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GBS- Gullan Barre Syndrome

Attack PNS
attacks myelin sheate
ascending paralysis
respiratory depression
viral infection
can be recovered from as long as proper management and tx is done
ascending muscle weakness and paralysis
diminish reflexes
progressive loss of function
muscle tone is same no atrophy
parasthesia- numbness lower extremities
chest physiotherapy and spirometry done with RD
mechanical ventilator last resort
difficulty of swallowing-intravenous replacement
improve communication- writing, pointing out parts and characteristics of
pain
address anxiety and stress- proper education,
RD: give IV immunoglobulin, IV fluids, ICU
Plasmapheresis- dialysis- one vein one artery on brachial it suctions blood
and separates plasma and return the other particles

Multiple Sclerosist cells attack myelin sheate causing sclerosis plaque formation
upon perfrming dx lessons is evident
Attack CNS
several highly sentesize t cells attacking myelin sheate
most common affected area is the chiasm optic nerve responsible with eye
vision
cerebrum- major biggest part for auditory and higher order thinking
cerebellum- affecting respiratory center
s/sx- visual problem such as diplopia, blurry vision, irregular improper
contraction of muscle in optic nerve: nistagmus
motor disfunction, weakness and body malaise, mood swings, spasticity over
contracting
Dx test: Mri and Ct scan
Mri is primary dx tool. seeing multiple plaques
CSF immunoglobulin G is elevated
it tries to compensate
CSF is used
Descending paralysis- respiratory depression

anticipate insertion of intubation tube


impaired physical mobility- perfume ROM PROM
Swimming and cycling good exercise with multiple sclerosis
schedule activity with rest period
preventing injury includes decreaseding muscle weakness and paralysis
modify environment
enhance bladder and bladder control. occupational therapist fine motor
movement
give client high fiber diet and high fluid intake to promote peristalsis
condom catheter less infection
-Manage speech
-cognition and auditory and reasoning is impaired
-use eye patch to exercise
-give large printed
-strengen emotional and how to manage disease
-improve self care abilities
- promote sexual functioning
interferon alpha
-disentesize highly sensitize t cells
resulting decreed damaged in the neuron
-depressed immune function
-corticosteroid further immune suppress
-baclofen drug of choice for muslce spasm
-nsaids for pain

AD Alzheimers Disease
-common with old people
-progressive neurologic disorder
-irreversible
-alter or lessen disease
-cognitive impairement
-cause by amiloid plaques
-reduction
5 symptoms of early s
1. forgetful
2. resent memory loss
4. deteriorating personal hygiene
5. inability to concentrate
late signs
1. difficulty in abstract thinking

2.
3.
4.
5.

difficulty communicating
severe deterioration in memory language and motor function
repetitive action perceveration
personality changes

risk for infection


imobile-thrombus fomation
nutrition imbalance- can swallow
DX exam
PET SCAN
CT SCAN
MRI
autopsy most definitive
Drug therapy
1. antipsychotic to tx behavioral sx
2. antianxiety
3. Valium
Nx Intervention Mild
1. support pt ability
2. provide emotional support
3. provide materials for communication
Risk factors for Parkinsons Disease
Obese Hyperlipidemia
viral infections
head trauma
environmental factors
free radical stress or normal aging problems
genetics
Decreased dopamine levels
substancial nigra
Clinical Manifestation
-tremors
-rolling
-rigidity
-shuffling gait
-angle of arm movement greater behind
-bradikinesia- abnormally slow movement
-dementia
-depression
-sleep disturbance

-hallucination
-diaphoretic
Medical Mgt.
1. Levodopa increases level of dopamine
2. Carvodopa mimics level of dopamine decreasing tremors
3.Anticholinergic- inhibitory
4. Antiviral-amantadine
5. dopamine agonist: bromocriptine
6. Pergolide
7. MAOi mono amine oxidase inhibitor
8. Antihistamine for allergic reactions
Bells Palsy
-causes infection
-hemmorhage
-tumor
-local traumatic injury
Definitive symptoms
-paralysis one side of face
-facial nerve cranial nerve #5
-facial drooping
-mouth drooping: drooling
-unilateral movement
-distorted function
-inability to close affected eyelid-give artificial eye drops
-excessive tearing on affected
management
-artificial tears
-prednisone anti-inflammatory and pain
-heat packs
-massage face to improve muscle tone
-frequent mouth care because of improper chewing
-encourage chew on affected side
-eye patch to prevent infection and dryness
-wisp of cottons
-pinching
-applying safety pins
Tic Douloureux Trigeminal Neuralgia

-painful disorder affecting one or more branches of the fifth cranial nerves
-pain sensation eyebrows, cheeks
-caused by repetitive pulsation of the artery
-pain assessment: PQRST assessment
-searing burning jabs of pain lasting 1-15 mins
nx intervention
-emotional support
-pain mgt
-encouraging to express feelings
-provide emotional support
-give small frequent feeding at room temperature
-painful if too cold or too hot
Myasthenia Gravis
-sporadic progressive illness
-abnormal fatigue
-like bells palsy with drooping called ptosis
-exacerbated repetitive use of muscles
etiology
-autoimmune disease
-thymoma
-common in women 30s and 40s
-high acetylcholine antibodies
1.
2.
3.
4.

Muscle weakness gradual and progressive


weakness that worsens during the day
definitive symptoms: ptosis or facial drooping, dyplopia
difficulty swallowing with respiratory depression

Dx
1. tensilon test
2. EMG
3. ct scan
4. serum antiacetylcholine antibody receptors
Med Mgt
anticholinesterase
1. pyridostigmine
2. neostigmine
Corticosteroids
Thyectomy

Nx Intervention
1. administer prescribed meds as prescribed and scheduled. Scheduling is
important. Missed dose worsens disease
2. prevent problem with chewing and swallowing with occupational therapist
3. promote reap function through incentive spirometry, mechanical
ventilation,
4. Maximize functional ability
Meningitis