Neuro

Question 1

What is Multiple sclerosis?
MS?

Answer 1

Chronic, progressive, degenerative(悪化) disorder of CNS
Chronic inflammation
Autoimmune process
Women 20-50 years

Question 2

This is genetic, but what can be triggered?

Answer 2

-Infections
-Smoking
-Trauma
-Stress
-Fatigue
-Pregnancy
-Childhood obesity

Question 3

Manifestations

Answer 3

-Muscle weakness
-Gait abnormalities
-Dizziness
-Diplopia(duble vision)
-Nystagmus(uncontrol eye movement)
-Pain
-Blurred. double vision
-Hearing loss
-inc osteoporosis

Question 4

Answer 4

Avoid triggers
maintain independence in ADL
-Pt unright (d/t dysphagia)
-Provide rest (d/t fatigue)
-Fluid intake (avout UTI)

Question 5

Myasthenia Gravis
Manifestations

Answer 5

-Muscle weakness worsens as days go by
rest can improve strength
-Ptosis (common early sing)
drooping of the upper eyelid
-Facial paralysis
difficult talking
dysphagia
hoarse voice
High risk of aspiration
-difficult breathing
-fatigue

Question 6

Anticholinesterase (Edrophonium,tensilon)
a) purpose?
b) how to evaluate?
c) if MG
d) cholinergic crisis

Answer 6

a) differentiate between MG and cholinergic crisis
b) muscle weakness before and after IV
c) strength improve after IV(because MG lack of cholinergic)
d) worsen weakness after 1hr IV

Question 7

Question 8

Amyotrophic Lateral Sclerosis (ALS)
a) what is it?
b) mortality rate
c) more common in which gender?

Answer 8

a) Very very rare
Neurodegenerative disease
b) 2-6 after diagnosis
rapid progression
c) Men(old)

No cure

Question 9

ALS
Manifestations

Answer 9

cognitive function not impacted
-limb weakness
-muscle cramps
-respiratory paralysis (within 3-5yr)

Question 10

Question 11

Guillain-Barre Syndrome(GBS)
a) cause?
b) how to recover?

Answer 11

a) autoimmune
follow infection (super rare flu vaccine)
b) spontaneously at about 28 days

Question 12

Question 13

Question 14

Parkinson’s disease
Charactristic

Answer 14

-Chronic, progressive
-Neurodegenerative disorder
-May affect cognitive but much later
-Inc acetylcholine
-Dec dopamine

Question 15

Answer 15

Tremor worsens with stress
Fatigue
Urinary retention
Constipation
Dyspagia

Question 16

Question 17

Question 18

Which care measure is a priority for a patient with multiple sclerosis (MS)?
a) Vigilant infection control and adherence to standard precautions
b) Careful monitoring of neurologic assessment and frequent reorientation
c) Maintenance of a calorie count and hourly assessment of intake and output
d) Assessment of blood pressure and monitoring for signs of orthostatic hypotension

Answer 18

a
infection control is a priority in the care of patients with MS because infection is the most common cause of an exacerbation of the disease. Decreases in cognitive function are less likely, and MS does not typically result in malnutrition, hypotension, or fluid volume excess or deficit.

Question 19

Which problem is the nursing priority when caring for a patient with myasthenia gravis (MG)?
a) confusion
b) Bowel incontinence
c) Activity intolerance
d) Disturbed sleep pattern

Answer 19

c
The primary feature of MG is fluctuating weakness of skeletal muscle. Bowel incontinence and confusion are unlikely signs of MG. Although sleep disturbance is likely, activity intolerance is of primary concern.