Neuro Diseases Intro & Quick Overview brain & spinal cord M.S. - Multiple Sclerosis Parkinsons Alzhemiers Huntington disease peripheral nervous system M.G. - Myasthenia Gravis A.L.S G.B. - Guillain-Barré Syndrome Highlighted are the Most Tested TEST TIP • NO drugs or interventions will CURE these conditions • We can only treat to prevent progression M.S. - Multiple Sclerosis (autoimmune disease - body attacks itself) Memory Trick: • MS - Myelin Sheath destruction • MS - Muscle Spasm & Stiffness • MS - Mellow out & Stay cool (no sun) Teach: • Balance exercise & rest • AVOID 4 Ss = Trigger Flare Ups • S - Stress (exercise, surgery, injury) Don’t over exercise • S - Sickness or Sepsis - Stay healthy & free from infections • S - Smoking - use smoking cessation • S - Sun & Extreme heat (hot tub, bath, sauna) Pharmacology • IVIG - acts as bait - the body attacks this substance instead of the nerves. • Cyclosporine - immunosuppressive think “CycloSPARIN”- spares the body from attacking itself M.G. - Myasthenia Gravis (autoimmune disease - body attacks itself) Memory Trick: • MG - MYasthenia Gravis • MG - DRY-asthenia Gravity Dry body & Weak muscles - like Loads of Gravity weighing down the body. AVOID the 4 S’s = Trigger Flare Ups (see above) Myasthenic crisis: respiratory arrest! Airway protection (safety with swallowing) • Intubation set up - BEDSIDE • BEFORE meals: Give pyridostigmine (anticholinesterase drug) NCLEX TIP • Encourage semi-solid foods Promote Independence All Neuro Disease Patients Never do All ADLs Gait training 1st - Teach Gait training Then offer Cane, then Walker, last wheelchair Parkinson’s Disease Patho: Low dopamine - HIGH acetylcholine 3 Key Signs for NCLEX 1. Shuffling gait & Decreased arm swinging NCLEX TIP 2. Pill rolling - looks like rolling a pill between fingers 3. Tremors at rest - lots of jittery movements Memory Trick: You can’t jump ROPE if you got low DOP improved movement with more dopamine. Pharmacology • LevoDOPA & CarbiDOPA Leaves more DOPAmine in the body & Carbidopa helps conserve MORE dopamine • AVOID protein - can block absorption Memory Trick: LEAVE the protein with LEVOdopa Huntington Disease Key Point • Passed on by Genetics • Only requires 1 parent! • Recommend Genetic counseling Memory Trick HuntingTON - One parent needed to pass on the disease A.L.S. (Amyotrophic Lateral Sclerosis) • Dysphagia - Difficulty swallowing • Dysphasia - Difficulty speaking • Priority finding - Increased respiratory secretions Pharmacology Neostigmine: given to treat the dry. Think Stigmine adds Secretions. Alzheimer’s Patho: Brain damage resulting in Dementia “daMage to the brain” Signs & symptoms: VERY forgetful & loss of reality Key Point • Safety: NO rugs, LOCK everything • Location: Lock doors leading outside! • Communication: Distract & REDIRECT from reality REdirect any Dementia clients who get easily frustrated G.B. - Guillain-Barré Syndrome Patho: clients get RAPID ascending paralysis from the legs up eventually reaching the respiratory system which ultimately kills the patient! Memory Trick: Ground up barees - paralysis from the legs up Respiratory failure (early signs) • Inability to cough NCLEX TIP • Inability to lift the head or eyebrows NCLEX TIP
