Neurologic Disorders Part 1 Flashcards by Sydney Perry

Nutritional Issues with Neurologic Disease
- Significant risk for _________
- Difficulties with _______ : depends on the area of the nervous system affected

malnutrition
feeding

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What is Hemiparesis ?

paralysis of the one side

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Paralysis & Hemiparesis

___________ is a problem if the paralysis is on the dominant side
Difficult to eat with one hand
Fatigue
Difficulty obtaining & preparing food
May require __________

Coordination

assistive feeding devices

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adaptive feeding devices can be ?

a strap around the hand to hold the utensil

silverware with large foam handles

a jar opener

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defective vision or blindness in half the visual field

Hemianopsia

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If patient has hemianopsia, what’s the nutrition concern?

may only recognize half of a meal

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inattention to a weakened or paralyzed side of the body

Neglect

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When a patient has neglect, the ability to _____ may be severely impaired

eat

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Loss of the ability to produce and/or comprehend language due to injury to brain

aphasia

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two types of aphasia

brocas aphasia (non-fluent or expressive aphasia)

wernike’s aphasia (receptive aphasia)

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Broca’s aphasia is a lesion of the Broca’s area (______ lobe)

Unable to create _____________
Patients are usually _____ that they cannot speak properly
_________ is relatively normal

left frontal

grammatically-complex sentences
aware
Comprehension

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Wernicke’s aphasia is a lesion of Wernicke’s area (______lobe)

Speech pattern sounds _______, but sentences are ________

Pronounced impairment in _________

left temporal

normal
nonsensical

comprehension

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General term for a decline in mental ability severe enough to interfere with daily life

dementia

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Causes of dementia include _________ of the brain and _______disorders

Associated with loss of brain function resulting in memory, behavior, learning, & communication problems

degenerative diseases
vascular

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Dysphagia

Cranial nerves involved in swallowing:

___________: Mastication
______________: swallowing
___________: tongue movement

May lead to malnutrition, dehydration, and aspiration pneumonia

Trigeminal (V)
Glossopharyngeal (IX)
Hypoglossal (XII)

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Neurologic Diseases Caused by Nutritional Deficiencies

Pernicious anemia
Wernicke-Korsakoff syndrome

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cerebrovascular accident (CVA) is damage to brain tissue due to ___________

Acute onset of neurologic deficits lasting for ____ hrs and attribute to diseases of intra or extra cranial vasculature

sudden interruption to blood supply
>24

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Non-Modifiable Risk Factors for CVA

Older age*
Family history
Race: Black individuals have higher risk
Female gender
Prior stroke, TIA, or MI

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what is TIA

transient ischemic attack

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CVA is ____ most common cause of death in the US

5th

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CVA can have _____ and ______

ischemia
intracranial hemmorhage

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ischemia can me _______ or ________

embolic
thrombotic

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what is thrombotic ischemia caused by

atherosclerosis in cerebral or carotid arteries

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intracranial hemorrhage consists of ____ or ______

HTN
aneurysm

modifiable risk factors for CVA

HTN smoking atrial fibrillation carotid or peripheral artery disease DM sick cell anemia CHD high serum cholesterol physical activity obesity diet

For CVA prevention focuses on lifestyle and diet changes to decrease risk factors. What does this include?

low sodium DASH diet Mediterranean or AHA diet (increase omega 3) weight management

For CVA also individualize MNT based on feeding difficulties such as _______ or ______ Also dress food-drug interactions which is ?

dysphagia (IDDSI diets) hemiparesis warfarin (anticoagulant) - moderate intake of vitamin K

Alzheimer's disease is a progressive ___________ disorder with loss of ______ Characterized by microscopic changes in the brain that include deposition of ______, ______, and ______

neurodegenerative brain neurons amyloid plaques, tau proteins, and neurofibrillary tangles

alzheimers is the ___ most common type of dementia cause? cure?

1st unknown no cure

about ___ in 9 people aged 65 or older has Alzheimers almost 2/3 of Americans with alzheimers are _______ older ____ are twice as likely

1 women black Americans

non modifiable risk factors of AD

advanced age family history genetic factors female down syndrome

modifiable risk factors for AD

HTN DM smoking obesity physical activity low social contact hearing impairment depression low education level excessive alcohol consumption traumatic brain injury air pollution

manifestations of alzheimers disease

memory loss agnosia (cant recognize senses) aphasia behavioral changes sundowning progresses to a vegetative state

Medical management of AD involves _________

cholinesterase inhibitors Aducanumab

cholinesterase inhibitors example? how do they work? how do they help?

cholinesterase inhibitors donepezil increase level of acetylcholine in the brain may help reduce some cognitive and behavioral symptoms

cholinesterase inhibitors (donepezil) drug interactions

may cause wt loss N/V/D increased gastric acid GIB

cholinesterase inhibitors (donepezil) instructions

take with food to decrease GI irritation monitor wt and food intake

aducanumab helps how? food drug interactions?

helps to reduce amyloid deposits in the brain and may help disease progression N/V/D

common nutritional issues with people with AD

inadequate intake increased energy expenditure dehydration dysphagia weight loss and malnutrition pressure injury risk

inadequate intake with AD from?

inability to obtain and prepare food cant feed self may not eat safely eating is neglected

energy placement increased in AD due to ?

constant moving such as pacing

MNT prevention for AD ?

a healthier diet during middle age years - adequate B vitamin, antioxidants, PUFAs A Mediterranean style dietary pattern

MNT for advanced AD

maintain a desirable body weight provide nutrient dense foods to avoid deficiency multivitamin hydration decrease distractions during meals

despite decreased intake and resulting malnutrition the practice of using EN for individuals with advanced AD is ______ due to lack of proven benefits

declining

progressive and fatal neurodegenerative disorder affecting the MOTOR neurons in the CNS resulting in generalized skeletal muscle weakness and atrophy

Amyotrophic lateral sclerosis (ALS) or Lou Gehrigs's disease

ALS is more common in ____ gender and people have more risk if aged ≥____ years. cause? cure? death usually occurs ____ after the onset of sumptoms

male 60 unknown no cure 3-5 years

med used for ALS

edarabone

early symptoms of ALS are ___________, _____________ advanced symptoms include ________, __________, ______________ ________ and _______ are maintained

muscle weakness in the hands and legs oropharyngeal weakness and jaw spasticity Tetraplegia, dysphagia, and respiratory weakness sensation and mental acuity

decline in respiratory muscle strength in ALS can cause _____, ______, ______, ______, and ______

dyspnea weak cough decreased ventilation respiratory failure death

In ALS patients hard food are difficult to eat because _____ dysphagia due to ______________ aspiration risk with ______ also risk of ______ and _______

jaw fatigue oropharyngeal weakness think liquids dehydration constipation

nutrition problems with late ALS

negative nitrogen balance will need assistance eating progresses to an inability to eat

MNT for ALS

Proper texture food and thickened liquids proper positioning while eating adequate fluid and fiber small, frequent meals vitamin and mineral supplement early placement of a feeding tube (*PEG if abides by patient wishes)

myasthenia Gravis (MG) is an ______ disease where circulating ______ attack ______ at the neuromuscular junction preventing _____ from binding to the receptors

autoimmune antibodies acetylcholine receptors acetylcholine

myasthenia Gravis (MG) results in a defect in _______ at the neuromuscular junction

nerve impulse transmission

myasthenia Gravis (MG) is characterized by relapsing and remitting ________________ varying from ____ to _____

muscle weakness and fatigue minutes days

MG mainifestations ________ ________ resulting in ________ symptoms are worse at ______ ________ is possible

diplopia (double vision) facial muscle weakness - difficulty chewing - drooling - dysarthria (trouble speaking) - dysphagia end of the day respiratory insufficiency

if muscle fatigue is a problem with MG, serve ________ should consume ______ first meals should be ________ rest _____ before a meal

largest meal in the morning nutrient dense foods Frequent and easy to chew/swallow (SLP decodes) 30 minutes