409 2 Flashcards by Richard smith

an autoimmune disorder characterized by development of plaque in the white matter of the central nervous system

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plaque damages the myelin sheath and interferes with impulse transmission between the CNS and the body

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MS plaque damages the myelin sheath which

interferes with impulse transmission between the CNS and the body

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Myasthenia Gravis

an autoimmune disorder characterized by antibody-mediated loss of ach receptors, interfering with communication between neurons and muscles

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MS: The disease is marked by

relapses and remissions

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MS: Overtime, the client may eventually progress to the point of

quadriplegia

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MS: In most cases, life expectancy is

not affected by this disease

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Fatigue – especially of the lower extremities

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Diplopia, changes in peripheral vision, decreased visual acuity

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MS dx tests

CSF test

MRI (shows plaques in the brain)

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MS: to decrease the risk of developing a urinary tract infection, encourage

increased fluid intake

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MS: Facilitate effective communication (dysarthria) using a

communication board

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MS: to treat diplopia

Apply alternating eye patches

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MS: ______ agents are used to reduce the frequency of relapses.

Immunosuppressive

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Intrathecal _____ can be used for severe cases of MS.

Intrathecal baclofen

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___ ___ is suggested for family members of clients who have ALS.

Genetic counseling

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ALS: labs show increased levels of

CKBB

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ALS: _____ can be caused by respiratory muscle weakness and paralysis contributing to ineffective airway exchange

Pneumonia

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MG: Muscle weakness improves with

rest and worsens with activity

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MG: Frequently associated with hyperplasia of the

thymus

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Drooping eyelids – unilateral or bilateral

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Baseline assessment of the cranial muscle strength is done

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MG feeding consideration

Provide small, frequent, high-calorie meals and schedule at times when medication is peaking.

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The MG client may need _______ at night to prevent damage to the cornea.

tape his eyes shut

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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.

autoimmune process that sometimes is triggered by a virus

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

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