Chapter 10 Word Scramble
|
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Question | Answer |
Multiple Sclerosis, Amyotrophic Lateral Sclerosis, & Myasthenia Gravis (Pg. 100) | Neuro diseases that typically result in impaired & worsening function of voluntary muscles |
Multiple Sclerosis: Define | Autoimmune disorder characterized by development of plaque in the white matter of the CNS -Plaque damages the myelin sheath & interferes w impulse transmission between the CNS & the body |
What is MS marked by? r&r | Relapsing & remitting (common courses) -Overtime client may progress to quadriplegia |
Is there a known cure to MS? | No & it's chronic |
Risk factors: Age, gender, family | 20-40 yrs old onset, 2x likely in women -Family hx |
What can trigger relapses? (Autoimmune disease) | Viruses/infectious agents, cold, physical injury, emotional stress, pregnancy, fatigue, overexertion, temperature extremes, hot shower/bath. |
S/s of MS (Pg. 101) -Fatigue, pain, vision | Fatigue (lower extremities), pain/paresthesia, diplopia, changes in peripheral vision |
What is diplopia and paresthesia? | Diplopia: double vision Paresthesia: tingling sensation "pins & needles" |
S/s of MS con't (Pg. 101) -What is uhthoff's sign? -Hearing, mouth | -Temporary worsening of vision & other neuro functions just after exertion or situation where they are exposed to heat -Tinnitus, vertigo, decreased hearing acuity -dysphagia, dysarthria |
What is tinnitus? | Ringing or buzzing in the ears |
What is dysarthria? for MS | Slurred & nasal speech |
S/s of MS con't -muscles, bowels/bladder | Muscle spasms, ataxia, nystagmus, constipation/incontinence, areflexia, sexual dysfunction |
What is ataxia? | Loss of full control of bodily movements |
What is nystagmus? | Rapid involuntary movement of the eyes |
What is areflexia? | Absence of reflexes |
MS lab tests? | CSF analysis ^ protein level & slight ^ WBC |
Dx procedures for MS? | MRI reveals plaques of the brain & spine |
MS meds: -Azathioprine (Imuran) & Cyclosporine (Sadimmune) & s/e | Immunosuppresive agents; to reduce frequency of relapses -htn, kidney dysnfunction (s/e) |
MS meds: -Prednisone (Deltasone) & s/e | Corticosteroid; reduce inflx in acute exacerbations -^ risk of infection, hypervolemia, hypernatremia, hypokalemia, hyperglycemia, GI bleeding, personality changes |
MS meds: -Dantrolene (Dantrium), Tizanidine (Zanaflex), Baclofen (Lioresal), & Diazepam (Valium) -s/e | Antispasmodics; tx muscle spasticity -^ weakness, liver damage, jaundice |
MS meds: -Interferon beta (Betaseron) | Immunomodulators; prevent/tx relapses |
MS meds: -Carbamazepine (Tegretol) | Anticonvulsants; tx paresthesia |
MS meds: -Docusate sodium (Colace) | Stool softners; constipation |
MS meds: -Propantheline (Pro-Banthine) | Anticholinergics; bladder dysfunction |
MS meds: -Primidone (Mysoline) & Clonazepam (Klonopin) | Beta-blockers used for tremors |
Amyotrophic Lateral Sclerosis: (Pg. 103) Define & what does this cause | Degenerative neuro disorder of the upper & lower motor neurons = death & deterioration of the motor neurons -Progressive paralysis & muscle wasting that eventually causes respiratory paralysis & death |
Does ALS usually affect cognitive function? | Cognitive function not usually affected |
ALS is also known as: | Lou Gehrig's disease |
How does death usually occur? and when? ALS | D/t respiratory failure, within 3-5 years |
Is there a cure for ALS? | No & the cause is unknown |
Risk factors for ALS? gender, ages | More men than women, 40-70 onset |
S/s of ALS? | Fatigue, twitching/cramping muscles, muscle weakness, muscle atrophy, dysphagia, dysarthria, hyperreflexia of DTR |
Lab tests for ALS? | Increased CK-BB level; creatine kinase |
Dx procedures for ALS? | -Electromyogram (EMG): reduction in # of functioning motor neurons of peripheral nerves -Muscle biopsy: reduction in # of motor units of peripheral nerves & atrophic muscle fibers |
Nursing care w ALS? (Pg. 103) -airway, HOB, speech, intake, nutrition | Maintain patent airway; suction/intubate, ABGs, o2, bpap, vent, etc. -HOB 45, TCDB q2h, IS, chest physiotherapy -Communication method -Swallow reflex, oral intake.. thicken liquids -Enteral nutrition when you can't swallow |
Meds for ALS: Riluzole (Rilutek) | Glutamate antagonist; can slow the deterioration of motor neurons by decreasing the release of glutamic acid. -Can add 2-3 months of lifespan, take early in disease |
S/e of Rilutek: | Hepatotoxic (monitor LFTs) Dizzy, vertigo, somnolence |
Educating on Rilutek: -Avoid, take, store | Avoid alcohol Take med at evenly spaced intervals (q12h ex) Store away from bright light |
Meds for ALS: Baclofen (Lioresal), Dantrolene sodium (Dantrium), Diazepam (Valium) | Antispasmodics are used to decrease muscle spasticity |
Complications of ALS: -Think airway | Pneumonia & respiratory failure |
Myasthenia Gravis: (Pg. 105) | Progressive autoimmune disease; produces muscular weakness. -Periods of exacerbation & remission |
MG, muscle weakness improves with ___ & worsens with ____ | Rest, increased activity |
What causes MG? | Antibodies that interfere w the transmission of acetylcholine at the neuromuscular junction |
Risks to MG: -Causes | Coexisting autoimmune disorder, hyperplasia of the thymus gland |
Risks to MG: -Triggers | Infection, stress, fatigue, pregnancy, ^ in body temperature |
S/s of MG: | Progressive muscle weakness, diplopia, dysphagia & chewing, respiratory dysfunction, bowel/bladder issues (incontinence), poor posture |
For MG where is the decreased muscle strength usually seen? | Face, eyes & proximal portion of major muscle groups -drooping eyelids |
Dx testing for MG: | Tensilon testing: baseline assessment of cranial nerve strength is done & Edrophonium (Tensilon) is administered -Positive test; marked improvement in muscle strength that lasts approximately 5 minutes |
What does Tensilon do? MG | Inhibits the breakdown of acetylcholine |
Complications of the Tensilon test? | Fasciculations around the yes & face, cardiac arrhythmias |
What is the antidote for Tensilon? | Atropine |
Another dx test for MG? | Electromyography: shows the neuromuscular transmission characteristics of MG |
Nursing care for MG? (Pg. 106) basics, types of meals, eyes, ID | Airway, rest, swallowing precautions -Small, frequent, high-calorie meals -eye drops day & night if client can't close eyes, might need to tape eyes shut at night to prevent damage to the cornea -med ID band |
First line therapy for MG? | Anticholinesterase agents -Usually given 4x a day |
Client education for anti cholinesterase agents? | Hx of asthma, cardiac dysrhythmias (be careful) -Take w food, eat within 45 mins of taking the med to strengthen chewing & reduce the risk for aspiration, maintain therapeutic levels |
Meds for MG: Pyridostigmine (Mestinon) & Neostigmine (Prostigmin) | Used to increase muscle strength in the symptomatic tx of MG -Inhibits breakdown of acetylcholine and prolongs its effects -Careful w asthma, seizures, cvd |
Meds for MG: Prednisone (Deltasone) & Azathioprine (Imuran) | Immunosuppressants given during exacerbations when Mestinon is not effective -they decrease the production of antibodies -prednisone (corticosteroid) is the 1st med of choice |
S/e of immunosuppressants: | Monitor for infection, taper off slowly |
Therapeutic procedures for MG: | Plasmapheresis: removes circulating antibodies from the plasma -VS, wt, labs before -lasts 2-5 hrs |
Plasmapheresis intraprocedure nursing care: -Assess for | Dizziness & hypotension -Maintain shunt patency (usually 1 in each upper extremity) |
Post procedure for plasmapheresis: | Apply a pressure dressing, monitor for infection, labs, monitor for hypokalemia,volemia,calcemia |
Surgical interventions for MG: | Thyectomy- removal of thymus gland; attain better control & complete remission |
How long until you can see the results of a thyectomy? | Months to years d/t the life of circulating T cells |
Nursing action postop thyectomy? -Airway | Client may have had a chest tube or intubated -TCDB q2hr -Pneumo/hemothorax (observe for s/s) |
Complications of MG: | Myasthenic crisis & cholinergic crisis |
What is myasthenic crisis? S/S pg. 108 | Occurs when client is experiencing a stressor that causes an exacerbation of MG; i.e.. infection -Or taken too little cholinesterase inhibitor |
What is cholinergic crisis? S/S pg. 108 | Occurs when the client has taken too much cholinesterase inhibitor |
Created by:
mary.scott260!
Popular Nursing sets