Alzheimer’s Disease Covered in chapter 47 Unknown cause Can only be detected with an autopsy Slow onset, progresses at varying rates of speed through several stages, and eventually fatal
Amyotrophic Lateral Sclerosis (ALS) aka Lou Gehrig’s disease Etiology and pathophysiology: › Progressive degeneration of the gray matter › Electrical and chemical messages can’t reach muscles to activate them › Death within 3 years usually Signs and symptoms: › Progressive weakness to the point of atrophy of the voluntary muscles › Remains mentally alert with no sensory impairment › Mental depression
Amyotrophic Lateral Sclerosis Diagnosis: › No confirmatory laboratory test › Electromyelography and muscle biopsy Treatment: › No cure › Supportive care ADLs Eventually need trach and ventilator Planning with family signals acceptance
Guillain-Barré Syndrome (GBS) Etiology and pathophysiology: › Affects the peripheral nervous system › Unknown cause but usually follows viral respiratory infection or gastroenteritis with 10-21 days › Pathologic changes include Demyelination, inflammation, edema, and nerve root compression which lead to: Paresthesia, pain, progressive ascending paralysis
Guillain-Barré Syndrome (GBS) Signs and symptoms: › Progressive muscle weakness usually starting in the extremities and moves medial in 24-72hrs › Numbness and tingling in feet and hands › Hyperesthesia : Abnormal sensitivity to stimuli › Pain Diagnosis: › Mimics many other neuro diseases and mostly depends on clinical presentation › CSF analysis › Electromyography (EMG) and nerve conduction show reduced conduction velocity
Guillain-Barré Syndrome (GBS) Treatment: › Plasmapheresis: pt’s plasma removed and “washed” to remove antibodies and their “heathy” cells given back to them once cleaned › IV immune globulin › Nutritional support d/t dysphagia TPN or tube feedings
Nursing Management of Guillain- Barré Syndrome (GBS) Monitor progression of ascending paralysis. Assess respiratory function. Assess gag, corneal, and swallowing reflexes. Observing vital signs. Watch for orthostatic hypotension and cardiac dysrhythmia.
Guillain-Barré Syndrome: Evaluation Acute phase: › Sustain life › Prevent complications related to immobility › Promote rest and comfort Static phase: › Plateau usually reached in 1-3 weeks after onset › This phase may last days to months › Motor loss and paresthesia no longer progress › No better or no worse = stabilized › Balance of rest and exercise
Guillain-Barré Syndrome: Evaluation Rehabilitation phase: › Gradual recovery ›
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- Fall '19
- Neurology, Myasthenia gravis