chronic neuro problems 3

Question 1

amyotrophic lateral sclerosis (ALS)

Answer 1

• rare progressive neuro disorder characterized by loss of motor neurons
• Lou Gehrig’s dz
• men:women 2:1
• onset between 40 and 70

Question 2

cause of ALS

Answer 2

motor neurons in the brainstem and spinal cord gradually degenerate

Question 3

s/s of ALS

Answer 3

• weakness of the limbs
• dysarthria (language)
• dysphagia, drooling
• muscle wasting and twitching
• pain
• sleep dx
• spasticity
• depression
• constipation
• esophagial reflux

Question 4

diagnosing ALS

Answer 4

• H/P
• PE
• EMG

Question 5

drugs used in ALS

Answer 5

CNS agent/glutamate antagonist: Rilutek

• slows the progression of ALS
• no cure

Question 6

nursing interventions in ALS

Answer 6

• facilitate communication
• risk for aspiration
• early ID of respiratory insufficiency
• decrease pain from muscle weakness
• reduce risks of injury
• support

Question 7

dementia

Answer 7

• syndrome characterized by dysfunction or loss of:
• memory
• orientation
• attention
• language
• judgment
• reasoning
• personality and behavioral problems
• neurodegenerative and vascular causes

Question 8

diagnosing dementia

Answer 8

2 or more brain functions are significantly impaired

Question 9

delirium

Answer 9

• state of temporary but acute mental confusion

- common, life threatening, and possible preventable

Question 10

causes of delirium

Answer 10

• cholinergic deficiency
• excess release of dopamine
• increased and decreased sertonergic activity

Question 11

s/s of delirium

Answer 11

• early: inability to concentrate, loss of appetite, restlessness
• late: agitation hallucinations
• give Haldol

Question 12

Alzheimer’s Dz (AD)

Answer 12

• chronic, progressive, degenerative disease of the brain
• family vs sporadic
• genetic and environmental factors

Question 13

changes in the brain structure and function in AD

Answer 13

• amyloid plaques
• neurofibrillary tangles
• loss of connections between neurons
• neuron death

Question 14

s/s of AD

Answer 14

• memory loss that affects job
• difficulty performing familiar tasks
• language problems
• disorientation to time and place
• poor judgment
• problems with abstract thinking
• misplacing things
• changes in mood or behavior
• changes in personality
• loss of initiative

Question 15

mild stage of AD

Answer 15

• forgetfulness beyond what is seen in a normal person
• short term memory impairment, especially for new learning
• loss of initiative and interests
• may forget recent events or the names of people or things
• small personality changes
• unable to solve simple math
• slowly lose the ability to plan and organize

Question 16

moderate stage of AD

Answer 16

• memory loss and confusion become more obvious
• has more trouble organizing, planning, and following directions
• may need help getting dress
• may start having incontinence
• trouble recognizing family members and friends
• agitation, restlessness
• may lack judgment and being to wander
• difficulty sleeping
• delusions, hallucinations, paranoia
• behavioral problems

Question 17

severe stage of AD

Answer 17

• severe impairment of all cognitive functions
• little memory, unable to process new info
• unable to do self care
• often needs help with daily needs
• may not be able to talk
• cannot understand words
• difficulty, eating, swallowing
• may not be able to walk or sit up without help
• immobility
• incontinence

Question 18

retrogenesis

Answer 18

degenerative changes occur in the reverse order in which they were acquired
-adult back to baby

Question 19

diagnostic studies for AD

Answer 19

• H/P
• CT, MRI, PET, MRS
• neuropsychologic testing
• biomarkers
• definitive dx: autopsy

Question 20

drug tx for AD

Answer 20

• aricept, exelon
• namenda
• zoloft, celexa
• haldol