Flashcards in Test #1 Chapter 46 Care of patients with problems of the peripheral nervous system Deck (20):
mobility and sensation problem. Acute inflammatory demyelinating polyneuropathy that affects the peripheral nervous system causing motor weakness and sensory abnormalities.
Ascending paralysis might start out not being able to walk and travels to be complete paralysis.
Key features of Guillain-barre syndrome,
ascending symmetric muscle weakness, flaccid paralysis without muscle atrophy.
Decreased or absent deep tendon reflexes.
Respiratory compromise, dyspnea, diminished breath sounds, decreased tidal volume and vital capacity and respiratory failure.
Loss of bladder and bowel control (less common)
Sensory manifestations, paresthesia, pain, cramping
Cranial nerve manifestations, facial weakness, dysphasia, diplopia, difficulty speaking.
Autonomic manifestations, labile blood pressure, cardiac dysrhythmias, tachycardia.
Factors associated with development of Guillain-barre syndrome,
upper respiratory infection,
Nursing interventions for Guillain-barre syndrome,
CSF, lumbar function, protein increased but not white count.
Plasmapheresis, like dialysis but it removes antibodies that they feel are attacking the Mylein sheath, hypertension and tachycardia are the main concerns during and after plasmapheresis
Recovery is very slow
acquired autoimmune disease characterized by fatigue and weakness primarily in the muscles.
Auto antibody attack on the acetylcholine receptors, nerve impulses are not making it to the muscle. Worried about breathing. Think it is related to enlarge thymus.
Correlation between hyperplasia and the thymus gland
Myasthenia gravis diagnostic assessment,
lab for acetylcholine antibodies 90% will have elevated levels.
Tensilon testing, try to check the body into working. Doctors give med through the IV that prevents acetylcholine from breaking down. They can move for a few minutes, then it wears off. They can go into VFIB because of the medicine, have to give atropine to counteract the tensile to fix the problem. Need to be hooked to a heart monitor during the test.
Drug therapy, real important,
give immunosuppressive's to calm the body from attacking The acytlcholine receptors.
Give and teach to avoid crowds.
Give meds one hour before eating to prevent aspiration.
not enough of the medication in their system.
Getting sick can throw them into this crisis.
Causes muscle issues and not being able to breathe.
Interventions are based on the patient's reactions.
Need more meds, and may need to be intubated.
too much medication on board, give atropine which is the antidote.
cut the chest open, go in, remove the thymus.
They avoid deep breaths but need to be encouraged to use the incentive spirometer and to cough and deep breathe.
Worry about the airway and about infection with these patients.
Restless leg syndrome
leg paresthesias which with the irresistible urge to move.
Peripheral and Central nerve damage in the legs and in the spinal cord.
Nursing interventions for restless leg syndrome
avoid caffeine and alcohol, no smoking, exercise, weight loss.
Caffeine and alcohol can cause hydration issues and smoking causes vasoconstriction.
Drug therapy is Lyrica.
affects the trigeminal or fifth cranial nerve
Etiology of Trigeminal neuralgia,
impaired inhibitory mechanisms in the brain stem. This causes brainstem issues, signals get messed up, chronic pain, typically starts in 50 or older.
This is a chronic pain syndrome of the face. Teach the patient to use eyedrops at night, do not sleep on that side, eat on the good side.
Drug therapy for Trigeminal neuralgia,
Tegretol, and neurontin, so cannot drink alcohol will make too drowsy.
Percutaneous stereotactic rhizotomy,
destroys nerve fibers that are causing the pain. The entire nervous not destroyed just the irritated park.
Surgical management microvascular decompression
more serious surgery, craniotomy, reroutes the artery from the nerves. ICU Postoperative.
disease of the cranial nerve number 7, causes acute paralysis unilateral.
Eitiology of Bells Palsy
implement inflammatory process triggered by herpes of the mouth.