Week 1 - Neuro Disorders & Eyes Flashcards
what is M.S. ?
an autoimmune disease that causes progressive demyelination of oligodendrocytes in the CNS
*affects nerve impulses
no cure
*muscle SPASM & STIFFNESS
MS risk factors
WOMEN (20-40) > men
family history
vitamin D deficiency
M.S. s/s
*muscle spasticity
*altered vision - scotoma & diplopia
*Urinary retention (urinary/bowel problems)
*loss of cognitive function / coordination
*sexual dysfunction
diagnosing MS
2 lesions on MRI
CSF lumbar puncture
multiple flare ups > 1 month a part
MS drug classes
- Immunosuppressants = corticosteroids
- antispasmodics
- anti-seizures
- anticholinergics
- laxatives
- K channel blockers
- Immunomodulators
corticosteroids used for M.S.
- methylprednisolone (solumedrol) *IV PUSH
- dexamethasone (decradon) *IV INFUSION
- prednisone = PO
antispasmodics used for M.S.
*dantrolene - assess for liver injury & sclera jaundice
*baclofen - do not stop abruptly
adv effect = dizziness
laxatives used for M.S.
docusate sodium = mush not push
psyllium = bulk forming (increase water
anticholinergics used for MS & consideration
*Oxybutynin = helps w bladder control
- Propantheline
- Tolterodine
dries everything – offer HARD CANDY
K+ channel blocker used for MS and what it does
Dalfampridine
*makes AP last longer but has increased risk for seizures & hyperkalemia
nursing interventions for MS patients
*speech pathologist
monitor visual acuity
avoid stress
increase sleep / rest
avoid sun exposure
Uhthoff’s sign
worsening vision/neuro function for 24hrs following exposure to heat
MS patients
triad to diagnose parkinson’s
disease
- tremors at rest
- bradykinesia
- muscle rigidity
what is Parkinson’s Disease & who gets it more?
degeneration/depletion of dopamine and excess secretion of acetylcholine
*MEN (40-70)
s/s of Parkinson’s
constipation
drooling
dysarthria (slurred speech)
insomnia
lack of facial expression
PILL THUMB ROLLING
posture / gait disturbance
parkinson’s complications
*orthostatic hypotension
aspiration pneumonia
altered cognition
5 types of meds for parkinsons
- levodopa / carbidopa = produce dopamine
- BenzTropine = anticholinergic
- Apomorphine & Bromocriptine = stimulate dopamine
- MAOi’s = Selegiline & Rasagiline
- entacaPONE & tolcaPONE = prevent dopamine breakdown
levodopa / carbidopa considerations
can lower blood pressure
*orthostatic hypotension
avoid protein w levodopa
benztropine considerations
*anticholinergic
treats tremors
DRIES EVERYTHING - can cause blurry vision
Bromocriptine & Apomorphine considerations
stimulate dopamine
adv effects = gi disturbances
n/v
- watch for psychosis
MAOi considerations
*selegiline & Rasagiline
avoid tyramine = wine & deli meats
entacaPONE & tolcaPONE considerations
derease breakdown of levodopa
dark urine = normal
assess for diarrhea
5 stages of parkinson’s
Stage 1 = unilateral shaking of one limb
stage 2 = bilateral limb movement & shuffling gait
stage 3 = postural instability & slow physical movement *walker
stage 4 = decreased tremors, akinesia & rigidity
stage 5 = dependent & dementia
Nursing care considerations for parkinson’s disease
bite-size food
cold fluids
puree diet
safe environment
thickener to liquids
weigh weekly
