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exam 7 alterations

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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  
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debilitation from parkinsons results with what   falls, self-care deficits, failure of body systems and depression  
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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)  
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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  
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manifestations of parkinsons disease   Loss of coordination and balance Shuffling steps, stooped position and propulsive gait  
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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  
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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  
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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  
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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  
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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  
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medication for parkinsons disease   Carbidopa-levodopa (Sinemet) Symmetrel Requip  
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parkinsons disease nursing diagnosis   Imbalanced nutrition related to difficult swallowing Impaired body image  
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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  
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is there a cure for ALS   no  
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ALS manifestations   Respiratory difficulty Fatigue while talking Muscle and tongue atrophy and weakness Dysphagia  
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manifestations of ALS   Weakness of hands and arms Facial twitching (fasciculation’s) Nasal quality of speech Dysarthria  
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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  
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ALS interventions   Assess for complications of immobility Address advance directives Provide client and family with support  
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ALS medications   Rilutek, antiglutamate Medication given same time each day without food  
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patient information for ALS   Patients are to avoid alcohol and have liver function, CBC, blood chemistry’s and alkaline phosphate regularly monitored  
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what is MS   a chronic progressive non-contagious degenerative disease of the CNS characterized by demyelination of the neurons  
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when does MS usually occur   usually occurring between the ages of 20-40 with periods of remission and exacerbation  
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what is the cause of MS   cause unknown but thought to be a result of an autoimmune disease or viral infection  
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what are precipitating factors for MS   pregnancy, fatigue, stress and trauma  
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what are diagnostic results with MS patients   EEG findings are abnormal while CSF indicated increased gamma globulin but serum globulin is normal  
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manifestations of MS   Fatigue/weakness Ataxia/vertigo Tremor and spasticity of lower extremities Paresthesias Blurred vision, diplopia and transient blindness  
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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  
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manifestations of MS   Emotional changes, apathy, euphoria, irritability and depression Memory changes and confusion  
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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  
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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  
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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  
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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  
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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  
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interventions for MS   Instruct client in the self-administration of prescribed meds Provide information about National MS association  
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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  
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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  
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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  
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muscle relaxants for MS   Baclofen/diazepam/dantrium given to patients to relieve muscle spasms  
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immunosuppressants for MS   Imuran/Cytoxan given to MS patients because of the autoimmune component of disease  
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