Neurons Meet Nursing
Assessment of the Neuro system includes
LOC Motor and sensory fx reflexes and Brainstem activtiy.
Define Parkinsons disease
is a progressive neurodegenerative disease that is one of the most common neurologic disorders of older adults. It is a debilitating disease affecting mobility
Muscle stiffness and resistance to movement in Parkinsons disease is called this
What is rigidity?
This is two or more seizures experienced by a person. It is a chronic disorder in which repeated unprovoked seizure activity occurs
What is epilepsy
What is demyelination?
destruction of the myelin, the fatty and protein material that surrounds certain nerve fibers in the brain and spinal cord resulting in impaired transmission of nerve impulses
What are common Neurotransmitters
Dopamine Serotonin Acetycholine GABA
List the s/sx of parkinsons disease
the 4 cardinal symptoms are: tremor, muscle rigidity, bradykinesia (slow movement) or akinesia (no movement), and postural instability
Because of balance and coordination challenges, Parkinsons patients are at an increased risk of these types of injuries
What are falls
Define seizure
p. 876- abnormal, sudden, excessive, uncontrolled electrical discharge of neurons within the brain that may result in a change in LOC, motor or sensory ability and behavior
Name are the most commonly reported symptoms
fatigue, depression, weakness, numbness, difficulty in coordination, loss of balance, and pain
Describe babinski sign
is a dorsiflexion of the great toe and fanning of the other toes, is abnormal in anyone older than 2 years and represents the presence of central nervous system disease
What medications are used to manage parkinsons disease
levodopa-carbidopa (sinemet), anticholinegic agnest, antiviral agents, dopamine agonists (mirapex, requip), catechol O-methyltransferases (COMTs)inhibitors such as comtan, monamine oxidase type B (MAO-B) inhibitors See Table 66-1
The age range symptoms usually start to manifest, even though a person can get multiple sclerosis at any point in their lives.
What do the ages of 20-50 years old have to do with M.S.?
Name the different types of seizures and characteristics of each
p. 876- generalized seizures
tonic-clonic seizure lasting 2-5 minutes begins with a tonic phrase that causes stiffening or rigidity of the muscles. Clonic or rhythmic jerking of all extremities follows
tonic seizure- abrupt increase in muscle tone and loss of consciousness
clonic seizure- causes muscle contraction and relaxation
myoclonic seizure- causes a brief jerking or stiffening of the extremities
atonic seizure- sudden loss of muscle tone followed by postictal confusion
Partial Seizures- are focal or local begin in a part of one cerebral hemisphere
Complex partial seizure- cause a blackout for 1-3 minutes
Simple partial seizure- remains conscious throughout the episode and often reports an aura
Unclassified or idiopathic seizures- they occur for no known reason and do not fit into the generalized or partial classification
What are the four types of MS?
relapsing-remitting, primary progressive, secondary progressive, and progressive-relapsing
What is the Glasgow Coma Scale
p. 850- standard rapid neurologic assessment tool used to establish baseline data in each of these areas: eye opening, motor response, and verbal response. The patient is assigned a numeric score for each of these areas. The lower the score, the lower the patient's neurologic function. The highest possible score is 15.
What surgical interventions manage parkinsons
deep brain stimulation- electrodes are implanted into the brain and connected to a small electrical device called a pulse generator that delivers electrical current
Magnetic Resonance Guided High Intensity Focused Ultrasound.
What is one type of medication that can be used to alleviate the symptoms of MS?
- Corticosteroids
How are seizures diagnosed?
Diagnosis is based on the history and physical exam. Typical diagnostic tests include an electroencephalogram (EEG), CT scan, MRI, or PET scan.
How is MS diagnosed?
Primarily clinical based on dissemination of lesions in time and space. MRI is the gold standard.
Common diagnostic tests? List 4
MRI, CT scan Cerebral Angiography Skull xray EEG
evolked potential
How is Parkison's Disease diagnosed?
PD is a clinical diagnosis based on history and physical exam. Response to Levadopa, PET Scan CT scan and DaTscan (dopamine transporter)
What is the first nursing priority during a seizure?
ABC and safety
What drug therapy is used to manage a patient having a seizure
Antiepileptic drugs (anticonvulsants)
Examples: phenytoin, carbamazepine, lamictal, valproic acid, gabapentin, lyrica, keppra, topamax
What is the aimed effect of medications to treat multiple sclerosis.
They are to decrease the inflammatory process of nerver fibres and improve the conduction of demyelinating axons.