Chapter 50: nursing care of patients with peripheral nervous system disorders Flashcards
1
Q
multiple sclerosis: pathophysiology
A
- degeneration of myelin sheath
- inflamed nerves
- slowed or blocked nerve impulses
2
Q
multiple sclerosis: etiology
A
- unknown
- a possible autoimmune response
- possible viral infection
- heredity
3
Q
signs and symptoms of MS
A
- muscle weakness
- numbness
- fatigue
- slurred speech
- vision disturbances
- vertigo
- ataxia
- dysphagia
- bowel/bladder problems
- sexual dysfunction
- mood alterations
4
Q
disease progression
A
- relapsing remitting
- secondary progressive
- primary progressive
5
Q
relapsing remitting (RRMS)
A
relapses that resolve
6
Q
secondary progressive (SPMS)
A
patients may progress to symptoms not completely resolving after relapse
7
Q
primary progressive (PPMS)
A
patients have progressive worsening of neurological condition throughout course of the disease
8
Q
additional manifestations of MS
A
- remissions
- exacerbations: due to stress or illness
- immobility
- death usually from infection
9
Q
diagnostic tests for MS
A
- history and physical
- CSF analysis
- MRI
10
Q
therapeutic interventions for MS
A
- steroids
- interferon therapy
- immunosuppressant gents
- anticonvulsants
- muscle relaxants
- plasmapheresis
- physical, occupational, speech therapies
11
Q
myasthenia gravis: pathophysiology
A
- antibodies destroy acetylcholine receptors
- Ach cannot stimulate muscle contraction
- loss of voluntary muscle strength results
12
Q
etiology of myasthenia gravis
A
- unknown
- autoimmune
- thymus disorders
- possible viral origin
13
Q
signs and symptoms of myasthenia gravis
A
- progressive muscle weakness
- fatigue w/ activity
- ptosis
- difficulty chewing, swallowing
- difficulty breathing
- remissions
- exacerbations: stress
14
Q
complications for myasthenia gravis
A
- aspiration
- respiratory infection and failure
- myasthenic crisis
- cholinergic crisis: sludge
15
Q
diagnostic tests for myasthenia gravis
A
- history and physical
- Tensilon test
- anti ach receptor antibodies
- electrop,&myography
16
Q
therapeutic interventions for myasthenia gravis
A
- thymectomy
- anticholinesterase agents
- steroids
- plasmapheresis
17
Q
nursing process of myasthenia gravis: activity intolerance
A
- teach methods to conserve energy
- teach avoidance of infection
- teach signs and symptoms of crisis
- teach medications to avoid
18
Q
pathophysiology of Amyotrophic lateral sclerosis (ALS)
A
- also called Lou Gehrig’s disease
- motor neurons degenerate
- nerve impulse transmission blocked
- muscle weakness and atrophy
19
Q
etiology of ALS
A
- unknown
- possible genetic predisposition
20
Q
ALS signs and symptoms
A
- progressive muscle weakness and atrophy
- decreased coordination
- muscle spasm
- difficulty chewing and swallowing
- emotional lability
- speech difficulty
- pulmonary compromise
- death due to pulmonary complications
21
Q
diagnostic tests for ALS
A
- history and phycal
- lumbar puncture w/ CSF analysis
- electroencephalogram
- nerve biopsy
- EMG
22
Q
therapeutic interventions for ALS
A
- muscle relaxants
- Riluzole (Rilutek)
- physical, occupational, speech therapies
- pain control
- enteral feedings
- prevention of infection
- augmentative alternative communication
23
Q
patient education for ALS
A
- support groups
- importance of avoiding infection
- teach family to provide care
24
Q
pathophysiology of Guillain-Barre Syndrome
A
- inflammation of spinal and cranial nerves
- segmental demyelination in ascending pattern
- lymphocyte infiltration
- descending remyelination
25
etiology of Guillain Barre Syndrome
- unknown
- possible autoimmune response
26
signs and symptoms of guillain barre syndrome
- stage 1: 24 ours - 3 weeks
- stage 2: 2-14 days
- stage 3: 6-24 months
27
stage 1 Guillain Barre syndrome
- abrupt onset weakness and paralysis
- may affect respiration
- autonomic nervous system effects
28
stage 2 Guillain Barre syndrome
- plateau
- progression stopped
29
stage 3 Guillain
- recovery
30
complications of Guillain Barre syndrome
- respiratory failure
- infection
- depression
- pneumonia
- urinary tract infection
- complications of immobility
31
diagnostic tests for Guillain Barre syndrome
- lumbar puncture with CSF analysis
- EMG
- nerve conduction velocity
- pulmonary function testing
32
therapeutic interventions for Guillain Barre syndrome
- plasmapheresis
- oxygen
- mechanical ventilation
- emotional support
- rehabilitation
33
nursing care for Guillain Barre syndrome
- monitor vital capacity and arterial blood gases
- provide supportive care
- manage pain
- maintain nutrition
- assist w/ communication
- provide diversional activities
34
postpolio syndrome
- affects polio victims 10-40 years later
35
signs and symptoms of postpolio syndrome
- muscle weakness
- fatigue
- pain
- respiratory compromise
36
treatment for postpolio syndrome
rest
37
nursing diagnoses for neuromuscular disorders
- ineffective airway clearance
- impaired physical mobility
- impaired verbal communication
38
pathophysiology of restless legs syndrome
- dopamine and serotonin imbalance
39
etiology of restless legs syndrome
- kidney failure
- iron deficiency
0 diabetes
- parkinson disease
- peripheral neuropathy
- family history
40
signs and symptoms of resrtless legs syndrome
- feeling of creeping crawly
- throbbing
- pulling
- pins and needles
- daytime fatigue
- insomnia
41
diagnosis for restless legs syndrome
- patient report of symptoms
- sleep history
- laboratory test for iron deficienc
- medication history
42
therapeutic interventions for restless legs syndrome
- application of heat or cold
- leg massage
- warm baths
- medications to control symptoms
- lifestyle modifications
43
lifestyle modifications for restless legs syndrome
- smoking cessation
- regular sleep schedule
- alcohol avoidance
- exercise routine
44
cranial nerve disorders
- trigeminal neuropathy
- bell palsy
45
trigeminal neuralgia pathophysiology
- irritation of the trigeminal nerve
- affects sensory portion of nerve
46
etiology of trigeminal neuralgia
- irritation or chronic compression
47
signs and symptoms of trigeminal neuralgia
- intense pain on one side of face: forehead, cheek, nose, jaw
- triggered by touch, talking, other stimulation
48
diagnostic tests for trigeminal neuralgia
- history and physical
- computed tomography scan
- MRI
49
therapeutic interventions for trigeminal neuralgia
- anticonvulsants
- nerve blocks
- surgery to block pain signals
50
bell palsy pathophysiology
- inflammation and edema of facial nerve
- loss of motor control
51
bell palsy etiology
unknown
52
signs and symptoms of bell's palsy
one sided facial:
- pain
- weakness
- speech difficulty
- drooling
0 tearing o eye
- inbility to blink
53
bell palsy diagnostic tests
- history and physical
- EMG
- rule out stroke
54
bell palsy therapeutic interventions
- prednisone
=- analgesics
- antiviral medication
- moist heat
- gentle massage
- facial sling
55
nursing diagnoses for cranial nerve disorders
- acute pain
- imbalanced nutrition
- risk for injury to eyes (bell palsy)
56
the LPN will...
- use transfer assistive devices
- assist in the care of a client experiencing sensory/perceptual alterations
- assure availability and safe functioning of client care equipment
- evaluate the appropriateness of HCP order for client
- reconcile and maintain medication list or medication administration record
