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AH2 Chapter 50

Nursing Care of Patients with PNS Disorders

QuestionAnswer
complications with MG that cause a cholingergic crisis not enough medication
complications and GBS and respiratory involvement fatigue and paralysis of the respiratory muscles lead to insufficient respiratory effort, can result in pneumonia
what lab test would you order for respiratory function with GBS Pulmonary function testing
baclofen side effects and nursing implications CNS depression, n, c, avoid operating machinery or driving until effects are known, monitor for respiratory depression
trigeminal neuralgia affects only the sensory portion of the nerve; sudden jabbing pain (5th cranial nerve)
bells palsy Loss of motor control typically occurs on one side of the face; pain behind the ear may precede the onset of paralysis (7th cranial nerve)
another name for ALS Lou Gehrig’s disease
anticonvulsants treat what? nerve pain, i.e. pheynotoin (Dilantin), carbamazepine (Tegretol), gabapentin (neurontin)
which med increases blood glucose Prednisone (a glucocorticoid)
atropine is antidote for what medication class cholinesterase inhibitors
how many cranial nerves are there 12 pairs
plasmapheresis the goal is to remove antibodies through plasma exchange, suppressing the immune response and inflammation
plasmapheresis preprocedure nursing care assess baseline vs, weight, CBC, platelet count, and clotting studies; check blood type and crossmatch
pathophysiology of MS Degeneration of myelin sheath; inflamed nerves; slowed or blocked nerve impulses
MS exacerbations due to stress or illness
MS S/S muscle weakness, numbness, intense fatigue, muscle spasticity, bowel or bladder dysfunction, paralysis, difficulty with concentration, forgetfulness, diplopia, blurred vision, vertigo, ataxia, constipation, sexual dysfunction, anger, depression, euphoria
MS therapeutic measures steroids such as adrenocorticotropic hormone and prednisone to decrease inflammation and edema of the neurons; dilantin and tegretol to relieve nerve pain
MS rehabilitation after an acute episode physical, speech, and occupational therapies
Teaching and myasthenia gravis energy conservation, schedule activities when meds are at peak level, proper nutrition, s/s of crisis conditions, rest periods, avoid people with infections and exposure to cold
S/S of GBS 3 stages: abrupt and rapid onset of muscle weakness and paralysis, with little or no muscle atrophy (24 hours to 3 weeks); s/s most severe but progression stops (2to 14 days); symptoms slowly improve (6 to 24 months)
Treatment for trigeminal neuralgia Dilantin, nerontin, and tegretol for nerve pain; baclofen and clonazepam may also be effective in controlling symptoms; alcohol injection; nerve block, surgery, radio-frequency ablation, or gamma knife radiosurgery
Treatment for Bell’s palsy prevention of complications; Prednisone to decrease inflammation; analgesics for pain; antivirals; moist heat and gentle massage; facial sling
Thymectomy and what disorder used to treat MG; decreases production of Ach receptor antibodies which decreases symptoms in most patients
Treatment for MS interferon therapy with beta-interferons such as Betaseron or Avonex may reduce exacerbations and delay disability
Eye care for Bells palsy administer eye drops or eye ointment; teach patient to use a patch over the affected eye; advise patient to wear glasses or goggles especially when outside or in areas with particles in the air ( all interventions to protect the eye)
Created by: laotracuata