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