409 2 Flashcards
MS
an autoimmune disorder characterized by development of plaque in the white matter of the central nervous system
plaque damages the myelin sheath and interferes with impulse transmission between the CNS and the body
MS
MS plaque damages the myelin sheath which
interferes with impulse transmission between the CNS and the body
Myasthenia Gravis
an autoimmune disorder characterized by antibody-mediated loss of ach receptors, interfering with communication between neurons and muscles
MS: The disease is marked by
relapses and remissions
MS: Overtime, the client may eventually progress to the point of
quadriplegia
MS: In most cases, life expectancy is
not affected by this disease
Fatigue – especially of the lower extremities
MS
Diplopia, changes in peripheral vision, decreased visual acuity
MS
MS dx tests
CSF test
MRI (shows plaques in the brain)
MS: to decrease the risk of developing a urinary tract infection, encourage
increased fluid intake
MS: Facilitate effective communication (dysarthria) using a
communication board
MS: to treat diplopia
Apply alternating eye patches
MS: ______ agents are used to reduce the frequency of relapses.
Immunosuppressive
Intrathecal _____ can be used for severe cases of MS.
Intrathecal baclofen
___ ___ is suggested for family members of clients who have ALS.
Genetic counseling
ALS: labs show increased levels of
CKBB
ALS: _____ can be caused by respiratory muscle weakness and paralysis contributing to ineffective airway exchange
Pneumonia
MG: Muscle weakness improves with
rest and worsens with activity
MG: Frequently associated with hyperplasia of the
thymus
Drooping eyelids – unilateral or bilateral
MG
Baseline assessment of the cranial muscle strength is done
MG
MG feeding consideration
Provide small, frequent, high-calorie meals and schedule at times when medication is peaking.
The MG client may need _______ at night to prevent damage to the cornea.
tape his eyes shut
Undermedication in MG is aka
Myasthenic crisis
Overmedication in MG is aka
Cholinergic crisis
Undermedication in MG: BP
htn
Overmedication in MG: BP
hypotensive
Parkinson’s involves degeneration of the
dopamine-producing neurons
Parkinson’s: tremor is prominent at rest and aggravated by
emotional stress
Levodopa overdose can cause
freezing (akinesia)
Ultimate confirmation of PD is
a positive response to anitparkinsonian drugs
Neupro
a patch that treats Parkinson’s
Neupro can be used with
levodopa-carbidopa
DBS (deep brain stimulation) can be adjusted to
control symptoms better and is reversible
A chronic, progressive, degenerative disorder of the CNS characterized by disseminated de-myelination of nerve fibers of the brain and spinal cord.
MS
autoimmune process that sometimes is triggered by a virus
MS
MS: Without myelin, the nerve impulses
slow down
Lhermitte’s Phenomenon
in MS, feels like electricity shooting down the spine
MS: Death usually occurs due to
infection
MS: common mental comorbidity
depression
MS: DMT should be discontinued prior to
a women getting pregnant
The hallmark of myasthenia gravis is muscle weakness that
increases with fatigue
A hallmark of __ is muscle weakness that increases with fatigue
MG
The left cerebral hemisphere is responsible for _____, _____, _____
language, math, analyzing
Symptoms consistent with a ___ hemispheric stroke include: Expressive and receptive aphasia
left
Symptoms consistent with a ___ hemispheric stroke include: Agnosia
left
Symptoms consistent with a ___ hemispheric stroke include: Alexia (can’t read)
left
Symptoms consistent with a ___ hemispheric stroke include: Agraphia (can’t write)
left
Symptoms consistent with a ___ hemispheric stroke include: Altered perception of deficits (overestimation of abilities)
right
Symptoms consistent with a ___ hemispheric stroke include: Loss of depth perception
right
Symptoms consistent with a ___ hemispheric stroke include: Poor impulse control and judgment
right
hemorrhage stroke: A lumbar puncture is used to assess for the presence of
blood in the cerebrospinal fluid (CSF)
Stroke: Monitor the client’s vital signs every
l to 2 hr
Stroke: Notify the provider immediately if the client’s blood pressure exceeds
180/110
Stroke: Provide oxygen therapy to maintain the client’s oxygen saturation level greater than
92%
Stroke: even if POX is above 92%, you should give O2 if
LOC is decreased
Stroke: Elevate the client’s head of the bed approximately
30 degrees
Dysphagia: Have the client eat in an upright position and swallow with the head and neck
flexed slightly forward
Stroke: An ___ glove can be placed on the affected hand if swelling is severe
elastic
Stroke: Use of anticoagulants is
controversial and not recommended due to the high risk of brain bleeding.
Low-dose ____ is given within 24 to 48 hr following a stroke to prevent further clot formation.
aspirin
Stroke: besides aspirin, other antiplatelets, such as clopidogrel (Plavix)
aren’t used
Stroke: phenytoin and gabapentin
not commonly given following a stroke unless the client develops seizures.
Stroke: _____ can be given for paresthetic pain in an affected extremity.
Gabapentin
Possibility of a _____ ____ is ruled out with an MRI prior to the initiation of thrombolytic therapy
hemorrhagic stroke
Stroke: Instruct the client to dress the ____ side first.
affected
