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What is the name of the progressive degenerative disease affecting upper motor neurons in the cerebral cortex and lower motor neurons in brain stem and spinal cord?
AMYOTROPHIC LATERAL SCLEROSIS (ALS)
This is a chronic demyelinating disorder that affects the brain, spinal cord, and optic nerves.
Multiple Sclerosis
What is the drug class of Valium?
A benzodiazepine.
An autoimmune disease damaging receptors at the neuromuscular junction, causing weakness and rapid fatigue of skeletal muscles in the face and neck.
Myasthenia Gravis
Inflammation in the peripheral nervous system impairs nerve conduction, causing paralysis ascending through the lower extremities to the trunk and arms
Guillain-Barré syndrome (GBS)
True or False:
Cognition is impaired with ALS?
False
During your discharge teaching to a patient with multiple sclerosis, you educate the patient on how to avoid increasing symptoms and relapses. You tell the patient to avoid: Select all that apply
A. Cold temperatures
B. Infection
C. Overexertion
D. Salt
The answer is B and C. The patient should also avoid extreme heat, which can increase symptoms.
10. A patient with multiple sclerosis has issues with completely emptying the bladder. The physician orders the patient to take ___________, which will help with bladder emptying.
A. Bethanechol
B. Oxybutynin
C. Avonex
D. Amantadine
A. Bethanechol
This medication is a cholinergic medication that will help with bladder emptying.
6. Which patient below is MOST at risk for developing a cholinergic crisis?
A. A patient with myasthenia gravis is who is not receiving sufficient amounts of their anticholinesterase medication.
B. A patient with myasthenia gravis who reports not taking the medication Pyridostigmine for 2 weeks.
C. A patient with myasthenia gravis who is experiencing a respiratory infection and recently had left hip surgery.
D. A patient with myasthenia gravis who reports taking too much of their anticholinesterase medication.
D. A patient with myasthenia gravis who reports taking too much of their anticholinesterase medication.
When does Guillain-Barré syndrome (GBS) occur?
Within 2-4 weeks after a preceding infection.
This is displayed with the loss of upper motor neurons in cerebral cortex.
Spastic paralysis and hyperreflexia
Between ALS and MS which gender is more likely to get each disease?
MS is more common in women.
ALS is more common in men.
How does Riluzole help an individual with ALS?
By helping reduce damage to neurons by
lowering glutamate levels.
The nurse is caring for a client admitted with suspected myasthenia gravis. Which finding is usually associated with a diagnosis of myasthenia gravis?
A. Visual disturbances, including diplopia
B. Ascending paralysis and loss of motor function
C. Cogwheel rigidity and loss of coordination
D. Progressive weakness that is worse at the days end
D. Progressive weakness that is worse at the days end
4. A 25 year-old presents to the ER with unexplained paralysis from the hips downward. The patient explains that a few days ago her feet were feeling weird and she had trouble walking and now she is unable to move her lower extremities. The patient reports suffering an illness about 2 weeks ago, but has no other health history. The physician suspects Guillain-Barré Syndrome and orders some diagnostic tests. Which finding below during your assessment requires immediate nursing action?
A. The patient reports a headache.
B. The patient has a weak cough.
C. The patient has absent reflexes in the lower extremities.
D. The patient reports paresthesia in the upper extremities.
B.
The respiratory system can be affected leading to respiratory failure. Therefore, the nurse should assess for any signs and symptoms that the respiratory system may be compromised.
This is displayed with damage to lower motor neurons
Flaccid paralysis and decreased muscle tone and reflexes
4. A patient is suspected of having multiple sclerosis. The neurologist orders various test. The patient's MRI results are back and show lesions on the cerebellum and optic nerve. What signs and symptoms below would correlate with this MRI finding in a patient with multiple sclerosis?*
Which muscle relaxer is a peripherally acting muscle relaxer and which is a centrally acting muscle relaxer?
Dantrolene is peripherally acting.
Prostigmine (neostigmine)
The nurse is caring for a client diagnosed with Guillain-Barré syndrome (GBS) following a severe viral infection. Which classification of medication should the nurse anticipate the health care provider will prescribe?
A. Neuromuscular blocking agents
B. Corticosteroids
C. Cholinergic muscle stimulants
D. Interleukin inhibitors
B. Corticosteroids
Treatment of GBS is aimed at reducing the symptoms and involves medications that suppress the immune system, such as corticosteroids.
What is the cause of death for an individual who expires due to ALS?
Respiratory Failure.
You’re performing a head-to-toe assessment on a patient with multiple sclerosis. When you ask the patient to move the head and neck downward the patient reports an “electric shock” sensation that travels down the body. You would report your finding to the doctor that the patient is experiencing:
A. Romberg’s Sign
B. Lhermitte’s Sign
C. Uhthoff’s Sign
D. Homan’s Sign
B. Lhermitte’s Sign
What is a major adverse effect of Dantrolene?
Hepatotoxicity
A patient with myasthenia gravis will be eating lunch at 1200. It is now 1000 and the patient is scheduled to take Pyridostigmine. At what time should you administer this medication so the patient will have the maximum benefit of this medication?*
A. As soon as possible
B. 1 hour after the patient has eaten (at 1300)
C. 1 hour before the patient eats (at 1100)
D. at 1200 right before the patient eats
C. 1 hour before the patient eats (at 1100)
It is important the patient has maximum muscle strength while eating for the chewing and swallowing process. The medication should be given 1 hour before the patient eats because this medication peaks (has the maximum effect) at approximately 1 hour after administration.
When caring for a patient who has Guillain-Barré syndrome, which assessment data obtained by the nurse will require the most immediate action?
a. The patient complains of severe tingling pain in the feet.
b. The patient has continuous drooling of saliva.
c. The patient's blood pressure (BP) is 106/50 mm Hg.
d. The patient's quadriceps and triceps reflexes are absent
b. The patient has continuous drooling of saliva.