ALS Flashcards
ALS
LOU Gehrigs’s ceases
Unknown cause symptoms develop after age 50
More men than women are affected
ALS patho
Rapidly progressing, fatal CNS disease
Affects voluntary muscle control
Does not impair senses or ability to think
Both upper and lower neurons degenerate and die
Affects diaphragm and chest wall
What happens towards the end ofALS
Respiratory failure-ventilator support
Advance directives
Do you want peg tube? Ventilator ?
ALS clinical manifestations
Muscle cramps, stiffness, muscle weakness, slurred speech , difficulty swallowing
Upper motor neuron damage(associated with spasticity)
Lower motor neuron damage
(Associated with flaccidity)
Mas clinical manifestation
Fatigue while talking
Tongue atrophy
Dysphagia
Dysarthria
Nasal quality of speech
Fasciculation of the face
Weakness of arms and hands
Spascity
Muscle atrophy
Eventual muscle respiratory involvement
Assessment and diagnostics
No single test can be used
Based on s/s
EMP& nerve conduction studies
Ct scan or MRI of neck and head
Lumbar puncture
Genetic testing
Swallow studies
Medical management
ruluzole
Riluzole
First drug approved to slow progression
Delayed need for tracheostomy by 3-6 months
Well tolerated
MOA of riluzole
Reduces damage to motor neurons by decreasing release of glutamate
Adverse effects of riluzole
Asthenia, GI reactions, dizziness, vertigo, somnolence, decreased lung function, neutropenia, and liver injury
Complications of ALS
Aspiration
Respiratory failure
Pneumonia
Pressure ulcers
DVT
PE
Constipation, contractures
Depression , weight loss
Loss of ability for self care
ALS nursing interventions
ROM exercising rolled towels , contractures
Nursing diagnoses
Ineffective airway clearance
R/t weak cough secondary to motor neuron death and muscle weakness
Ineffective breathing patter (weakness of respiratory muscles
Potential for injury (impaired physical mobility
Impaired oral communication
Ineffective coping
Teaching for family
Skin care
Aspiration precautions
Lower extremity circulation
