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ALS, MS, Parkinson

exam 7 alterations

what is parkinsons disease Degenerative disease caused by depletion of dopamine which interferes with inhibition of excitatory impulses resulting in a dysfunction of extrapyramidal system
debilitation from parkinsons results with what falls, self-care deficits, failure of body systems and depression
manifestations of parkinsons disease Bradykinesia, abnormal slowing of movement, sluggishness of physical and mental responses Akinesia – loss of voluntary muscle Monotone speech Handwriting that becomes progressively smaller Tremors in hands and fingers at rest (pill rolling)
manifestations of parkinsons disease Tremors increasing when fatigued and decreasing with purposeful activity Rigidity with jerky movements Restlessness and pacing Blank facial expressions (mask-like) Drooling Difficulty swallowing and speaking
manifestations of parkinsons disease Loss of coordination and balance Shuffling steps, stooped position and propulsive gait
interventions for parkinsons disease Assess neurologic status and ability to swallow and chew Provide high calorie, high protein, and high fiber soft diet with frequent feedings Increase fluid intake to 2000mL/day Monitor for constipation
interventions for parkinsons disease Promote independence with safety Avoid rushing the client with activities Assist with ambulation and provide assistive devices Instruct client to rock back and forth to initiate movement
interventions for parkinsons disease Instruct client to wear low heeled shoes Encourage client to lift feet when walking no shuffling and to avoid prolonged sitting Provide firm mattress and position client prone without a pillow to promote posture
interventions for parkinsons disease Instruct client to hold hands behind their back and keep back and spine erect Promote physical therapy and rehab Administer meds
interventions for parkinsons disease Instruct client to avoid foods rich in vitamin b6, they block the effects of meds Instruct client to avoid MAOI’s
medication for parkinsons disease Carbidopa-levodopa (Sinemet) Symmetrel Requip
parkinsons disease nursing diagnosis Imbalanced nutrition related to difficult swallowing Impaired body image
what is ALS (Amyotrophic lateral sclerosis) Lou Gehrigs Disease – progressive degenerative disease involving motor system, may be caused by excess glutamate, as the disease progresses muscle weakness and atrophy develop until flaccid tetraplegia develops
is there a cure for ALS no
ALS manifestations Respiratory difficulty Fatigue while talking Muscle and tongue atrophy and weakness Dysphagia
manifestations of ALS Weakness of hands and arms Facial twitching (fasciculation’s) Nasal quality of speech Dysarthria
ALS interventions Care is directed toward treatment of symptoms Monitor respirations and institute measures to prevent aspiration Provide respiratory treatment Prepare to administer respiratory support
ALS interventions Assess for complications of immobility Address advance directives Provide client and family with support
ALS medications Rilutek, antiglutamate Medication given same time each day without food
patient information for ALS Patients are to avoid alcohol and have liver function, CBC, blood chemistry’s and alkaline phosphate regularly monitored
what is MS a chronic progressive non-contagious degenerative disease of the CNS characterized by demyelination of the neurons
when does MS usually occur usually occurring between the ages of 20-40 with periods of remission and exacerbation
what is the cause of MS cause unknown but thought to be a result of an autoimmune disease or viral infection
what are precipitating factors for MS pregnancy, fatigue, stress and trauma
what are diagnostic results with MS patients EEG findings are abnormal while CSF indicated increased gamma globulin but serum globulin is normal
manifestations of MS Fatigue/weakness Ataxia/vertigo Tremor and spasticity of lower extremities Paresthesias Blurred vision, diplopia and transient blindness
manifestations of MS Nystagmus Dysphagia Decreased sensation to pain, touch and temperature Bladder and bowel disturbances including, urgency, frequency, retention and incontinence Abnormal reflexes, hyperreflexia, absent reflex, positive Babinski reflex
manifestations of MS Emotional changes, apathy, euphoria, irritability and depression Memory changes and confusion
interventions for MS Provide energy conservation during times of exacerbation Protect client from injury by providing safety measures Place an eye patch on the eye for diplopia
interventions for MS Monitor for UTI’s, calculi, pressure ulcers, respiratory tract infections and contractures Promote regular elimination of bladder and bowel training Encourage independence
interventions for MS Assist client to establish regular exercise and rest program Balance moderate activity with rest periods Assess the need for and provide assistive devices
interventions for MS Initiate physical and speech therapy Instruct the client to avoid, fatigue, stress, infection, overheating and chilling Instruct client to increase fluid intake, eat a balanced diet, low-fat, high-fiber, and foods high in potassium
interventions for MS Instruct client in safety measures including sensory loss, regulating body temperature and avoiding heating pads Instruct client in safety measures related to motor loss including moving throw rugs and using assistive devices
interventions for MS Instruct client in the self-administration of prescribed meds Provide information about National MS association
immunomodulator for MS Interferon beta 1a (Avonex) produces a decrease in MS lesions IM 1x week Interferon beta 1a (Rebif) produces a decrease in MS lesions subq 3x week
immunomodulator for MS Interferon beta 1b (Betaseron) produces a decrease in MS lesions subq every other day Natalizumab (Tysabril) produces a decrease in MS lesions IV monthly
adrenocorticosteroid therapy for MS ACTH used to sustain a remission and treat exacerbations usually given to induce a remission Prednisone/Solu-Medrol used to suppress the immune system
muscle relaxants for MS Baclofen/diazepam/dantrium given to patients to relieve muscle spasms
immunosuppressants for MS Imuran/Cytoxan given to MS patients because of the autoimmune component of disease
Created by: bkgrota