENTER FOR AUDITORY AND VISUAL REFLEXES
MIDBRAIN
CONTROLS RESPIRATION
PONS
CONTROLS HEART RATE, BLOOD PRESSURE, RESPIRATIONS, COUGHING, SWALLOWING, AND VOMITING.
MEDULLA OBLONGATA
CONNECTED TO THE MIDBRAIN, PONS, AND MEDULLA, AND COORDIANTES INVOLUNTARY MUSCLE ACTIVITY AND FINE MOTOR MOVEMENTS AS WELL AS BALANCE AND POSTURE.
CEREBELLUM
CLEAR, COLORLESS LIQUID THAT PROTECTS THE BRAIN AND SPINAL CORD FROM TRUAMA AND IS COMPRISED OF WATER, GLUCOSE, PROTEIN, AND SODIUM CHLORIDE
CEREBROSPINAL FLUID
WHAT 2 THINGS MAKE UP THE CENTRAL NERVOUS SYSTEM?
1.BRAIN
2.SPINAL CORD
WHAT IS THE BASIC CELL OF THE NERVOUS SYSTEM AND IS MADE UP OF A DENDRITE, CELL BODY, AND AN AXON?
NEURON
THE CONTROL CENTER OF THE NERVOUS SYSTEM.
BRAIN
LARGEST AREA OF THE BRAIN AND IS DIVIDED INTO A RIGHT AND LEFT HEMISPHERE.
CEREBRUM
WHAT IS THE LEFT HEMISPHERE RESPONSIBLE FOR?
SPEECH,PROBLEM SOLVING,REASONING, AND CALCULATIONS
WHAT IS THE RIGHT HEMISPHERE RESPONSIBLE FOR?
VISUAL-SPATIAL INFORMATIONS SUCH AS ART, MUSIC, AND THE SURROUNDING PHYSICAL ENVIRONMENT.
CONTAINS THE THALAMUS AND HYPOTHALMUS
DIENCEPHALON
RELAYS ALL SENSORY INFORMATION INTO THE CORTEX
THALAMUS
REGULATES TEMP., FLUID BALANCE, THIRST, APPETITE, EMOTIONS, AND THE SLEEP WAKE CYCLE
HYPOTHALAMUS
CONSISTS OF THE MIDBRAIN, PONS, AND MEDULLA OBLONGATA
BRAIN STEM
CENTER FOR AUDITORY AND VISUAL REFLEXES
MIDBRAIN
CONTROLS RESPIRATION
PONS
CONTROLS HEART RATE, BLOOD PRESSURE, RESPIRATIONS, COUGHING, SWALLOWING, AND VOMITING.
MEDULLA OBLONGATA
CONNECTED TO THE MIDBRAIN, PONS, AND MEDULLA, AND COORDIANTES INVOLUNTARY MUSCLE ACTIVITY AND FINE MOTOR MOVEMENTS AS WELL AS BALANCE AND POSTURE.
CEREBELLUM
CLEAR, COLORLESS LIQUID THAT PROTECTS THE BRAIN AND SPINAL CORD FROM TRUAMA AND IS COMPRISED OF WATER, GLUCOSE, PROTEIN, AND SODIUM CHLORIDE
CEREBROSPINAL FLUID
CONTROLS VOLUNTARY MORTOR CONTROL ON THE OPPOSITE SIDE OF THE BODY AND DETERMINES EMOTIONS, MOTIVATION, COMPLEX THINKING, JUDGEMENT, AND PERONALITY. (BROCA'S AREA PORMOTES SPEAKING ABILITY.
FRONTAL LOBE
INTERPRETS SENSATIONS AND DETERMINES RIGHT FROM LEFT AND WHERE THE BODY IS IN RELATION TO THE ENVIRONMENT.
PARIETAL LOBE
PROCESSES TAST, SMELL, AND HEARING STIMULI; ALSO IMPORTANT IN LONG TERM MEMORY (WERNICKE'S AREA PROMOTES UNDERSTANDING OF SPOKEN AND WRITTEN WORD)
TEMPORAL LOBE
PROCESSES VISUAL STIMULI
OCCIPITAL LOBE
EXTENDS FROM THE BRAIN DOWN TO L2, SURROUNDED AND PROTECTED BY VERTEBRAL COLUMN.
SPINAL CORD
INJURY BELOW L2 DOES NOT RESULT IN PARALYSIS B/C...
NOT PART OF THE SPINAL CORD
H-SHAPED AND CONSISTS OF GRAY MATTER SURROUNDED BY WHITE MATTER
CORD
VERTEBRAL COLUMN CONSISTS OF...
7 CERVICAL
12 THORACIC
5 LUMBAR
5 SACRAL
4 FUSED VERTEBRAE = COCCYX
LINKS THE CNS TO THE REST OF THE BODY...
PERIPHERAL NERVOUS SYSTEM
MAKES UP THE PNS...
SPINAL NERVES
CRANIAL NERVES
GANGLIA
PNS IS DIVIDED INTO WHAT 2 SYSTEMS
SOMATIC SYSTEM
AUTONOMIC SYSTEM
CONNECTS SKIN AND MUSCLES TO THE CNS
SOMATIC SYSTEM
CONTROLS VISCERAL ORGANS AND SOME GLANDS
AUTONOMIC NERVOUS SYSTEM
HOW MANY PAIRS OF SPINAL NERVES ARE THERE...
31 PAIRS
NAME LOCATION AND NUMBER OF PAIRS IN EACH LOCATION (SPINAL NERVES)
CERVICAL: 8 PAIRS (C1-C8)
THORACIC: 12 PAIRS (T1-T12)
LUMBAR: 5 PAIRS (L1-L5)
SACRAL: 5 PAIRS (S1-S5)
AREA OF SKIN SUPPLIED BY A SINGLE SPINAL NERVE, AND ARE USEFUL FOR LOCATING PAIN SITES AND NEUROLOGIC LESIONS
DERMATOMES
COME FROM BRAIN STEM ITSELF; CONVEYS INFO DIRECTLY TO THE BRAIN
CRANIAL NERVES
SMELL
CRANIAL NERVE I: OLFACTORY
VISION
CRANIAL NERVE II: OPTIC
PUPIL CONSTRICION
EYEBALL MOVEMENT
RAISING OF UPPER EYELID
CRANIAL NERVE III: OCULOMOTOR
EYEBALL MOVEMENT
CRANIAL NERVE IV: TROCHLEAR
SENSATION OF THE SCALP,NOSE,MOUTH, AND CORNEA
CHEWING
CRANIAL NERVE V: TRIGEMINAL
LATERAL MOVEMENT OF THE EYEBALL
CRANIAL NERVE VI: ABDUCENS
MVMT. OF FACIAL MUSCLES
SECRETIONS FROM LACRIMAL AND SALIVARY GLANDS
TASTE IN ANTERIOR TWO THIRDS OF TONGUE
CRANIAL NERVE VII: FACIAL
SENSE OF HEARING AND EQUILIBRIUM
CRANIAL NERVE VIII: VESTIBULOCOCHLEAR
TASTE IN POSTERIOR ONE THIRD OF TONGUE
SENSATION OF PHARYNX AND TONGUE
GAG REFLEX
SWALLOWING
SECRETIONS OF PAROTID GLAND
CRANIAL NERVE IX: GLOSSOPHARYNGEAL
SWALLOWING
CONTROLS PARASYMPATHETIC NERVOUS SYSTEM ACTIVITIES(HR, RESP RATE, DIGESTION)
SENSATION IN PHARYNX AND LARYNX
CRANIAL NERVE X: VAGUS
NECH AND SHOULDER MVMT'S
CRANIAL NERVE XI: ACCESSORY
TONGUE MOVEMENT
CRANIAL NERVE XII: HYPOGLOSSAL
HOW MANY PAIRS OF CRANIAL NERVES?
12 PAIRS
RESPONSIBLE FOR MAINTAINING THE BODY'S INTERNAL HOMEOSTASIS
AUTONOMIC NERVOUS SYSTEM
2 SYSTEMS OF ANS:
SYMPATHETIC NERVOUS SYSTEM
PARASYMPATHETIC NERVOUS SYSTEM
FIGHT OR FLIGHT
SYMPATHETIC NERVOUS SYSTEM
OPERATES DURING NONSTRESSFUL SITUATIONS
PARASYMPATHETIC NERVOUS SYSTEM
HELPS NERVE IMPULSES CROSS THE SYNAPSE OR STOPS IT
NEUROTRANSMITTER (EX: ACETYLCHOLINE)
EPINEPHRINE
BRONCHODILATOR, VASOPRESSOR
INCREASES BP, STIMULATION OF HEART, DILATION OF BRONCHIOLES
SE: RESTLESSNESS, PALP.,
NOREPINEPHRINE
CARDIAC STIMULATION,
VASOPRESSOR
VASOCONSTRICTION, DILATION OF CORONARY ARTERIES, INCREASES BLOOD PRESSURE
SE:OCCASIONAL BRADYCARDIA, HA
ACETYLCHOLINE
ADRENERGIC
GLAUCOMA
SE: HA
DOPAMINE
ADRENERGIC
INCREASES CARDIAC OUTPUT
SHOCK;INCREASED PERFUSION;HYPOTENSION
SE: HA, PALP,TACHY, HTN, ECTOPIC BEATS,ANGINA,WIDE QRS COMPLEX, N/V/D
CAUSATIVE FACTORS INVOLVED IN NEURO DISORDERS:
-GENETIC & DEV. DISORDERS
-INFECTION & INFLAMMATION
-BENIGN & MALIG. TUMORS
-METABOLIC & ENDOCRINE DISORDERS
-VASCULAR DISORDERS
-DEGENERATIVE PROCESSES
-TRAUMA
PREVENTION OF NEURO INJURIES
-PREVENT HEAD & SPINAL INJURIES
-OBSERVE SAFETY PRECAUTIONS WHEN SWIMMING & DIVING
-WEAR SEAT BELTS
-AVOID RECREATIONAL DRUG USE & EXCESSIVE ALCOHOL
-PROMOTE IMMUNIZATION (MMR CAN CAUSE NEURO PROBS)
-PREVENT OR CONTROL HTN TO PREVENT CVA
-PROMOTE LOW-FAT DIET TO PREVENT ATHEROSCLEROSIS & CVA
EVALUATION OF NEURO STATUS
HEALTH HISTORY
NEURO ASSESSMENT
DIAGNOSTIC TESTS
EEG (ELECTROENCEPHALOGRAM)
-CAN DETERMINE THE TYPE OF SEIZURE AND LOCATE THE SEIZURE FOCUS
EEG NURSING CARE
-EXPLAIN PROCEDURE TO CLIENT
-TELL THEM TO WITHHOLD TRANQUILIZER AND DEPRESSANT MEDS 24-48H BEFORE AND CAFFEINE,BUT NOT NPO
-SHAMPOO HAIR NIGHT BEFORE AND SHORTEN SLEEP PERIOD
EEG CLIENT AND FAMILY TEACHING
-TEST LASTS FROM 1-2H
-TEST IS PAINLESS, DONE WHILE LYING ON STRETCHER OR SITTING IN RECLINER
-ELECTRODES ARE APPLIED TO SCALP WITH A THICK PASTE
-AFTER TEST NURSE WILL HELP REMOVE PASTE FROM HAIR
EEG NORMAL VALUES:
NORMAL FREQUENCY, AMPLITUDE, AND CHARACTERISTICS OF BRAIN WAVES
LUMBAR PUNCTURE
PT TEACHING: NEEDLE WILL BE PLACED IN SUBARACHNOID SPACE OF SPINAL CORD, TO MEASURE PRESSURE OF THAT SPACE AND COLLECT CSF
-CLARIFY INFO ABOUT PROCEDURE
-EXPLAIN IMPORTANCE OF NOT MOVING DURING
-EMPTY BOWEL AND BLADDER BEFORE HAND
-NOT NPO
-BAND-AID WILL COVER WHERE NEEDLE INSERTED
-REMAIN FLAT IN BED 4-24H AFTER PROCEDURE (AOBP)
-IF HA OR BACK ACHE OCCUR, ASK FOR PAIN MED
NORMAL VALUES: CLEAR CSF, PRESSURE < 20CM, NO ORGANISMS, VERY LITTLE PROTEIN
NURSING: MONITOR VS AND NEUROLOGIC SIGNS
MONITOR PUNCTURE SITE FOR LEAKAGE OF CSF OR HEMATOMA FORMATION
ENCOURAGE FLUID INTAKE
GIVE PAIN MEDS AS PRESCRIBED
MYELOGRAM
PT. TEACHING:
-ASSESS FOR ALLERGIES TO SHELLFISH OR IODINATED CONTRAST DYE
-DO NOT EAT OR DRINK FOR SEVERAL HOURS BEFORE TEST
-EMPTY BOWEL AND BLADDER BEFORE
-WILL BE PLACED ON TILTING TABLE SO DYE CAN CIRCULATE IN SPINAL COLUMN
-DYE INJECTED THROUGH LP, MAY FEEL WARMTH OR BURNING SENSATION, TELL DR. IF PAIN
-DO NOT MOVE UNLESS DOCTOR ORDERS DIFFERENT POSITION
-IMMEDIATELY REPORT FEVER, STIFF NECK, OR SEIZURES.
NORMAL VALUES:
-NORMAL SPINAL CANAL
NURSING:
-MONITOR VS AND ASSESS NEURO STATUS Q1-4H FOR 24H
-INCREASE FLUIDS 2400-3000 ML IN 24H (MAY REDUCE HA)
-MAKE SURE PT. VOIDS WITHIN 8H AFTER
-GIVE PAIN MEDS AND N/V AS NEEDED
-IF WATER SOLUBLE DYE USED, ELEVATE HOB 45 DEGREES FOR 8-12H
IMAGING PROCEDURES
CT
PET
SPECT
MRI
(PREP ACCORDING TO GUIDELINES @ FACILITY)
*BE SURE TO REMOVE ALL METAL OBJECTS
CEREBRAL ANGIOGRAPHY
PT.TEACHING:
-ASSESS FOR ALLERGIES TO SHELLFISH OR IODINE
-EXPLAIN PROCEDURE
-WARMTH UPON INJECTION
-ASSESS ANTICOAGULANT THERAPY
-NPO 2-8H PRIOR
-NEURO ASSESSMENT PRIOR
-REMOVE VALUABLES/DENTURES
-VOID PRIOR
NORMAL VALUES:
NORMAL ARTERIAL VASCULATURE
NURSING:
-MONITOR VS
-NEURO CHECKS
-ASSESS SITE FOR BLEEDING
-BR 6-24H
-WATCH FOR DELAYED REACTION TO DYE
-GIVE MILD PAIN MED IF NEEDED
-NOTIFY DR.IF PAIN SEVERE
BRAIN SCAN (PET SCAN)
R.A. CHEMICAL ADMINISTERED TO PT.
PT TEACHING:
-EXPLAIN PROCEDURE
-CONSENT
-POSS. 2 IV LINES INSERTED
-NPO 4H PRIOR
-NO ALCOHOL,CAFFEINE, OR TOBACCO 24H PRIOR
-DIABETIC TAKE PRETEST MED 3-4H BEFORE
-NO SEDATIVES OR TRANQUILIZERS PRIOR
-EMPTY BLADDER BEFORE TEST
NORMAL VALUES:
NORMAL PATTERNS OF TISSUE METABOLISM
NURSING:
-TELL PT. TO CHANGE POSITION SLOWLY TO AVOID POSTURAL HYPOTENSION
-ENCOURAGE TO DRINK FLUIDS AND URINATE FREQUENTLY TO AID IN REMOVAL OF RADIOACTIVE ISOTOPES FROM BLADDER
ELECTROMYOGRAPHY
NEEDLE ELECTRODES INSERTED INTO MUSCLES
PT. TEACHING:
-EXPLAIN PROCEDURE
-CONSENT
-RESTRICT STIMULANTS 2-3H PRIOR, NOT NPO
-PREMED NOT USUALLY GIVEN
-USUALLY NOT PAINFUL
NORMAL VALUES:
NO EVIDENCE OF NEUROMUSCULAR ABNORMALITIES
NURSING:
-OBSERVE NEEDLE SITE FOR HEMATOMA OR INFLAMMATION
-GIVE PAIN MED IF NEEDED.
COMMON NEURO PT. CARE PROBLEMS:
-INEFFECTIVE AIRWAY
-IMPAIRED MOBILITY
-SELF-CARE DEFICIT
-DYSPHAGIA (DIFF. SWALLOWING)
-INCONTINENCE
-PAIN
-CONFUSION
-APHASIA (W/O SPEECH)
-SEXUAL DYSFUNCTION
-PSYCHOSOCIAL CONCERNS
-INEFFECTIVE FAMILY COPING
INCREASED INTRACRANIAL PRESSURE
DEF: WHEN PRESSURE OF ONE OF THE THREE CRANIAL COMPARTMENTS (BRAIN,BLOOD,OR CSF) INCREASES CAUSING THE OTHER TWO TO DECREASE.
PATHO:TUMOR,BLEEDING,SWELLING,SOME MEDS
S/S:
-ALTERED LOC
-HA
-VOMITING (PROJECTILE, NO NAUSEA
-PAPILLEDEMA (EDEMA OF OPTIC NERVE
-CHANGE IN VS (T/BP UP, P/R DOWN & IRREGULAR (CHEYNE-STOKES)
-UNEQUAL PUPIL & ABNORMAL RESPONSE TO LIGHT
-POSTURING
PRECIPITATING FACTORS:(IMPENDING CERBRAL DISASTER)
-CHANGE IN LOC
-CHANGE IN LIMB MOTION
-CHANGE IN PUPIL SIZE
-CHANGE IN VS
MEDICAL MNGMT:
-BLOOD GLUCOSE
-ABGS
-TOXICOLOGY SCREENING
-CREAT. & BUN
-LFT'S
-CBC W/ DIFF
-CT
-CEREBRAL ANGIOGRAPHY
-LUMBAR PUNCTURE
-PHARMACOLOGY
-ICP MONITORING
-FLUID RESTRICTION
-KEEP HOB ELEVATED
-AVOID VALSALVA MANEUVER
-MECHANICAL VENTILATION
NURSING MGMT:
-ASSESS CHANGE LOC OR MEMORY, OCCUR? FAST OR SLOW
-PRESENCE OF HA, N/V
-VISUAL CHANGES
-RINGIN IN EARS
-PAST MEDICAL HISTORY
-VS
-MEMORY LAPSES
-G.C.S.
-PERRLA
-STRENGTH
-NOTE N/V
-NOT COLOR/AMT OF DRAINAGE FROM EARS/NOSE
ISOTONIC IV FLUIDS
NS OR LR B/C CAN REDUCE CEREBRAL EDEMA WHILE OTHER IV FLUIDS INCREASE IT
OSMOTIC DIURETICS
MANNITOL OR LASIX
DRAWS WATER OUT OF EDEMATOUS BRAIN TISSUE TO BE EXCRETED BY THE KIDNEYS
CORTICOSTEROIDS
REDUCES INFLAMMATION AND CEREBRAL EDEMA BUT CAUSES IRRITATION AND POSSIBLY GASTRIC ULCERS
ANTICONVULSANTS
PHENYTOIN(DILANTIN),DIAZEPAM(VALIUM),OR PHENOBARBITAL
MAY TREAT OR PREVENT SEIZURE ACTIVITY ASSOCIATED WITH A HEAD INJURY
APAP
ACETAMINOPHEN
ANTIPYRETIC TO TREAT HYPERTHERMIA WITH CAN RAISE CEREBRAL METABOLISM AND INCREASE ICP
BARBITUATES
PLACES CLIENT IN A COMA, REDUCING CEREBRAL METABOLISM, ALLOWING THE BRAIN TIME TO HEAL WITHOUT PERMANENT DAMAGE.
WHEN A PROBE IS ENTERED INTO THE VERTRICAL OF THE SKULL TO CONSTANTLY MONITOR INTRACRANIAL PRESSURE
ICP MONITORING
REMOVING A BONE FLAP FROM THE SKULL TO ALLOW ROOM FOR BRAIN TO EXPAND, REMOVE A BLOOD CLOT OR EVACUATE A HEMATOMA, OR ALSO RELIEVE THE PRESSURE OF A BRAIN TUMOR.
CRANIOTOMY
OTHER WAYS TO MONITOR ICP:
-RESTRICT FLUIDS TO PREVENT OVERLOAD
-AVOID VALSALVA MANUEVER
-MECHANICAL VENTILATION
MENINGITIS
DEF: INFLAMMATION OF THE MENINGES OF THE BRAIN AND SPINAL CORD
PATHO:INFLAMMATION INCREASES PRODUCTION OF CSF LEADING TO CEREBRAL EDEMA AND IICP.
PRECIP:ORGANISMS ENTER THE BRAIN BY WAY OF: THE BLOODSTREAM, RESPIRATORY TRACT, OR PENETRATING WOUNDS OF THE SKULL OR CRANIAL SURGERY.
S/S: CLASSIC SYMPTOM: NUCHAL RIGIDITY. HA,IRRITABILITY, FEVER, BRUDZINKSKI'S SIGN, KERNIG'S SIGN
COMPLICATIONS: SEIZURES, SEPSIS, CRANIAL NERVE DYSFUNCTION, CEREBRAL INFARC, COMA, AND DEATH
MEDICAL MGMT:
-ANALYSIS OF CSF WITH C/S
(+ APPEARS MILKY)
-ANTIBIOTICS (IMMEDIATELY)
-ANTICONVULSANTS
-ANTIPYRETICS
-ANALGESICS
NURSING:
-DECREASE ICP
-PREVENT SEIZURES
-PROMOTE SAFETY & COMFORT
WHEN NECK IS FLEXED, THE KNEES AND HIPS FLEX
BRUDZINSKI'S SIGN
INABILITY TO EXTEND THE LEGH WHEN THE HIP IS FLEXED AT A 90 DEGREE ANGLE
KERNIG'S SIGN
ENCEPALITIS
DEF: ACUTE INFLAMMATION OF BRAIN AND SPINAL CORD ALMOST ALWAYS CAUSED BY A VIRUS
S/S:HA, FEVER, EXTREME RESTLESSNESS, LETHARY, CONFUSION, VISUAL DISTURBANCES, DELIRIUM
MEDICAL MGMT:
-ANTIVIRAL AGENTS, TX SX
NURSING MGMT:
-VS
-ORIENTATION, LOC, MEMORY, AND RESPONSE TO STIMULI
-ASSESS FOR DIZZINESS, DIPLOPIA, DROOPING EYELIDS, PUPIL CHANGES, AND HEARING DIFF. DUE TO CRANIAL NERVE DAMAGE
-ASSESS FOR BRUDZ. AND KERN. SIGNS
-OBSERVE FOR ANY SEIZURE ACTIVITY, RESTLESSNESS, AND/OR AGITATION
-INSPECT SKIN FOR PRESENCE OF PETECHIAL RASH OVER THE BODY
GUILLAIN-BARRE SYNDROME
DEF: AN ACUTE, PROGRESSIVE INFLAMMATION OF THE PNS.
PATHO: ANTIBODIES ATTACK THE MYELIN SHEATH COVERING THE PERIPHERAL NERVES CAUSING IMPULSES TO BE POORLY CONDUCTED
S/S: BILATERAL WEAKNESS, NUMBNESS, AND TINGLING IN THE LEGS WHICH OVER 24-72H PROGRESSES TO PARALYSIS (STARTS AT FEET AND MOVES UP)
-PRECIP: RECENT VIRAL INFECTION, INCREASED LEVEL OF PROTEIN IN CSF
COMPLICATIONS:(MOST SERIOUS = RESPIRATORY FAILURE)
-SKIN BREAKDOWN
-DVT
MEDICAL MGMT:
-PLASMAPHERESIS
-INTRAVENOUS IMMUNE GLOBULIN
-ABX GIVEN FOR UTI & URI
-ANTICOAGULANTS GIVEN TO PREVENT DVT AND PE
NURSING MGMT:
-PROMOTE SAFETY
-PREVENT COMPLICATION OF IMMOBILITY
-PROMOTE ADEQUATE HYDRATION, NURTRITION, AND RESPIRATORY FXN
POLIOMYELITIS
DEF:VIRAL INFECTION THAT ATTACKS CNS
-PREVENTABLE BY VACCINE (INJECTABLE BETTER)
TX: SYMPTOMATIC,
-CONSERVE ENERGY & MAINTAIN MOBILITY
BRAIN ABSCESS
DEF: COLLECTION OF PURULENT MATERIAL WITHIN THE BRAIN
PATHO: MICROORGANISMS IN THE BRAIN TISSUE CAUSE LOCAL INFLAMMATION
S/S: IICP, HA, FEVER, CHILLS,(AS ABSCESS EXPANDS = N/V, DROWSINESS, CONFUSION, WEAKNESS ON ONE SIDE, & SEIZURES)
PRECIP:
-INFECTION OF MIDDLE EAR OR NASAL SINUSES
-HEAD INJURY
-INTRACRANIAL SURGERY
-BACTERIAL ENDOCARDITIS
-OSTEOMYELITIS
-LUNG, PELVIC, OR SKIN INFECTION (STREP, STAPH, & PNEUMOCOCCI ARE OFTEN UNDERLYING CAUSES)
MEDICAL MGMT:
-START ABX ASAP
-POSS. SURGERY TO DRAIN OR REMOVE
-SYMPTOMS TREATED AS THEY GO
COMPLICATIONS AND NURSING SAME AS ENCEPHALITIS
(MAY CAUSE BRAIN DAMAGE IF NOT TREATED)
INVOLVES AND OPENING B/W THE OUTSIDE ENVIRONMENT AND THE BRAIN
OPEN HEAD INJURY
(THESE CLIENTS AT GREATER RISK FOR MENINGITIS)
USUALLY RESULTS FROM AN ACCERLERATION-DECELERATION INJURY (COUP-CONTRECOUP PHENOMENON)-BRUISES BRAIN AT 2 POINTS
CLOSED HEAD INJURY
ACCUMULATION OF BLOOD IN THE EPIDURAL, SUBDURAL OR SUBARACHNOID SPACES, OR W/IN THE CEREBRAL LOBES
HEMATOMA
-CLASSIFIED BY THEIR LOCATION
-ARTERIAL BLEEDING
-ON TOP OF DURA
-RAPIDLY CAUSES ICP
-SEPERATES DURA FROM CRANIUM
-DESTRUCTION OF BRAIN TISSUE FAST
EPIDURAL HEMATOMA
-BELOW DURA
-VENOUS BLEEDING (SLOW)
-CLOT FORMS
-USUALLY ABSORBED BACK IN TO BODY AND PT. RECOVERS
-IF LARGE CAN BE ASPIRATED BY DOING A CRANIOTOMY
SUBDURAL HEMATOMA
-SLOW BLEED
-ACTUALLY IN CEREBRAL TISSU
-GRADUALLY REABSORBED
INTRACEREBRAL HEMATOMA
BONE FRAGMENT MAY BE PUSHED IN TO THE BRAIN; USUALLY CAUSED BY A POWERFUL BLOW TO THE SKULL.
DEPRESSED SKULL FX
CARE OF HEAD INJURY
ASSESS:
-LOC, PUPILS, VS, N/V (VOMITING WITH NO NAUSEA = VERY BAD), LOSS OF SENSATION, SLURRED SPEECH
DX: X-RAY, ANGIOGRAM, EEG, CT
TX: CONSERVATIVE AT 1ST. SURGERY IF NEEDED
NURSING:H.E.A.D.S.
-HOB SEMI-FOWLERS
-EVALUATE ICP/NEURO CHECKS
-AIRWAY
-DRAINAGE (EAR/NOSE)
-SAFETY:(SEIZURE PREC., RESTRICT FLUID, NO SEDATIVES OR NARC (BE CAUTIOUS IF ORDERED), MAINTAIN TEMP., AVOID VALSALVA MANEUVER
BRAIN TUMOR
DEF: ABNORMAL GROWTHS WITHIN CRANIUM
PATHO: INVADE, DISPLACE, AND DESTROY BRAIN TISSUE
S/S: HA, VOMITING W/O NAUSEA, VISUAL PROBS, PERSONALITY CHANGES, DISTURBANCES IN JUDGEMENT, MEMORY, COORDINATION, & SPEECH
PRECIP: CAUSE UNKNOWN, BUT EXPOSURE TO CERTAIN CHEMICALS AND RADIATION INCREASES THE INCIDENCE.
MEDICAL MGMT:
-SURGERY
-STEROSTACTIC SURGERY
-RADIATION
-CHEMO
NURSING:
-PREOP
-BASELINE NEURO ASSESS.
POST-OP NSG:
*MONITOR:
-RESP. STATUS Q 1-2H, AIRWAY PATENCY
-O2 SATS
-POSITION ON NON-OP SITE
-COOL CLOTH OVER EYES
-REDUCE NOISE/BRIGHT LIGHTS
-NON-NARC ANAL. OR CODEINE
-REPORT CSF LEAK (EARS, NOSE, OR WOUND)
-USE INTERVENTIONS TO PREVENT INFECTION EX: STERILE DSG CHANGES.
-MONITOR FOR SEIZURES
MIGRAINE HEADACHES
-CONSTRICTION & THEN DILATION OF CERBRAL ARTERIES
-MAY HAVE AURA OR SCOTOMA-SPOTS BEFORE EYES
S/S: N/V, SENSITIVITY TO LIGHT
TX:
-IMITREX, ERGOTAMINE DERIVATIVE
-REST IN DARKENED RM
-COLD COMPRESS
-IDENTIFY TRIGGERS: STRESS, WINE, CHOCOLATE, CHEESE...
CEREBROVASCULAR ACCIDENT (STROKE)
DEF:BRAIN ATTACK, DECREASED BLOOD SUPPLY TO A LOCAL AREA OF THE BRAIN
PATHO: TIA-BRIEF EPISODE OF REVERSIBLE NEUROLOGIC DEFICITS
S/S:
-DIZZINESS
-VISUAL LOSS IN ONE EYE
-ONE SIDED NUMBNESS OR WEAKNESS OF FINGERS, ARMS, OR LEGS, APHASIA
-PRECIP: HTN, ATHEROSCLEROSIS, CARDIAC DISEASE, HIGH CHOLESTEROL, OBESITY, DM, SMOKING, EXCESSIVE ALCOHOL, DRUG USE (COCAINE), ORAL CONTRACEPTIVES, OVER 65 YRS. OLD, AFRICAN AMER., MALES (SLIGHTLY HIGHER RISK)
COMPLICATIONS:
-MOTOR DEFICITS
-SPEECH DEFICITS
-VISUAL DEFICITS
-SENSORY-PERCEPTUAL DEFICITS
-COGNITIVE/BEHAVIORAL CHANGES
-URINARY/GASTRO PROBS
DX:CT,MRI,PET,CEREBRAL ANGIOGRAM, EEG, DOPPLER ULTRASOUND, OCCAS. LP
TX:
-ANTIPLATELETS
-THROMBOLYTICS
-ANTICOAGULANTS
-ANTIHYPERTENSIVES
-EMOBLUS REMOVAL
NURSING CARE FOR CVA
PHASE ONE: (ACUTE CARE)
-FREQ. VS & NEURO CHECKS
-MAINTAIN PATENT AIRWAY
-DECREASE ICP
-PRESERVE JOINT & MUSCLE FXN
-PREVENT COMPLICATIONS
PHASE TWO (REHAB):
-STREGTHEN MUSCLES & MAKE ADAPTATIONS FOR ADL'S
PHASE THREE (DISCHARGE & REFERRAL):
-CONT. REHAB & PT/OT AS OUTPATIENT
DEF: WHEN SEIZURES OCCUR IN A CHRONIC PATTERN
PATHO: WHEN UNSTABLE NEURONS CONTINUE TO SEND ELECTRICAL IMPULSES TO THE CEREBRAL CORTEX
EPILEPSY
START IN ONE AREA OF THE CEREBRAL CORTEX
PARTIAL SEIZURES
2TYPES:
SIMPLE
COMPLEX
CAUSE UNCONTROLLED JERKING MVMTS OF A FINGER, HAND, FOOT, LEG, OR THE FACE, LASTS 20-30 SEC, AND CLIENT DOES NOT LOSE CONSCIOUSNESS.
SYMPTOMS: FLASHING LIGHTS, TINGLING, HALLUCINATIONS
SIMPLE PARTIAL SEIZURE
-PSYCHOMOTOR SEIZURE
-NONPURPOSEFUL ACTIONS: LIP SMACKING, AIMLESS WALKING, OR PICKING AT CLOTHING (AUTOMATISMS)
-LAST LESS THAN A MINUTE
-CLIENT HAS ALTERED LOC
-CONFUSED, MAY NOT REMEMBER SEIZURE
-AURA MAY BE WARNING SIGN
COMPLEX PARTIAL SEIZURE
SEIZURE THAT INVOLVE BOTH HEMISPHERES OF THE BRAIN AND RESULT IN LOSS OF CONSCIOUSNESS.
GENERALIZED SEIZURES
ABSENCE SEIZURES
-PETIT MAL SEIZURE
-MORE COMMON IN CHILDREN
-BRIEF CHANGE IN CONSCIOUSNESS
-LASTS ON 5-10 SEC.
TONIC CLONIC SEIZURES
-GRAND MAL SEIZURE
-MOST COMMON DISORDER IN ADULTS AND CHILDREN
-EXPERIENCE:
AURA
EPLIPTIC CRY
TONIC PHASE
CLONIC PHASE
POSTICTAL PHASE
WHEN THE BODY BECOMES RIDGID WITH AREMS AND LEGS EXTENDED, JAW CLENCHED, EYES ROLL BACK, BREATHING STOPS BRIEFLY
TONIC CONTRACTION
MVMTS ARE JERKY AS MUSCLES ALTERNATELY CONTRACT AND RELAX, TONGUE/CHEEK BITING, FROTHING FROM MOUTH, URINARY/BOWEL INCONT. COMMON.
CLONIC CONTRACTION
UNCONSCIOUS FOR UP TO 30 MIN, UPON WAKING-CONFUSED AND DISORIENTED, EXPER. HA, MUSCLE ACHES, AND FATIGUE, USUALLY SLEEP FOR HOURS AFTERWARD.
POSTICAL PHASE (POST SEIZURE)
STATUS EPILEPTICUS
-UNRELENTING CONVULSIONS
-PT. DOES NOT REGAIN CONSCIOUSNESS
-CAN HARM THE BRAIN'S NERVE CELL AND LEAD TO PERM. DAMAGE
-CONSIDERED A LIFE THREATENING EMERGENCY
-CAN BE TRIGGERED BY ABRUPT DC'ING OF ANTICONVULSANTS
TX OF EPILEPSY
-EEG
-ANTICONVULSANTS
-SURGERY (REMOVING EFFECTED TISSUE WITH PT. AWAKE)
NURSING CARE OF EPILEPSY
-SEIZURE PRECAUTIONS:
PUT IN ROOM CLOST TO NURSES
PAD SIDE RAILS
-DURING SEIZURE:
1ST GET HELP
MAINTAIN AIRWAY
PROTECT HEAD
DON'T RESTRAIN
-ASSESS:
ONSET
DURATION
BEHAVIOR A/P
TYPE OF MVMTS
LOSS OF CONSCIOUSNESS
INCONTINENCE
SEIZURE AWARENESS
-DURING POSTICTAL PHASE:
ASSESS FOR INJURY
VS
PROMOTE REST
-LONG-TERM SUPPORT:
EDUCATION (SAFETY, MEDS)
AVOIDANCE OF TRIGGERS
MEDIC ALERT BRACELET
NO DRIVING
IDENTIFICATION OF AURA (TEACH TO GET IN SAFE PLACE IF OCCURS)
HUNTINGTON'S DIEASE
DEF: PROGRESSIVE, INHERITED NEUROLOGICAL DISEASE (TYPICALLY EFFECTED B/W AGES 40-50)
-S/S:CHOREA(CONSTANT, JERKY, UNCRONTROLLED MVMTS OF THE BODY), DEMENTIA, EMACIATION & EXHAUSTION
DX: SYMPTOMS AND FAMILY HISTORY
TX:
-NO SPECIFIC TEST FOR THIS DISEASE
-ANTIDEPRESSANTS
-ANTIPSYCHOTICS
-DOPAMINE BLOCKERS
TRIGEMINAL NEURALGIA
DEF: SEVERE, ONE-SIDED FACIAL PAIN LASTING A FEW SECONDS TO A FEW MINUTES, AFFECTS CRANIAL NERVE V
S/S:
-NEURALGIA (EXCRUTIATING PAIN
-FACIAL MUSCLE CONTRACTION
UNKNOWN ETIOLOGY
TX:
-DILANTIN OR TEGRETOL(ANTICONVULSANT)
-LOCAL NERVE BLOCK
-SURGICAL INTERRUPTION OF NERVE IMPULSE TRANSMISSION (RHIZOTOMY)
NURSING CARE:(N.E.U.R.A.L.G.I.A.)
-NATURE OF PAIN
-EYE CARE
-UNEFFECTED SIDE-CHEW ON
-ROOM TEMP.
-ASSESS NATURE OF PAIN
-LUKEWARM FOOD
-hyGiene-ORAL
-INCREASE PROTEIN/CALORIES, SOFT DIET
-AVOID TOUCHING CLIENT (LET PT WASH THAT SIDE OF THEIR FACE)
BELL'S PALSY
DEF: FACIAL PARALYSIS (ASSOC. WITH THE HERPES SIMPLEX VIRUS)
-CRANIAL NERVE VII
S/S: AFFECTS ONE SIDE OF FACE, NUMBNESS, PARTIAL OR TOTAL PARALYSIS
TX:
-STEROIDS (CORTICOSTEROIDS)
-ANTIVIRAL DRUGS
-ANALGESICS
NSG:
-PROMOTE + SELF IMAGE
-MEDS
-EYE DROPS
-OPTHTHALMIC OINT. & EYE PATCH AT NIGHT
-EVALUATE ABILITY TO EAT
-WARM, MOIST HEAT
SPINAL CORD INJURY
MOST OCCUR IN CERVICAL AND LUMBAR REGIONS
PATHO:
-HYPERFLEXION-MVA
-HYPEREXTENSION-WHIPLASH
-COMPRESSION-DIVING, SKIING, SPORTS INJURY
GOALS OF SPINAL CORD INJURY
-STABILIZE VS
-PREVENT FURTHER CORD DAMAGE
-REPAIR DAMAGE TO SPINAL CORD
-PREVENT COMPLICATIONS
-MAINTAIN AS MUCH FUNCTION AS POSS.
-PROMOTE REHABILITATION
NURSING CARE SCI
-PREVENT FURTHER CORD DAMAGE
-ASSESS RESP. FUNCTION
-MAINTAIN URINARY/BOWEL FXN
-PREVENT THROMBUS
-MAINTAIN CARDIOVASCULAR STABILITY
-HELP MAINTAIN ONGOING NEURO. ASSESSMENTS
-ENCOURAGE ADEQUATE FLUID & NUTRITION
-PREVENT SKIN BREAKDOWN
-PROVIDE EMOTIONAL SUPPORT
-LOGROLL THESES PT'S
-REMEMBER PARALYSIS OCCURS BELOW LEVEL OF INJURY
SPINAL SHOCK
DEF: TEMPORARY LOSS OF REFLEX ACTIVITY BELOW LEVEL OF SPINAL CORD INJURY
-CESSATION OF MOTOR, SENSORY, AUTONOMIC & REFLEX IMPULSES
-BRADYCARDIA
-HYPOTENSION
-LOSS OF SWEATING & TEMP CONTROL
-BOWEL/BLADDER DYSFUNCTION
-FLACCID PARALYSIS
-POIKILOTHERMIA_(CLIENT ASSUMES TEMP. OF ENVIRONMENT)
-LAST FROM 1-6 WKS
-UNTIL RESOLVED PT. NEEDS MEDICAL SUPPORT
HERNIATED INTERVERTEBRAL DISK
DEF: WHEN THE NUCLEUS PULPOSUS PROTRUDES THROUGHA WEAKENED OR TORN ANNULUS FIBROSUS.
LUMBAR/SACRAL S/S:
-PAIN IN LOWER BACK RADIATING DOWN ONE LEG; HX OF FEELING SOMETHING "GIVE WAY"
CERVICAL S/S:
-PAIN IN NECK & SHOULDER RADIATING DOWN ONE ARM
DX:
-MYELOGRAPHY: R/O TUMORS & LOCATE HERNIATION
-CT/MRI: SHOW SITE OF HERNIATION
MEDS:
-NSAIDS (ASA, MOTRIN, NAPROSYN)
-NON-NARCOTIC ANALGESICS (VICODIN)ACUTE PAIN
-MUSCLE RELAXANTS
-TENS (RELIEVES UNCONTROLLED PAIN
TX H.I.D.
-CHIROPRACTIC
-BR W/ FIRM MATTRESS
-PELVIC OR HEAD TRACTION
-HEAT/COLD
-MILD EXERCISE TO STREGTHEN ABD
-BACK BRACE
-PT
-SURGERY:
DISKECTOMY
LAMINECTOMY
SPINAL FUSION
CHEMONUCLEOLYSIS
-SURGERY DEPENDS ON THE LOC/SIZE OF RUPTURED DISK
-P SUCCESSFUL SURGERY MOST CAN RETURN TO JOBS IN ABOUT 6 WKS.
REMOVAL OF THE HERNIATED DIS OR DISK FRAGMENTS
DISKECTOMY
REMOVAL OF THE VERTEBRAL LAMINA TO RELIEVE PRESSURE ON THE NERVES. (MOST COMMON)
LAMINECTOMY
INSERTION OF BONE GRAFT (FROM ILIAC CREST) B/W THE VERTEBRAE.
SPINAL FUSION
INJECTION OF THE ENZYME CHYMOPAPAIN INTO THE NUCLEUS PULPOSUS TO SHRINK OR DISSOLVE THE PROTRUDING HERNIATION
CHEMONUCLEOLYSIS
PARKINSON'S DISEASE
DEF: CHRONIC, PROGRESSIVE, DEGENERATIVE NEURO DISEASE THAT ALTERS MOTOR COORDINATION (CAUSE UNKNOWN)
PATHO: DEFICIENCY OF DOPAMINE
S/S:
-TREMOR
-RIGIDITY
-BRADYKINESIA
SLOWED, VOLUNTARY MVMT
SLURRED SPEECH
MASKLIKE, EXPRESSIONLESS
DX: BASED ON SYMPTOMS
MEDS:
-LEVODOPA
-CARBIDOPA
-DOPAMINE AGONIST
-MAOI'S
-ANTICHOLINERGICS: ARTANE, CONGENTIN
-ANTIDEPRESSANTS
SURGERY:
-PALLIDOTOMY
-STEREOTAXIC THALAMOTOMY
PART OF THE GLOBUS PALLIDUS IS DESTROYED TO CONTROL RIGIDITY AND TREMORS
PALLIDOTOMY
DESTROYS PART OF THE THALAMUS TO REDUCE TREMORS
STEREOTAXIC THALAMOTOMY
MULTIPLE SCLEROIS
DEF: CHRONIC, DEGENERATICE DISEASE THAT DAMAGES THE MYELIN SHEATH SURROUNDING THE AXONS OF THE CNS.
-MARKED BY PERIODS OF REMISSION AND EXACERBATION
-ONSET 20-40YRS OF AGE
-EXACT CAUSE UNKNOWN
SYPTOMS: FATIGUE IS COMMON BUT OFTEN IGNORED, DIPLOPIA,WEAKNESS, TINGLING, & NUMBNESS IN EXTREMITIES
DX:
-BASED ON PT'S HX, PX EXAM & SX
-CSF ANALYSIS=ELEV. WBC'S
-MRI DETECTS PLAQUE LESIONS
-EEG SHOW SLOWED BRAIN ACTIV.
GOAL OF TX: KEEP CLIENT FXNING AS LONG AS POSS.
-TX:
BETA-INTERFERON
ADRENOCORTICOTROPIC HORMONE, STEROIDS
IMMUNOSUPPRESSANTS
NSG INTERVENTIONS TO HELP MS PT. COPE WITH:
-IMMOBILITY
-FATIGUE
-INCONTINENCE
-VISUAL PROBLEMS
-SPEECH DISORDERS
-SEXUAL IMPOTENCE
-MUSCLE SPASTICITY
ALZHEIMER'S DISEASE
DEF: PROGRESSIVE, IRREVERSIBLE DETERIORATION OF THE BRAIN (MOST COMMON)
-CAUSES ATROPHY OF PORTIONS OF FRONTAL & TEMPORAL LOBES
-SLOW ONSET, EVENTUALLY FATAL
PATHO:
-LOSS OF NERVE CELLS
-REDUCED BRAIN SIZE
-PRESENCE OF NEUROFIBRILLARY TANGLES
-NEURITIC PLAQUES(AMYLOID CAUSES PLAQUE FORMATION)
FIRST SIGN: MEMORY LOSS
NSG: HELP CLIENT MAINTAIN THE HIGHEST QUALITY OF LIFE
GOALS:
-PROMOTE PERFORMANCE ADL'S
-PROTECT FROM INJURY
-PRESERVE DIGNITY
AMYOTROPHIC LATERAL SCLEROSIS
(LOU-GEHRIG'S DISEASE)
DEF: RAPIDLY PROGRESSIVE, FATAL NEUROLOGICAL DISEASE
-DEGENERATION OF MOTOR NEURONS-MUSCLE ATROPHY
-CLIENT REMAINS FULLY ALERT
-FATAL, NO TX OR CURE
-CAUSE UNKNOWN
-MEN, AGES 40-70S\
COMPLICATIONS:
-MUSCLE WEAKNESS
-FASCICULATIONS(INVOLUNTARY CONTRACTIONS)
-MUSCLE WASTING
-BRAIN STEM INVOLVEMENT (SPEECH/SWALLOWING DIFF.)
-BREATHING PROBS
DX:
-SYPMTOMS
-EMG-CONFIRMS MUSC. WEAK
-MUSCLE BIOPSY-SHOW LOSS OF MUSCLE FIBER
DEATH: USUALLY FROM ASPIRATION PNEUMONIA OR RESP. FAILURE
MEDS:RILUTEK(RILUZOLE)ONLY ONE THAT SEEM TO SLOW DESTRUCTION OF MOTOR NEURONS
ASSESS:
-PT'S LEVEL OF OPTIMAL PX ACTIVITY
-SPECIFIC PROBLEMS RELATED TO PARALYSIS
NSG INTERVENTIONS:
-PROVIDING PX COMFORT & EMOTIONAL SUPPORT
-PROMOTING MAX. INDEPENDENCE
MYASTHENIA GRAVIS
DEF: CHRONIC, AUTOIMMUNE DISORDER AFFECTING ACETYCHOLINE RECEPTORS & AFFECTING WOMEN B/W AGES OF 20-30.(CAUSES EXTREME MUSCLE WEAKNESS AND FATIGUE)
S/S: AGGRAVATED BY ACTIVITY, RELIEVED BY REST
-EYELID PTOSIS, DIPLOPIA, SLURRED SPEECH, NASAL VOICE, DIFFICULTY CHEWING & SWALLOWING, FATIGUE
-PROGRESSIVE DIFF. PERFORMING FINE MOTOR SKILLS
-RISK OF ASPIRATION & RESP INSUFFICIENCY
DX: TENSILON INJECTION IMPROVES CONDITION FOR ONLY 5 MIN
TX:
-ANTICHOLINESTERASE DRUGS(WATCH OUT FOR CRISIS)
-PLASMAPHERESIS
-SURGICAL REMOVAL OF THYMUS
NSG INTERVENTION:
-SAME AS MS OR PD
-MONITOR FOR MYASTHENIC CRISIS & CHOLINERGIC CRISIS
DEATH: USUALLY DUE TO RESP. FAILURE
-