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Neuro problems
Nursing care for chronic Neurological problems
| Question | Answer |
|---|---|
| Anticholinergics | Inhibit actions of Ach by occupying the Ach receptors. Also called parasympatholytics. |
| Anticholinergic drugs | Are parasympatholytics agents. |
| Cholinergics | Stimulate the parasympathetic NS. Also called parasympathomimetic because they mimic the parasympathetic neurotransmitter Ach. Produces the effect of Ach. |
| Acetylcholine (Ach) | Is a neurotransmitter in brain for cognitive function, memory storage & retrieval. Ach causes muscle contraction in body periphery. |
| Sympathetic | Activates and prepares body for vigorous muscular activity, stress and emergencies. |
| Parasympathetic | Lowers activity, operates during normal situations, permits digestion and conserves energy. |
| Acetylcholinesterase | An enzyme that breakdown Ach, so anticholinesterase is given to prolong the action of Ach & facilitate transmission of impulses at neuromuscular junction. It opposes cholinesterase. |
| Anticholinesterase | Enzyme that opposes cholinesterase |
| Cholinesterase | Catalyzes breakdown of Ach to acetic acid and choline. Inhibited by the drug Physostigmine (a parasympathomemetic med). |
| Multiple Sclerosis | Is a slow, chronic, progressive, degenerative demyelinating disease which attacks the myelin sheath of neurons in CNS. Has remissions and exacerbations. |
| Myelin Sheath in MS | Interrupted at intervals by the nodes of Ranvier, Myelin replaced with scar tissue forming plaques with each exacerbations, MS involves white matter of CNS. |
| Myasthenia Gravis | Is a chronic progressive disease of striated muscle (skeletal) weakness due to a defect at the myoneural junction Ach receptor sites become depleted at the myoneural junction. |
| Types of Myasthenia Gravis. | Ocular Myasthenia: will only affect the ocular muscle. Generalized Myasthenia: Is more of a concern. Can only treat the disease process |
| Complications of Myasthenia Gravis | Myasthenic crisis: Undermedication, is a sudden exacerbation of Myasthenic symptoms. Cholinergic Crisis: Excessive medication, toxic levels of anticholinesterase drugs. |
| Plasmapheresis | Removal of serum antibodies, needs to be done 2-3 days a week for 3-5 hours each treatment. |
| Amyotrophic Lateral Sclerosis (Lou Gehrig's Disease) | Rapidly progressing degenerative motor neuron disease in anterior horn of spinal cord, brainstem, and cerebral cortex. Involves both UMN and LMN. |
| Motor Neurons | Are cells that control essential voluntary muscle activity (speaking, walking, breathing, and swallowing) |
| Parkinson's Disease | Is a chronic, slow progressive disorder that involves a degeneration of dopamine producing cells in the midbrain. |
| Pathophysiology of Parkinson's Disease | Loss of cells in substantia nigra (within the basal ganglia) causes reduction of dopamine production. Dopamine (neurotransmitter) is essential for conrolling posture, supporting body in an uprighnt position & voluntary motions. |
| Six prominent features of Parkinson's Disease | "Classic Triad"- Tremor at rest, Rigidity, Bradykinesia- Flexed posture of neck, trunk, and limbs, loss of postural reflexes, and freezing movement. |
| Dementia | Syndrome with dysfunction or loss of memory, orientation, attention, language, judgment, and reasoning. |
| Delirium | State of temporary but acute mental confusion |
| Mild Cognitive Impairment (MCI) | State of cognitive functioning that is below normal, but does not meet criteria for dementia. |
| Alzheimer's Disease | Is a chronic, progressive degeneration of brain with intellectual and cognitive deterioration. |
| Characteristic findings of AD | Amyloid plaques, neurofibillary tangles, loss of connections between neurons leading to cell damage & death. |