Chapter 69

Most common PT with MS

20-40 yr old Women

Recovery time for Bells palsy

3-5 weeks

S&S of GBS

Ascending paralysis, Respiratory distress, issues with facial nerves

Guillian-Barre Syndrome (GBS)

Autoimmune attack of the PNS and some cranial nerves (myelin sheath) Goes away

MS medications

BETA INTERFERON decreases immune system response (risk for infections) Avonex, rebif, betafiron Corticosteroids helps inflammation of CNS Oxybutynin anticholinergic to help with overactive bladder OR bethanechol Cholinergic to help empty the bladder

ALS

Death of motor neurons that leads to progressive muslce weakening

Parkionson's Disease (PD)

Decreased levels of dopamine from degeneration of dopamine neurons in the substantia nigra

S/S of MS

Depends on the area of lesions (cerbellar, optic nerve) periods of remission/relapse very drained speech issues issues with mood trempors/spasm/clumsy, numbless and tingling cognitive/sensory issues/vision issues/elimination issues

Trigemnial Neuralgia

Disorder of the 5th cranial nerve leads to facial pain can lead to dysphagia

Bell's Palsy

Facial paralysis caused by inflammation of the 7th cranial nerve (Facial nerve)

Levodpa contraindications

Narrow angle glaucoma Angina TIA Melonoma Reglan MAO high protein

MS nursing interventions

Prevent s&s through education exercise helps depression (take it easy) like swimming promote safety through assistve devices assess for dysphagia encourage fluids (kidney stones) increase fiber, possible stool softeners

Myasthenic Crisis

Result of MG exacerbation Severe generalized weakness/ respiratory failure

GBS progression

Symetrical Ascending weakness that leads to paralysis, peak symtoms at 2 weeks myelenazation eventually reoccurs

medical tx for PD

levadopa

The primary arthropod vector in North America that transmits encephalitis is the

mosquito

Pathophys of MG

overactive thymus in adults secretes antibodies that destroy receptor sites on the motor endplate for ACH to bind- results in insufficient ach

A frontal lobe brain abscess produces which manifestation?

seizures

During the recovery phase of a neurologic deficit, assessment tools may be used to help identify a client's level of functioning. Which tool is used to measure performance in activities of daily living (ADL)?

the Barthel index

s&s of PD

tremors, bradykinesia, rigidity Pill rolling

test for MG

acetylcholinesterase inhibitor test

dyskinesia

difficult movement

multiple sclerosis (MS)

Autoimmune disease that affects the myelin sheath of the CNS Causes inflammation and scarring of the neuron MS Myelin Sheath

Cholinergic Crisis

Caused by overmedication with cholinesterase inhibitor med Same symptoms as Myasthenic crisis

What neuro disorder usually has a preciptating event 2 weeks before the onset of symptoms?

GBS

GBS acronym

Gradual Block of Sensation

Tx of GBS

IVIG or plasmapharesis within 2 weeks of s&s Catheter, Intubate, TPN/NG, "wait the storm out"

Nursing signs for MS

Rhombergs, Lhermittes (electric shock sensation) Uhthoffs sign ( Heat makes symptoms worse)

kernigs sign

a diagnostic sign for meningitis marked by the person's inability to extend the leg completely when the thigh is flexed upon the abdomen and the person is sitting or lying down

Myasthenia Gravis (MG

autoimmune disease that attacks the neuro muscular juntion (NMJ) Characterized by weakness of voulantary skeletal muscles

tx for trigeminal neuralgia

carbamzepine (tegretol) anti seizure meds

disphonia

difficulty producing speech sounds, usually due to hoarseness

clinical manifestations of MG

diplopia, ptosis, generalized muscle weakness

diplopia

double vision

Which is the most common cause of acute encephalitis in the United States?

herpes