Unit 7 40 Amyotrophic Lateral Sclerosis

Question 1

What is amyotrophic lateral sclerosis*(ALS)

Answer 1

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

Question 2

S/S OF ALS

Answer 2

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

Question 3

Normal range for lactic acid

Answer 3

0.5-1.0

Question 4

What is the function of lactic acid?

Answer 4

indicator of muscle breakdown

Question 5

Is there a tx or cure for ALS?
A. No
B. Yes

Answer 5

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

Question 6

How is ALC dx

Answer 6

Diagnosed through ruling out other causes and EMG and muscle biopsy

Question 7

What is the prognosis for ALS?

Answer 7

3 YEARS FATAL DISEASE

Question 8

Is palliative care needed for clients with ALS?
A. Yes
B. No

Answer 8

A. Yes
due to poor prognosis , they will need palliative care consult, hospice

Question 9

Should the client wil ALS need mechanical vetilation?
A. yes
B. no

Answer 9

yes. due to wasting of the respiratory muscle will need to be placed on mechanical vent

GI PROHYPLAXIS

Question 10

Nursing Care and Comfort for client with ALS

Answer 10

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

Question 11

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

Answer 11

A. Palliative consult

 Palliative care for symptom management at end of life
 End of life – have affairs in order

Question 12

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

Answer 12

B.Riluzole

Riluzole (Rilutek) (extends survival time-SLOWS DETERIATION OF NEURONS)- liver toxic(

Question 13

riluzole

Answer 13

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