Unit 7 40 Amyotrophic Lateral Sclerosis Flashcards
What is amyotrophic lateral sclerosis*(ALS)
amyotrophic lateral sclerosis (ALS) A progressive neurodegenerative disease that affects neurons in the brain and spinal cord that is likely caused by genetic mutations.
SUDDEN ONSET AND PROGRESSIVE
AKA Lou Gehrig’s Disease
S/S OF ALS
Fatigue
Muscle atrophy (including tongue)
Muscle weakness
Twitching of face and tongue
Dysarthria
(loss of speaking eating breathing)
Dysphagia
Stiff and clumsy gait
Abnormal reflexes
Usually the first muscles affected are those in the arms and legs – it’s ASYMETRIC
Normal range for lactic acid
0.5-1.0
What is the function of lactic acid?
indicator of muscle breakdown
Is there a tx or cure for ALS?
A. No
B. Yes
A. No
- Commonly seen in ages 40-70 * Affects men more than women * Cause is primarily unknown
- No established treatment or cure. 100% fatal. Typically die within 3 years of diagnosis d/t
pneumonia
How is ALC dx
Diagnosed through ruling out other causes and EMG and muscle biopsy
What is the prognosis for ALS?
3 YEARS FATAL DISEASE
Is palliative care needed for clients with ALS?
A. Yes
B. No
A. Yes
due to poor prognosis , they will need palliative care consult, hospice
Should the client wil ALS need mechanical vetilation?
A. yes
B. no
yes. due to wasting of the respiratory muscle will need to be placed on mechanical vent
GI PROHYPLAXIS
Nursing Care and Comfort for client with ALS
Focused on quality of life –
Tx of symptoms & rehabilitation measures
START EARLY - prevent immobility complications
Riluzole (Rilutek) (extends survival time-SLOWS DETERIATION OF NEURONS)- liver toxic(
Edaravone - IV infusion
Antispasmodics – Valium; Dantrium Pain control –NSAIDS; Tramodol (Ultram)
Remember SENSORY pathways are intact.
Antidepressants
Nutrition
Psychosocial support
Palliative care for symptom management at end of life
End of life – have affairs in order
What consult would you anticipate the provider to order for a client who has reached the 3 year mark? of ALS and is on a mechanical ventilator?
A. Palliative consult
B. Physical therapy consult
C. Cardiaologist consult
D. Geriatric consult
A. Palliative consult
Palliative care for symptom management at end of life
End of life – have affairs in order
Your client who has been taking medication for ALS has noticed grey stools and yellowing of his eyes and hands. Which medication would you suspect to have this adverse reaction?
A. Keterolac
B.Riluzole
C. Diphenhydramin
D. Aspirin
B.Riluzole
Riluzole (Rilutek) (extends survival time-SLOWS DETERIATION OF NEURONS)- liver toxic(
riluzole
One approved drug to slow disease (riluzole [Rilutek])
Supportive care to promote optimal function
Palliative care for symptom management at end of life Psychosocial support
LIVER TOXIC
