Alzheimer's Disease
Alzheimer's Disease is a cognitive disorder. This means there are deficits in a person's thought processes due to brain dysfunction and account for a significant decline from the previous level of functioning
What type of disorder is Alzheimer's Disease?
Severe headache caused by extracranial vasodilation, activation of trigeminal sensory nerves causing release of vasoactive neuropeptides, and sensitization of CNS sensory neurons.
What are migraine headaches?
Chronic autoimmune disease that affects the myelin sheath and conduction pathway of the CNS.
What is MS?
Stage 1 - Unilateral shaking or tremor of one limb.
Stage 2 - Bilateral limb involvement occurs, making walking and balance difficult.
Stage 3 - Physical movements slow down significantly, affecting walking more.
Stage 4 - Tremors may decrease but akinesia and rigidity make day-to-day tasks difficult.
Stage 5 - Client unable to stand or walk, is dependent for all care, and may exhibit dementia
What are the five stages of Parkinson's Disease?
Abnormal electrical activity in the brain.
What is seizures?
Delirium (time limited disturbance)
Amnestic (memory impairment only symptom)
Dementias (multiple cognitive deficits)
What are the major classifications for Cognitive Disorders
Can present with or without aura (flickering lights, spots, wavy lines, partial loss of vision, numbness, parasthesias, and speech deficits). Pain worsens with activity, is unilateral, and is pulsating. Patient also has at least 2 of the following: nausea, vomiting, photophobia, phonophobia, and osmophobia.
What are the clinical manifestations of a migraine headache?
High-fluid and high-fiber (for constipation)
What is the suggested dietary treatment for MS?
It is a progressively debilitating disease that grossly affects motor function, which occurs due to overstimulation of basal ganglia by acetylcholine caused by the degeneration of the substantial nigra resulting in a decrease of dopamine production. Acetylcholine dominates making smooth, controlled movement difficult.
What is Parkinson's Disease?
Simple or focal with involvement on only one side of the brain and activity only on one side of the body.
What is partial seizure?
Regular exercise,
Maintaining a low cholesterol
Use of statins (medications to lower cholesterol)
Absence of head trauma
What are some protective influences for Alzheimer's?
Keep a headache diary (track triggers, frequency, severity, and response to treatment), behavioral interventions (relaxation therapy, biofeedback, cognitive-based therapy), environmental control (rest in quiet, dark area; use ice packs), and healthy lifestyle (regular sleep, exercise, smoking cessation, and limited caffeine).
What are non-pharmacological treatments for patients with migraines?
Fatigue, heat intolerance, paresthesias, stiffness of extremities, spasticity, dysmetria, blurred vision, diplopia, nystagmus, scotomas, decreased hearing, tinnitus, vertigo, alterations in sexual function, tremors, ataxia, dysarthria, depression, memory loss, difficulty concentration or finding words.
What are some symptoms of MS?
Stooped posture
Slow, shuffling, and propulsive gait
Slow, monotonous speech
Tremors/pill-rolling tremor of the fingers
Muscle rigidity
Bradykinesia/akinesia
Mask-like expression
Autonomic symptoms (orthostatic hypotension, flushing, diaphoresis)
Difficulty chewing and swallowing
Drooling
Dysarthria
Progressive difficulty with ADLs
Mood swings
Cognitive impairment (dementia)
What are some clinical findings in patients with PD?
A grave condition in which there is a rapid, unrelenting series of convulsive seizures without interventing periods of consciousness, and absence of respiration.
What is status epilepticus?
Most AD patients lose their interest in eating
High carbs for those in later stages is recommended
Therapy to keep patients at the table longer is effective
What are some Nutritional Interventions for Alzheimer's?
Exertion, menstruation, lights, noise, smells, tobacco smoke, sleep extremes, caffeine/withdrawal, dairy products, fatty foods, chocolate tyramines, and alcohol.
What are common triggers for a migraine headache?
Maintain independence, muscle strength, balance, and manage spasticity.
What are the goals in treating MS?
Pureed foods or tube feedings are required because of dysphagia
Maintenance of weight may require high- or low-calorie diets.
In the early stages of PD, a diet high in antioxidants may alleviate some symptoms.A diet that discourages the formation of free radicals is high in complex carbohydrates (such as those found in whole-grain breads and lentils), low in fat, and high in vitamins A and E.
Large doses of supplemental vitamins A and E are also given.
A high-fiber diet helps prevent constipation.
What are some nutritional therapies used for patients with PD?
Provides calories from fats and proteins, but produces a ketotic (acidotic) state that seems to prevent seizure activity.
What is a ketogenic diet?
Strategies:
Loss of motor skills. Provide finger foods
Sensory loss. Provide strong contrast in color
Cognitive loss. Provide a quiet, non-distracting environment and serve favorite foods.
What are some strategies to counter weight loss, low energy and nutrient intake due to neurological impairment?
Valproic acid, topiramate, propranolol, and timolol.
What drugs are FDA approved for migraine prevention?
Well balanced, low fat, high fiber, with adequate fluids.
Encourage clients to maintain recommended weight.
May experience muscular problems and dysphagia that affect nutrition.
What are some nutritional goals for a patient with MS?
Encourage independence. Fatigue may cause more dependence. Assist to establish a regular bowel routine by encouraging the client to drink at least 2,000 mL of liquids daily and eat high-fiber foods. Provide an elevated toilet seat. Assist client and family to express feelings and frustrations.
What are some interventions provided by the nurse?
Acidosis, electrolyte imbalances, hypoglycemia, hypoxemia, alcohol or barbiturate withdrawal, & dehydration or water intoxication
What are some metabolic disturbances that can cause seizures?