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Nursing 281 > ATI Ch 10 MS ALG MG > Flashcards

ATI Ch 10 MS ALG MG Flashcards

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1
Q

Multiple Sclerosis description

A

autoimmune disorder where plaques develop in the white matter of the CNS, interferes w/ impulse transmission
can relapse and remit

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2
Q

Amyotrophic Lateral Sclerosis ALS description

A

disease of the upper and lower motor neurons with muscle weakness progressing to muscle atrophy and eventually paralysis and death

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3
Q

Myasthenia Gravis description

A

autoimmune disorder with loss of ACH receptors at the neuromuscular junction

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4
Q

MS onset

A

2x more likely in women

between ages 20-40

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5
Q

Factors that trigger MS relapse

A

Viruses and infectious agents, Living in a cold climate, Physical injury, Emotional stress, Pregnancy, Fatigue, Overexertion, Temperature extremes, Hot shower/bath

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6
Q

MS sx

A

lower extremity fatigue, vision changes (Uhthoff’s sign), muscle spacity, nystagmus, cognative changes, bowel/bladder dysfunction

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7
Q

Lab test for MS

A

Cerebrospinal fluid analysis (elevated protein level and a slight increase in WBCs)

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8
Q

How to diagnose MS

A

MRI reveals plaques of the brain and spine

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9
Q

Credé maneuver

A

placing manual pressure on abdomen over the bladder to expel urine, used in MS PTs

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10
Q

Tx for diplopia

A

apply alternating eye patches and teach scanning maneuvers, used for MS PTs

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11
Q

Immunosuppressive agents ex

A

Azathioprine (Imuran) and cyclosporine (Sandimmune)

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12
Q

Immunosuppressive agents use

A

reduce the frequency of MS relapses

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13
Q

Immunosuppressive agents nursing considerations

A

Assess for hypertensionand kidney dysfunction

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14
Q

Corticosteroids ex

A

Prednisone

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15
Q

Corticosteroids use

A

reduce inflammation in acute MS exacerbations

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16
Q

Corticosteroids nursing considerations

A

Monitor for infection, hypervolemia, hypernatremia, hypokalemia, hyperglycemia, GI bleeding, and personality changes

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17
Q

Antispasmodics ex

A

Dantrolene (Dantrium), tizanidine (Zanaflex), baclofen (Lioresal), and diazepam (Valium)

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18
Q

Antispasmodics use

A

treat muscle spasticity in MS

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19
Q

Antispasmodics nursing considerations

A

Observe for increased weakness, liver damage if on tizanidine or dantrolene, do not stop baclofen abruptly

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20
Q

Immunomodulators ex

A

Interferon beta (Betaseron)

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21
Q

Immunomodulators use

A

prevent or treat relapses of MS

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22
Q

Anticonvulsants ex

A

Carbamazepine (Tegretol)

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23
Q

Anticonvulsants use

A

paresthesia in MS

24
Q

Anticholinergics ex

A

Propantheline

25
Q

Anticholinergics use

A

bladder dysfunction in MS

26
Q

Beta-blockers ex

A

Primidone (Mysoline) and clonazepam (Klonopin)

27
Q

Beta-blockers use

A

treat tremors in MS

28
Q

ALS progression rate

A

death usually due to resp failure within 3-5 years from first manifestation

29
Q

ALS onset

A

effects more women than men, seen between ages 40-70

30
Q

ALS Sx

A

fatigue, twitching, cramping, atrophy, dysphagia, hyperreflexia of deep tendon reflexes

31
Q

ALS lab tests

A

Increased creatine kinase (CK-BB) level

Need to r/o other causes, there is no specific test

32
Q

ALS diagnostic tests

A

Electromyogram (EMG) – Reduction in number of functioning motor units of peripheral nerves, Muscle biopsy – Reduction in number of motor units of peripheral nerves and atrophic muscle fibers

33
Q

What ALS mostly effects

A

Respiratory!

Nursing interventions should be geared to respiratory functions

34
Q

glutamate antagonist ex

A

Riluzole (Rilutek) (this is the only one)

35
Q

glutamate antagonist use

A

slow the deterioration of motor neurons in ALS. It must be taken early in process, will add 2 to 3 months to the client’s lifespan

36
Q

glutamate antagonist nursing considerations

A

Monitor LFTs, no ETOH, assess dizziness, vertigo and somnolence, keep meds away from light

37
Q

Antispasmodics ex

A

Baclofen (Lioresal), dantrolene sodium (Dantrium), diazepam (Valium)

38
Q

ALS complications

A

pneumonia due to respiratory weakness/paralysis

39
Q

Causes of Myasthenia Gravis

A

Coexisting autoimmune disorder

hyperplasia of the thymus gland

40
Q

Factors that trigger MG exacerbations

A

Infection, Stress, emotional upset, and fatigue, Pregnancy, Increases in body temp

41
Q

Finding from MG assessment

A

impaired resp function, dysphagia, decreased muscle strength (especially in the face), incontinence, drooping eyelids

42
Q

Diagnostic procedures for MG

A

Tensilon testing/ anticholinesterase (edrophonium)

43
Q

Electromyography

A

Shows the neuromuscular transmission characteristics of MG

44
Q

Tensilon testing function

A

Baseline assessment of the cranial muscle strength

45
Q

Tensilon testing procedure

A

Edrophonium (Tensilon) is administered which improves muscle strength for 5 min by inhibiting breakdown of ACh

46
Q

Anticholinesterase agents for MG

A

are the first line of therapy

given 4x daily

47
Q

Anticholinesterase agents for MG cautions

A

clients who have hx of asthma or cardiac dysrhythmias

48
Q

Pyridostigmine (Mestinon) and neostigmine (Prostigmin) for MG function

A

increase muscle strength

inhibits breakdown of ACh and prolongs its effects

49
Q

Use of immunosuppressants with MG

A

given durring exacerbations when other meds are not sufficient because MG is an autoimmune disease

50
Q

When are IV immunoglobulins (IVIg) used?

A

for acute management in clients who do not respond to the above treatments

51
Q

Plasmapheresis

A

used in MG tx
removes circulating antibodies from the plasma
usually done several times over a period of days and may continue on a regular basis

52
Q

Plasmapheresis intraprocedure nursing actions

A

assess for dizziness and hypotension

maintain patence of shunts

53
Q

Thymectomy

A

surgical procedure for MG

removal of thymus gland

54
Q

Thymectomy complications

A

Myasthenic crisis and cholinergic crisis

pneumo or hemothorax

55
Q

Myasthenic crisis occurance

A

client is experiencing a stressor that causes an exacerbation of MG, such as infection, or is taking inadequate amounts of cholinesterase inhibitor

56
Q

cholinergic crisis occurance

A

the client has taken too much cholinesterase inhibitor

57
Q

Myasthenic crisis and cholinergic crisis sx

A

muscle weakness, respiratory failure

Nursing 281 (34 decks)

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