Term
| when are cognitive changes seen in MS |
|
Definition
|
|
Term
| what is the lab findings in one with MS |
|
Definition
abnoraml csf with elevated protein and wbc
IgG bands are also seen in those with MS |
|
|
Term
| progressive mltifocal leukoencephalopathy whend oes it occur/ what are the s/s and how is it confirmed |
|
Definition
this is a viral infection that leads to death or sever disbility with MS
look for neuerological changes like disrientation and confusion it is confirmed by mri |
|
|
Term
| what are some self manegment techniques with MS |
|
Definition
avoiding stress
extreme temp
and people with infecitons |
|
|
Term
| ALS (amyotropic lateral scleosis also lou gehrigs disease when does it occur and what is it characterized by |
|
Definition
adult onset
progressive weakness and msucle wasting leading to paralysis |
|
|
Term
| where does als begin and when can death occur |
|
Definition
| begins inone area of the body and spread until the entire body is involved death usually can occur in 3 years |
|
|
Term
| what are some early manifestations of als |
|
Definition
tongue atrophy
twitiching in the face
slurred speech and fatigue |
|
|
Term
| what is increased in the labs with ALS |
|
Definition
creatine kinase
muscle biopsy will show atropic fibers |
|
|
Term
|
Definition
| used for those with als it is not a cure but extends survival time |
|
|
Term
| CHAPTER 46 PERIPHERAL NERVOUS SYSTEM |
|
Definition
|
|
Term
| what are the 3 groups that acquired neuropathies are grouped into |
|
Definition
| inflammatroy, taumatic, and systemic |
|
|
Term
| inflammatory neuropathies can affect |
|
Definition
| the entire peipheral nervous system |
|
|
Term
| trigeminal neuralgia is a type neurapathy cuase dby |
|
Definition
| damge to a single nerve like trimengeminal nerve |
|
|
Term
| what are some systemic neuropathies |
|
Definition
| diabetic and chemo induced |
|
|
Term
| guillian barre sundrom si an acute inflammatory demylnating polyneuropathywho does it affect |
|
Definition
| both genders peaks after 55 |
|
|
Term
| guillian barre sundrom si an acute inflammatory demylnating polyneuropathywho does it affect |
|
Definition
| both genders peaks after 55 |
|
|
Term
|
Definition
| destruction of the myelin sheath |
|
|
Term
| where do symptoms for guillian barre begin |
|
Definition
| leg and spread to the arms- acending paralysis |
|
|
Term
| how does healing with guillian barre occur |
|
Definition
| in revers the neurons affected first are the last to recover |
|
|
Term
| guillkian barre what do pt report feeling |
|
Definition
|
|
Term
| on microscopic examination what is seen with guillian barre |
|
Definition
| groups of lymphocytes are seen at the points of the myelin breakdown but the axons remian intact |
|
|
Term
| what are the 3 stages of acute guillian barr |
|
Definition
1-4 week with the onset and ends whjen no further detrioration occurs
plateu period (days to weeks)
recovery phase (remyelination) |
|
|
Term
| what does the pt often report 3 wks before guillian barre |
|
Definition
| acute illness trauma surgery |
|
|
Term
| what can guillian barre do to the mind and what cranial nerve is affected |
|
Definition
| typically it does not affect the loc cerbral function or pupillary constriciton if there is cranial nerve involvement it is usually VII (facial) |
|
|
Term
|
Definition
| weakness of the face and muscles of the jaw that affect sternocleoidmastoid muscles then the tongue it then progresses down to the extremities |
|
|
Term
| asses cranial nerve VII in GBS for |
|
Definition
|
|
Term
| if a pt has an inability to cough gag or swallow what nerves are involved |
|
Definition
|
|
Term
| bradycardaia asystole and autonamic dysfunciton are associated with what cranila nerve |
|
Definition
|
|
Term
| asking the pt to shrug their shoulders is assesing for what cranila nerve |
|
Definition
|
|
Term
| what is seen in the csf of those with guillian bare |
|
Definition
| increased protein from inflammation degeneration |
|
|
Term
| what are three treatments used with guillian barr |
|
Definition
plasma exchange
iv immunoglobin
cerebrospinal fluid filtration |
|
|
Term
| what is typically not used with guillian barre |
|
Definition
|
|
Term
|
Definition
| this removes the circulating antibodies the blood cells are replacedwithout the plasma |
|
|
Term
| what should be checked for plasmapheresis |
|
Definition
shunt patency
asess for bruits
keep double bulldog clamps at bedside |
|
|
Term
| both para and sympathetic nerves may be affected with guillian barr so what may be needed to monitor and what is used to treat |
|
Definition
| heart so plave them on a monitor use atropine for brady and beta blockers for hypertension |
|
|
Term
| ROM exersices are provided every 3 to 4 hours who is delagated to this |
|
Definition
|
|
Term
| to prevent skin breakdown in those with guilian barr who is assinged to turn the pt |
|
Definition
|
|
Term
| why would a pt with guliian barr be on lovenox |
|
Definition
| deep vein thrombosis and emboli risks for immobility |
|
|
Term
| what is usually prescrived for pain in guillian barre |
|
Definition
|
|
Term
| myastheinia gravis what is it characterized by |
|
Definition
| weakness and fatigue in the muscles in the cranila nerves |
|
|
Term
| myastheenia gravis can occur at any age and has remisisons and exacterbations what happens at the junctions and nerve impulses |
|
Definition
| the muscle junction and the neromuscular junction can not contact eachother |
|
|
Term
| what relationship is related to myastehmia gravis |
|
Definition
| overgrown thymus gland or a thymoma |
|
|
Term
| how is the muscle weakness descrbied withmyasthemis gravis |
|
Definition
| weakness increases as the day wears on and improves with rest |
|
|
Term
| what are three things to ask when a pt is thought to have myastheia gravis |
|
Definition
|
|
Term
| what would you look at the pts face with myastheia gravis |
|
Definition
facial expression
smile
jaw may hang |
|
|
Term
| what will a pt with myastheia gravis voice sound like |
|
Definition
| voice will become weakened and exhibit a nasal twang |
|
|
Term
|
Definition
| a form of myastheia gravis seen wih small cell carcinoma of the lung and muscles of the trunk and pelvic and shoulder girdles are most commonly affected |
|
|
Term
| why should thyroid function be tested in those with myastheia gravis |
|
Definition
| becuase those with this desiase may producetoo mch thyroid hromones |
|
|
Term
| what testing for antibodies is done for those withmyasthesia gravis |
|
Definition
| acetylcholine recpetor antibodies if its positive it confirms the diagnosis |
|
|
Term
| tensilin testing is used for testing for MG because it is rapid, what does this drug do and how is it used for testing |
|
Definition
| it inhibits the breakdown of ACh at the postsynaptic membrane - most myasthenic pts show improvement in muslce tone |
|
|
Term
| cholinergic crisis/ myasthenic crisis |
|
Definition
| too much cholinerterase inhibotr/ too little inhibitor |
|
|
Term
| what should be present during a tensilin test and why |
|
Definition
| atropine sulfate this is the antidote for this test becuase it can cause v fib and cardiac arrest |
|
|
Term
| what are the 2 groups of drugs used for MG |
|
Definition
| abticholinerterases and immunosuppressants |
|
|
Term
| the first line of mg manegment is cholinerterase inhibitors, which one is the choice one to use |
|
Definition
|
|
Term
| why should the pt who takes pyridostigmine do when taking this med |
|
Definition
| take after meals to avoid aspiration |
|
|
Term
| a pt has sudden increase in weakness, can not clear secretions, swallow or breath what do these s/s indicate |
|
Definition
| cholinergic crisis due to potenital side effect of chE inhibitors |
|
|
Term
| myasthenic crisis/ cholinergic crisi |
|
Definition
| exacerterbation of myasthenic symptoms/ acute exacerterbation of muscle weakness |
|
|
Term
| myasthenic crisi is caused by an infection or overdose of anticholinergic what is the priority and why? what should not be given during this crisis |
|
Definition
respiratory funciton/
give atropine 1 mg
watch airway because the secreations may notbe cleared as well with this drug. do not give anticholinerterase drugs |
|
|
Term
what are some interventions to do with MG
4 |
|
Definition
swallow and gag reflex
artificial tears cover eyes with eye patches
letter picture board |
|
|
Term
| what may have to be removed with MG |
|
Definition
|
|
Term
| what are some lifestyle adaptions to MG 5 |
|
Definition
avoiding heat
crowds
sleep habits
drug regimen |
|
|
Term
| what are some drug regimens to keep in mind for MG |
|
Definition
do not take OTC
plan strenuous activites when possiblities |
|
|
