Chapter 14 Care of the patient with neurological disorders

Subjective data for mg

The patient's understanding of the disease, complaints of weakness or double vision, difficulty chewing or swallowing, and any bowel or bladder incontinence

What are the clinical manifestations the early stage of a person with Alzheimer's

The person has a relatively mild memory lapse and may have difficulty using the correct word. The attention span is decreased and there maybe disinterest in surroundings. depression may occur at this time.

Alzheimer's disease

A chronic progressive degenerative disorder that affects the cells of the brain and causes impaired intellectual functioning

Diagnostic test for Alzheimer's disease

A d has no specific diagnostic

Clinical manifestations of mg

An ocular mg the signs and symptoms include ptosis (eyelid drooping) and diplopia( double vision).the patient may complain initially of ptosis and diplopia. Skeletal weakness involving the muscles of the extremities, the neck, the shoulders, hands, and the diaphragm; dysarthria and dysphagia may follow. the vocal cords can become weak and voice can sound nasal

What is MG caused by?

And autoimmune process. It is thought to be triggered by acetylcholine receptor sites at neuromuscular Junction

Objective data includes

Any documented muscle weakness on neurologic testing. Nasal sounding speech may be noted .The Voice often fades after a long conversation and breath sounds diminish. Note prosise of the eyelids and weight loss if there are swallowing problems.

Medical management for Alzheimer's disease

Lorazepam Ativan or haloperidol in small doses may be necessary to lessen agitation and unpredictable behavior.

What antioxidant containing foods are considered to lower the risk of development of Alzheimer's disease

Citrus fruits,dark green vegetables,Tomatoes , brown rice, and foods high in beta-carotene which are sweet potatoes and carrots

What do most patients with Alzheimer's disease die from

Complications such as pneumonia, malnutrition, and dehydration

myasthenia gravis (MG)

Is it autoimmune disease of the neuromuscular Junction characterized by the fluctuating weakness of certain skeletal muscle groups. with mg, no observable structural change occurs in the muscle or nerve. Nerve impulses fail to pass at the neuromuscular Junction(the space between the nerve ending in muscle fiber)resulting in muscle

Clinical manifestations in the third stage of Alzheimer's disease

He or she has total disorientation to person, place, and time. Motor problems such as aproxia (an inability to carry out learned sequential movements on command, perform purposeful Acts, or use objects properly), visual agnosia (an inability to recognize objects by sight), and dysgraphia (difficulty communicating via writing) interfere with the ability to carry out daily functions. wandering is coming.

What to assess for with Alzheimer's disease

Memory loss is the first symptom usually notice combined with the inability to carry out normal activities. It is important to rule out other conditions such as pernicious anemia, drug reactions, depression, or hormonal imbalances.

Early warning signs of Alzheimer's disease

Memory loss that describes daily life, challenges in planning or solving problems, difficulty completing familiar tests at home, confusion with time or place, trouble understanding visual images and spatial relationships, new problems with words and speaking or writing, misplacing things and losing the ability to retrace steps, decreased or poor judgment, withdrawal from work or social activities, changes in mood and personality

Nursing interventions for Alzheimer's

Nursing interventions are directed toward maintaining adequate nutrition. Providing finger foods and letting the patient eat while walking may help. Frequent feedings with high nutritive value are important. Encourage fluids of at least 2000 ml per day. Measures that family can take include removing burner controls from the stove at night, double locking all doors and windows, and keeping the person under constant supervision.

What does changes in the brain of patients with alzheimers disease include

Plaques in the cortex, neurofibrillary tangles (a tangled mass of non-functioning neurons),loss of connections between cells, and cell death. this neurological damage occurs primarily in the cerebral cortex and causes a decrease in brain size

What activities could one engage in that require information processing and would help have a lower risk of developing Alzheimer's disease

Reading, learning a new language, and doing crossword puzzles

What activities thoughtout the life span might decrease the risk of developing Alzheimer's disease

Regular physical activity,leisure activities, and educational achievements

The terminal stage of Alzheimer's disease

Severe mental and physical deterioration is present. Total incontinence is common.

Memantine

The first drug approved for treatment of moderate-to-severe AD. Memantine does not prevent or slow neurodegeneration, but it was found in clinical studies to slow symptom progression.

What are the clinical manifestations in the second stage of Alzheimer's

The person has more obvious memory lapse, especially with search short-term memory, and usually is disoriented due to time. Loss of personal belongings is common, as is confabulating to explain the loss of memory. Patients may lose their ability to recognize familiar faces, places, and objects and may get lost in a familiar environment. loss of impulse control is coming. behavioral manifestations such as agitation, repetitiveness ,wandering, resting care results from changes in the brain

Diagnostic test for mg

The simplest diagnostic test for mg is to have the patient look up word for 2 to 3 minutes. If the problem is mg, the eyelids will droop so that the person can barely keep the eyes open. The diagnosis can be made partly on the basis of EMG. The IV anticholinesterase test is a reliable diagnostic test.

What are exacerbations of mg initiated by

Upper respiratory tract infections, emotional tension, and menstruation

Sundowning

When the patient becomes more confused and agitated in the late afternoon or evening

Psychotic manifestations

delusions, Illusions, hallucinations