Disorders of Immune System Flashcards
s/s MS
- including
fatigue,
weakness,
numbness,
difficulty in coordination (ataxia),
loss of balance,
pain, and
visual disturbances,
spasticity
Spasticity
- characterized by muscle hypertonicity with increased resistance to stretch
Major goal of MS and what to avoid
Minimizing spasticity and contractures- daily exercises for muscle stretching are prescribed to minimize contractures
Avoid hot baths because of risk for burn injury secondary to sensory loss and elevates body temp which may increase symptoms
Exposure to cold is avoided as this can increase spasticity
MS- med of choice for treating spasticity
Baclofen- muscle relaxant
location of damage- MG
myoneural junction
Diagnostic test- MG
Tensilon test- acetylcholinesterase inhibitor test
+ test –> Immediate improvement in muscle strength after admin of agent represents a positive test- confirms diagnosis
severe s/s- MG
affects breathing and limb movement
explain therapeutic plasma exchange (plasmapheresis) -MG and GBS
used to tx exacerbations
Pt’s plasma and plasma components are removed through a centrally placed large-bore double lumen catheter
Blood cells and antibody containing plasma are separated;
plasma and cells are reinfused
MG- optimal outcomes of thymectomy
pts younger than 60 years with MG diagnosis at least 3 years
what to avoid- Myasthenic and cholinergic crisis
sedatives and tranquilizers- increases progression
Drug used for long term tx of MG - results of drug
increase
relax
decrease
Neostigmine- anti-cholinesterase med
improved skeletal muscle tone and strength ;
increase in tone of GI smooth muscle;
increase salivary gland production;
increase tone and contractility of bladder muscles
relaxes bronchial muscles; ;
decreased HR
target location- GBS
peripheral nerve myelin
GBS most often follows what- ex
viral infection
Cytomegalovirus, Epstein-Barr virus, Mycoplasma pneumoniae, H. Influenzae, Zika virus
s/s GBS
Muscle weakness and diminished reflexes of the lower extremities
Hyporeflexia and weakness may progress to tetraplegia
Demyelination of the muscles of diaphragm and intercostal muscles may lead to respiratory failure
ataxia
aflexia
ascending weakness- toes to nose
diagnostic findings- GBS
Pt presents with symmetric weakness, diminished reflexes, and upward progression of motor weakness
History of viral illness in previous few weeks suggests diagnosis
Other interventions aimed at preventing complications- GBS
anticoagulant therapy
sequential compression boots to prevent VTE (DVT +PE)
therapeutic IVIG used for which immune disorder
GBS- to reduce circulating antibodies
MG
Med management for fibromyalgia
NSAIDs- Ibuprofen –> tx diffuse muscle aching and stiffness
Tricyclic antidepressants- amitriptyline –> restore sleep patterns
Muscle relaxants- cyclobenzaprine (flexiril)–> relaxation and pain
Vision changes and muscle weakness. Dysphagia and pytosis but not ataxia
MG
open fx are at increased risk for what (3)
infections
osteomyletitis
tetanus
how to reduce swelling of fx extremity
elevate above the <3
what measures used for closed fx
cast
splint
brace
Open reduction and internal fixation (ORIF) used for open or closed fx
open
Open reduction and internal fixation (ORIF)
5 p’s of neurovascular and circulation status
pallor
pulse
paresthesia
paralysis
pain
pressure injuries
painful “hot spot” and tightness under cast
what is used for lower extremity fx to realign bone fragment and correct deformities
what must nurse NOT do
traction
should not adjust weight, place weight on floor or bed or adjust traction
how to manage phantom pain
common after amputation
use analgesics
complications after amputation
hemorrhage
infection
joint contracture
phantom pain
technique used for pts with open fx, amputations, external fixation devices
aseptic skin care
causes progressive weakness of voluntary muscles
MG
pyridostigmine bromide
anticholinesterase med
used for MG tx
why corticosteroids are used for MG tx
suppress pt’s immune response
decrease amount of antibody production
