Term
Delpolarization
Repolarization
junction between neurons
Synaptic Cleft
Postsynaptic membrane |
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Definition
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Term
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Definition
Myselin Sheath Disruption and transmission problem
Autoimmune- Doesnt recongnize self
Prog demyelinization of neurons.
Central Nervous System
Sx begin with eyes (blurry, double or blind- may go away).
20-40 yrs, F>M
Ag : Ab response - T cells |
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Term
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Definition
thought- Mercury was cause- baby shampoo
Virus, infection, cold climate, Temp extremes, physical injury, stress, pregnancy, fatigue, overexertion, Hot shower/bath |
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Term
| MS Diagnostics and Assessment- |
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Definition
MRI brain and spine
Placques-
CSF analysis- elev Protein, slight elev WBC
Symptoms- vague non specific
Muscle weakness, spasticity
Disturbed sensory (vision) perception
Impaired mobility
Chronic pain |
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Term
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Definition
neurotransmitter Acetylcholine is present
Receptor sites go away
Tensalon Test- Prevents breakdown of Acetylcholine.
Anticholinesterase Acetylcholine more abundant. Should see neuromuscular improvement. Binds with available receptors.
Autoimmune at synnapses in vol muscles.
More peripheral
F>M
20-40 and 60-70
End up with breathing Issues ! |
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Term
| Myasthenia Gravis- Triggers |
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Definition
Infection, stress, fatigue, cathartics )habitual use of laxatives)
Heat- sauna, hottubs, sunbathing) |
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Term
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Definition
baseline crainal muscle strength
IV dose of Tensilon
marked muscle strength improvement for 5 minutes +
+ results if given to a client w myasthenic crisis |
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Term
| misc. info Myasthenia gravis- |
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Definition
Thymus gland- T cells for Immunity- remove
Concerns Breathing-patent airway, Swallowing, Aspiration, Pneumonia, Impaired Mobility PT OT Allow for rest, nutrition-sm. freq high calorie meals, swallow eval, constipation, decreased verbal communication- ST
Plasmaphoresis- Remove WBCs
monitor- I&O, alb, daily wt. |
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Term
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Definition
lmuran- flu sx
prednisone0- raises blood sugar
Monitor for infection
Taper Rx gradually
Cholinesterase inhibitor Mestinon give w food (Prevents acetylcholine from breaking down).
check theraputic levels
Check |
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Term
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Definition
Acute Emergency!
Esacerbation of respiratory muscles
triggers- infection, stress, surgery lack of scheduled anticholinesterase medication administration.
** give Mestinon on time !!! |
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Term
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Definition
Degenerative- CNS- PNS
Dopaimine too low. shuffle, unsteady.
Parkinsonian or Cog wheel shuffle. slow- get faster. happens w/ antipsychotics and triclyclic antidepressants.
M>F
PET scan- shows where dopamine is. |
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Term
| Parkinsons Disease- Symptoms- |
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Definition
stooped posture
slow shuffling and propulsive gait.
tremor, muscle ridigity, bradykinesia, difficulty chewing and swallowing. difficulty with ADLs progressively.
Mood swings, cognitive impairment.
blank stare, drooling |
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Term
| Parkinsons Disease- assess |
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Definition
On: Off Medication- Levodopa not avail-
Look in Lehne
swallowing
Nutrition/ hydration
cognitive
depression
family copeing
Carvodopa may loose effectiveness. |
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Term
Parkinsons Disease-
therapeutic proceedures- |
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Definition
sterotactic pallidotomy
neurostimulator- mild elec stim thru a burr hole
asses for decrease in tremor/ rigidity
Deep Brain Stimulation- electrone to thalamus
Currently delieverd thru implanted pacemaker generator. |
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Term
Parkinsons Disease-
Medications- |
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Definition
Several weeks to work
Dopamine replacements- levodopa, carbidiopa together increases effectiveness.
Dopamine agonists- Pradodel/Mirapex- watch for ortho htn and hallucinations
Anticholinergics- Cogentin or Artane to control tremors and rigidity. |
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Term
Parkinsons Disease-
interventions- |
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Definition
patent airway and suction
ABGs O2, IPPB (intermittent + pressure breathing)
vent, HOB 45 degress, TCDB q 2 hrs, IS
swallow, reflex, safe oral intake.
nutrition,
Allow energy conservation. |
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Term
| Amyotrophic Lateral Sclerosis ALS = Lou Gehrigs Dz. |
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Definition
Autoimmune
Spinal cord in spinal tract
Central
Ant. horn motor deficiet.
Paralysis ! |
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Term
| Amyotrophic Lateral Sclerosis ALS = Lou Gehrigs Dz. labs |
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Definition
CPK, CK, Muscle Biopsy- atrophy
serial muscle testing for loss of muscle strength |
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Term
| Amyotrophic Lateral Sclerosis ALS = Lou Gehrigs Dz. Symptoms |
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Definition
Muscle weakness, hands and arms esp.
fatigue, dysphagia (swallowing) Dysarthria (speech)
Reflex bowel and bladder |
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Term
| Amyotrophic Lateral Sclerosis ALS = Lou Gehrigs Dz. Medications- |
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Definition
Riluzole- extends survival time (high hepatic risk)
antispasmotics-
Baclofen- Lioresal
dantrolene- Dantrium
diazepan- Valium |
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Term
| Amyotrophic Lateral Sclerosis ALS = Lou Gehrigs Dz. Nursing considerations |
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Definition
patent airway
resp status
swallow ability
speech patterns fatigue with talking
skin integrity |
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Term
| Amyotrophic Lateral Sclerosis ALS = Lou Gehrigs Dz. Complications |
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Definition
Pneumonia- resp muscle paralysis, assess often, antibiotics
Resp failure- Mech vent,
assess often, provide vent support prn. |
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Term
Guillian-Barre Syndrome-
disease process |
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Definition
Autoimmune- attacks Peripheral nerve myelin- rapid dymyelinization
produces resp failure, parasthesias, pain, diminished or absent reflexes, starting with legs progressing up. Cranial nerve symptoms, tachycardia, bradycardia, htn, hypotension. |
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Term
Guillian-Barre Syndrome-
medical management |
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Definition
intensive care management constant monitoring and resp. support.
Plasmaphersis & IVIG are used to reduce circulating antibodies. - stops B cells turning into T cells. Frequent |
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Term
Guillian-Barre Syndrome-
Concerns |
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Definition
Airway, gas exchange, Mobility, verbal
ongoing assess for resp failure, dysrhythmias, DVTs.
check changes in vital capacity and neg inspiratory force.
Assess VS and ECG continuously, |
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Term
Guillian-Barre Syndrome-
Complications |
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Definition
Resp failure
autonomic dysfunction
DVTs- ROM 2 X day, turn q 2, hydrate,
PE
Urinary retention
nutrition- TPN, PPN
aspiration- check gag and swallow to prevent/ |
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