chronic neuro problems 3 Flashcards Preview

MedSurg > chronic neuro problems 3 > Flashcards

Flashcards in chronic neuro problems 3 Deck (20)
Loading flashcards...
1
Q

amyotrophic lateral sclerosis (ALS)

A
  • rare progressive neuro disorder characterized by loss of motor neurons
  • Lou Gehrig’s dz
  • men:women 2:1
  • onset between 40 and 70
2
Q

cause of ALS

A

motor neurons in the brainstem and spinal cord gradually degenerate

3
Q

s/s of ALS

A
  • weakness of the limbs
  • dysarthria (language)
  • dysphagia, drooling
  • muscle wasting and twitching
  • pain
  • sleep dx
  • spasticity
  • depression
  • constipation
  • esophagial reflux
4
Q

diagnosing ALS

A
  • H/P
  • PE
  • EMG
5
Q

drugs used in ALS

A

CNS agent/glutamate antagonist: Rilutek

  • slows the progression of ALS
  • no cure
6
Q

nursing interventions in ALS

A
  • facilitate communication
  • risk for aspiration
  • early ID of respiratory insufficiency
  • decrease pain from muscle weakness
  • reduce risks of injury
  • support
7
Q

dementia

A
  • syndrome characterized by dysfunction or loss of:
  • memory
  • orientation
  • attention
  • language
  • judgment
  • reasoning
  • personality and behavioral problems
  • neurodegenerative and vascular causes
8
Q

diagnosing dementia

A

2 or more brain functions are significantly impaired

9
Q

delirium

A
  • state of temporary but acute mental confusion

- common, life threatening, and possible preventable

10
Q

causes of delirium

A
  • cholinergic deficiency
  • excess release of dopamine
  • increased and decreased sertonergic activity
11
Q

s/s of delirium

A
  • early: inability to concentrate, loss of appetite, restlessness
  • late: agitation hallucinations
  • give Haldol
12
Q

Alzheimer’s Dz (AD)

A
  • chronic, progressive, degenerative disease of the brain
  • family vs sporadic
  • genetic and environmental factors
13
Q

changes in the brain structure and function in AD

A
  • amyloid plaques
  • neurofibrillary tangles
  • loss of connections between neurons
  • neuron death
14
Q

s/s of AD

A
  • memory loss that affects job
  • difficulty performing familiar tasks
  • language problems
  • disorientation to time and place
  • poor judgment
  • problems with abstract thinking
  • misplacing things
  • changes in mood or behavior
  • changes in personality
  • loss of initiative
15
Q

mild stage of AD

A
  • forgetfulness beyond what is seen in a normal person
  • short term memory impairment, especially for new learning
  • loss of initiative and interests
  • may forget recent events or the names of people or things
  • small personality changes
  • unable to solve simple math
  • slowly lose the ability to plan and organize
16
Q

moderate stage of AD

A
  • memory loss and confusion become more obvious
  • has more trouble organizing, planning, and following directions
  • may need help getting dress
  • may start having incontinence
  • trouble recognizing family members and friends
  • agitation, restlessness
  • may lack judgment and being to wander
  • difficulty sleeping
  • delusions, hallucinations, paranoia
  • behavioral problems
17
Q

severe stage of AD

A
  • severe impairment of all cognitive functions
  • little memory, unable to process new info
  • unable to do self care
  • often needs help with daily needs
  • may not be able to talk
  • cannot understand words
  • difficulty, eating, swallowing
  • may not be able to walk or sit up without help
  • immobility
  • incontinence
18
Q

retrogenesis

A

degenerative changes occur in the reverse order in which they were acquired
-adult back to baby

19
Q

diagnostic studies for AD

A
  • H/P
  • CT, MRI, PET, MRS
  • neuropsychologic testing
  • biomarkers
  • definitive dx: autopsy
20
Q

drug tx for AD

A
  • aricept, exelon
  • namenda
  • zoloft, celexa
  • haldol