chronic neuro problems 2 Flashcards

1
Q

multiple sclerosis (MS)

A
  • chronic, progressive, degenerative dx of the CNS

- demyelination of nerve fibers of the brain and spinal cord occurs

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2
Q

population affected by MS

A
  • ages 20-50

- women affected more than men

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3
Q

cause of MS

A
  • infectious
  • immunologic
  • genetic
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4
Q

s/s of MS

A
  • motor s/s
  • sensory (tingling)
  • Lhermitte’s sign
  • lack of coordination
  • depression
  • constipation
  • spastic or flaccid bladder
  • lack of concentration and memory
  • ED, decreased libido
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5
Q

Lhermitte’s sign

A

when neck is flexed, electric shock felt

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6
Q

diagnostic studies for MS

A
  • H/P
  • CSF analysis: increased IgG
  • MRI: to look for scar tissue and demyelination
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7
Q

drug tx for MS

A
  • prednisone
  • betaseron (immunomodulator)
  • imuran (immunosuppressants)
  • lioresal (muscle relaxant)
  • ritalin
  • oxybutynin
  • ampyra (nerve conduction enhancer)
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8
Q

nursing interventions for MS

A
  • help pt ID triggers
  • prevent major complications of immobility
  • good balance of exercise and rest
  • adeqaute intake of fiber
  • avoiding the hazards of immobility
  • self catherization
  • avoid fatigue, extreme heat or cold, exposure to infection
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9
Q

Parkinson’s disease (PD)

A
  • chronic, progressive neurodegenerative disorder
  • bradykinesia
  • muscle rigidity
  • tremors at rest
  • gait disturbance
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10
Q

s/s of PD

A
  • onset is gradual and insidious

- classic triad: tremors, rigidity, bradykinesia

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11
Q

complications of PD

A
  • nonmotor and motor symptoms
  • dementia and neuropsychiatric problems
  • dysphagia
  • general debilitation may lead to pneumonia, UTIs, and skin breakdown
  • orthostatic hypotension, falls/injury
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12
Q

diagnosing PD

A
  • no specific tests
  • firm dx made when 2/3 s/s seen of classic triad
  • ultimate confirmation is positive response to antiparkinsons drugs
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13
Q

drug tx of PD

A
  • sinemet (levodopa with carbidopa)
  • parlodel
  • artane
  • cogentin
  • benadryl
  • symmetrel
  • eldepryl
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14
Q

other tx for PD

A
  • deep brain stimulation
  • food easy to chew and swallow
  • adeqaute roughage
  • bite size pieces
  • small meals
  • limit protein and vitamin B6
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15
Q

myasthenia gravis (MG)

A

-autoimmune dx of the neuromuscular junction characterized by fluctuating weakness of certain skeletal muscle groups

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16
Q

s/s of MG

A
  • fluctuating weakness of skeletal muscles
  • eyes, eyelids, chewing, swallowing, speaking, breathing
  • peek’s sign: eyes don’t close completely
  • impaired speech
  • facial mobility and expression
17
Q

diagnostic studies for MG

A
  • H/P, neuro exam
  • EMG
  • tensilon
18
Q

myasthenia crisis

A
  • an acute exacerbation of muscle weakness
  • aspiration
  • respiratory insufficiency
  • respiratory tract infection
19
Q

cholinergic crisis

A
  • OD of anticholinestrase drug
  • muscle twitching
  • sweating
  • excessive salivation
  • constricted pupils
20
Q

drug tx of MG

A
  • mestinon
  • prednisone: to suppress immune system
  • immunosuppressants: imuran, sandimmune
21
Q

surgery for MG

A

thymectomy

22
Q

other tx for MG

A
  • plasmapheresis

- IV IgG

23
Q

plasmapheresis

A
  • replacement of antibodies, since antibodies are attacking you
  • usually done in crisis situation