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PNC 103 lecture > Chapter 50: nursing care of patients with peripheral nervous system disorders > Flashcards

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
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2
Q

multiple sclerosis: etiology

A
  • unknown
  • a possible autoimmune response
  • possible viral infection
  • heredity
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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
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4
Q

disease progression

A
  • relapsing remitting
  • secondary progressive
  • primary progressive
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5
Q

relapsing remitting (RRMS)

A

relapses that resolve

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6
Q

secondary progressive (SPMS)

A

patients may progress to symptoms not completely resolving after relapse

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7
Q

primary progressive (PPMS)

A

patients have progressive worsening of neurological condition throughout course of the disease

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8
Q

additional manifestations of MS

A
  • remissions
  • exacerbations: due to stress or illness
  • immobility
  • death usually from infection
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9
Q

diagnostic tests for MS

A
  • history and physical
  • CSF analysis
  • MRI
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10
Q

therapeutic interventions for MS

A
  • steroids
  • interferon therapy
  • immunosuppressant gents
  • anticonvulsants
  • muscle relaxants
  • plasmapheresis
  • physical, occupational, speech therapies
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11
Q

myasthenia gravis: pathophysiology

A
  • antibodies destroy acetylcholine receptors
  • Ach cannot stimulate muscle contraction
  • loss of voluntary muscle strength results
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12
Q

etiology of myasthenia gravis

A
  • unknown
  • autoimmune
  • thymus disorders
  • possible viral origin
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13
Q

signs and symptoms of myasthenia gravis

A
  • progressive muscle weakness
  • fatigue w/ activity
  • ptosis
  • difficulty chewing, swallowing
  • difficulty breathing
  • remissions
  • exacerbations: stress
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14
Q

complications for myasthenia gravis

A
  • aspiration
  • respiratory infection and failure
  • myasthenic crisis
  • cholinergic crisis: sludge
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15
Q

diagnostic tests for myasthenia gravis

A
  • history and physical
  • Tensilon test
  • anti ach receptor antibodies
  • electrop,&myography
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16
Q

therapeutic interventions for myasthenia gravis

A
  • thymectomy
  • anticholinesterase agents
  • steroids
  • plasmapheresis
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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
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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
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19
Q

etiology of ALS

A
  • unknown
  • possible genetic predisposition
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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
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21
Q

diagnostic tests for ALS

A
  • history and phycal
  • lumbar puncture w/ CSF analysis
  • electroencephalogram
  • nerve biopsy
  • EMG
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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
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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
Q

etiology of Guillain Barre Syndrome

A
  • unknown
  • possible autoimmune response
26
Q

signs and symptoms of guillain barre syndrome

A
  • stage 1: 24 ours - 3 weeks
  • stage 2: 2-14 days
  • stage 3: 6-24 months
27
Q

stage 1 Guillain Barre syndrome

A
  • abrupt onset weakness and paralysis
  • may affect respiration
  • autonomic nervous system effects
28
Q

stage 2 Guillain Barre syndrome

A
  • plateau
  • progression stopped
29
Q

stage 3 Guillain

A
  • recovery
30
Q

complications of Guillain Barre syndrome

A
  • respiratory failure
  • infection
  • depression
  • pneumonia
  • urinary tract infection
  • complications of immobility
31
Q

diagnostic tests for Guillain Barre syndrome

A
  • lumbar puncture with CSF analysis
  • EMG
  • nerve conduction velocity
  • pulmonary function testing
32
Q

therapeutic interventions for Guillain Barre syndrome

A
  • plasmapheresis
  • oxygen
  • mechanical ventilation
  • emotional support
  • rehabilitation
33
Q

nursing care for Guillain Barre syndrome

A
  • monitor vital capacity and arterial blood gases
  • provide supportive care
  • manage pain
  • maintain nutrition
  • assist w/ communication
  • provide diversional activities
34
Q

postpolio syndrome

A
  • affects polio victims 10-40 years later
35
Q

signs and symptoms of postpolio syndrome

A
  • muscle weakness
  • fatigue
  • pain
  • respiratory compromise
36
Q

treatment for postpolio syndrome

A

rest

37
Q

nursing diagnoses for neuromuscular disorders

A
  • ineffective airway clearance
  • impaired physical mobility
  • impaired verbal communication
38
Q

pathophysiology of restless legs syndrome

A
  • dopamine and serotonin imbalance
39
Q

etiology of restless legs syndrome

A
  • kidney failure
  • iron deficiency
    0 diabetes
  • parkinson disease
  • peripheral neuropathy
  • family history
40
Q

signs and symptoms of resrtless legs syndrome

A
  • feeling of creeping crawly
  • throbbing
  • pulling
  • pins and needles
  • daytime fatigue
  • insomnia
41
Q

diagnosis for restless legs syndrome

A
  • patient report of symptoms
  • sleep history
  • laboratory test for iron deficienc
  • medication history
42
Q

therapeutic interventions for restless legs syndrome

A
  • application of heat or cold
  • leg massage
  • warm baths
  • medications to control symptoms
  • lifestyle modifications
43
Q

lifestyle modifications for restless legs syndrome

A
  • smoking cessation
  • regular sleep schedule
  • alcohol avoidance
  • exercise routine
44
Q

cranial nerve disorders

A
  • trigeminal neuropathy
  • bell palsy
45
Q

trigeminal neuralgia pathophysiology

A
  • irritation of the trigeminal nerve
  • affects sensory portion of nerve
46
Q

etiology of trigeminal neuralgia

A
  • irritation or chronic compression
47
Q

signs and symptoms of trigeminal neuralgia

A
  • intense pain on one side of face: forehead, cheek, nose, jaw
  • triggered by touch, talking, other stimulation
48
Q

diagnostic tests for trigeminal neuralgia

A
  • history and physical
  • computed tomography scan
  • MRI
49
Q

therapeutic interventions for trigeminal neuralgia

A
  • anticonvulsants
  • nerve blocks
  • surgery to block pain signals
50
Q

bell palsy pathophysiology

A
  • inflammation and edema of facial nerve
  • loss of motor control
51
Q

bell palsy etiology

A

unknown

52
Q

signs and symptoms of bell’s palsy

A

one sided facial:
- pain
- weakness
- speech difficulty
- drooling
0 tearing o eye
- inbility to blink

53
Q

bell palsy diagnostic tests

A
  • history and physical
  • EMG
  • rule out stroke
54
Q

bell palsy therapeutic interventions

A
  • prednisone
    =- analgesics
  • antiviral medication
  • moist heat
  • gentle massage
  • facial sling
55
Q

nursing diagnoses for cranial nerve disorders

A
  • acute pain
  • imbalanced nutrition
  • risk for injury to eyes (bell palsy)
56
Q

the LPN will…

A
  • 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

PNC 103 lecture (31 decks)

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