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35 Cards in this Set
- Front
- Back
Alzheimers risk factors
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old age, family history, and female gender
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Alzheimers warning signs
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memory loss, difficulty performing familiar tasks, problems with language, disorientation, poor or decreased judgement, misplacing things, changes in mood or behavior, changes in personality, and loss of initiative
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Stage 1 AD alzheimers
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Physically healthy and alert
Cognitive deficits can go undetected May seem restless, forgetful, or uncoordinated, disoriented to time and date, subtile changes to personality, or problems with simple calculations |
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Stage 2 AD Alzheimers
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Deficits more apparent.
Less able to behave spontaneously May wander or get lost in own home Impaired cognition: confusion, astereogenisis, "sundowning", agitation, poor orientation |
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Stage 3 AD Alzheimers
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Cognitive abilities greatly decreased or absent.
Absent communication skills Limb rgidiy and poster flexion Incontinence |
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Alzheimer's medication
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no cure for AD
Cognex, Aricept, Exelon, Reminyl, Namenda. Haldol, Mellaril, antidepressants, antihypertensives, anti inflammatory, vit E |
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Dementia
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Almost ½ of population > 85 have some form of dementia. Dementia is not a normal part of aging
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Dementia risk factors
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Risk factors include advancing age, family history, smoking, ETOH use, atherosclerosis, ↑ cholesterol, DM, mild cognitive impairment & Down syndrome.
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Alzheimers patho
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AD is a form of dementia that is progressive, irreversible deterioration of general intellectual functioning r/t loss (death) of neurons. Pts live 8-10 years after dx. Cause of death is frequently aspiration pneumonia. Cause of AD is unknown. The only definitive diagnosis is postmortem examination of brain tissue
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Alzheimers Health Promotion
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Maintaining functional abilities and safety
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Muliple sclerosis
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Chronic demyelination nueroglogic disease of the CNS, associated with an abnormal immune response to an enviromental factor
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Multiple sclerosis Patho
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Result of autoimmune response to a prior viral infection. Inflammation destroys myelin and oligodendrocytes → axon dysfunction. Demyelination occurs in patches which slows, distorts and can totally eliminate nerve impulses.
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S/S of Multiple Sclerosis
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Fatigue affects almost all pts with MS. ♀2:1♂ ↑ prevalence in temperate climates, more common @ equator and in the northern US. Diagnosis of MS is challenging beaucse the disease doesn’t present uniformly
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Multiple Sclerosis Health Promotion
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The long-term goal is to enable the client to retain as much independence as possible. Physical and rehabilitative therapies are tailored to the pt’s level of functioning. Working pts should find a job that minimizes physical and emotional stress.
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Multiple Sclerosis Treatments
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immunosuppressive agents, azathioprine (Imuran), cyclophosphamide (Cytoxan); adrenocorticotrophic hormone (ACTH) & glucocorticoids; Interferon & glatiramer acetate
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MS classifications
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There are four classifications (1) relapsing-remitting [most common dx] (2) primary progressive, (3) secondary progressive and (4) progressive-relapsing. Triggers include fever, pregnancy, extreme physical exertion, increase serum calcium concentrations and fatigue
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MS health promotion
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The long-term goal is to enable the client to retain as much independence as possible. Physical and rehabilitative therapies are tailored to the pt’s level of functioning. Working pts should find a job that minimizes physical and emotional stress.
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Parkinsons disease
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progressive, degenerative disease characterized by tremor, muscle rigidity, and bradykinesia.
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Parkinsons Patho
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Failure of dopamine to inhibit acetylcholine.
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Parkinsons S/S
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Tremors [pill rolling at rest], muscle rigidity, bradykinesia, uncoordinated movements, staggering unsteady gate, postural instability, low pitched mono-tone voice, depression, dementia [bradyphrenia or slow thinking and decisional inability], and sleep disturbances. Dry, eczematous and seborrhea skin changes are also common.
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Parkinsons Treatments
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drugs i.e., monoamine oxidase inhibitors (MAOI), dopaminergics, dopamine agonists & anticholinergics. Other medications include antidepressants, propranolol (Inderal) for essential tremors and akathisia; & botulism toxin
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Parkinsons Health Promotion
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Activa TM tremor control therapy which uses electrical stimulation to block brain impulses that cause s/s. Pallidotomy to destroy the gobus pallidus. Stereotaxic thalamotomy to destroy brain tissue causing s/s. Fetal tissue transplantation. Rehab therapy is also helpful (teaching techniques i.e. rocking out of a chair etc.).
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Parkinsons Nursing Implications
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Teach preventive measures like malnutrition, falls, constipation, skin breakdown, and joint contractures.
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Huntingtons disease
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Progressive, degenerative, inheritied neurologic disease characerized by increasing dementia and chorea (jerky, rapid, involuntary movements)
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Huntingtons Patho
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↓ gamma-aminobutyric acid and acetylcholine levels. Genetic testing is the only test available to diagnose pts suspected of having Huntington’s disease.
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Huntingtons S/S
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abnormal movements (mostly with swallowing, chewing and speaking) and progressive dementia. Pts face inevitable total multisystem debilitation.
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ALS
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rapidly progressive and fatal degenerative neurologic disease characterized by weakness and wasting of muscles under voluntary control.
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ALS Patho
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Degeneration and Demyelination of both upper and lower motor neurons in the anterior horn of the spinal cord, brainstem, and cerebral cortex. Cause is not clear but could be linked to viral, environmental, ↑ calcium levels and antibodies to calcium channels.
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ALS S/S
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First affects the hands, then shoulders, upper arms and finally the legs. Increasing brainstem involvement causes progressive atrophy of the tongue and facial muscles.
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ALS Health Promotion
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Primary goal is to support the client and family in meeting physical and psychosocial needs
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Myasthenia gravis(MG)
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chronic autoimmune neuromuscular disorder characterized by fatigue and sever weakness of skeletal muscles.
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Myasthenia gravis Patho
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Antibodies destroy or block neuromuscular junction receptor sites ↓ acetylcholine receptors
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MG S/s
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Initially starts with diplopia or ptosis. Facial, speech, and mastication muscles become weak and dysarthria and dysphagia occur. Muscle weakness spreads to other muscle groups as the disease progresses. Can lead to life-threatening emergencies, i.e. myasthenic crisis (undermedicated condition where resp failure and aspiration are issues) and cholinergic crisis (over dosage of anticholinesterase medications → ↑ muscle weakness, vertigo & resp distress)
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MG Diagnosis
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Anticholinesterase test, nerve stimulation studies, antiacetylcholine receptor antibodies and Tensilon tests.
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Tensilon Test
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Pt injected w/ edrophonium chloride (tensilon) which increases their muscle strength
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