Neuro DiseasesIntro & Quick Overview

brain & spinal cordM.S. - Multiple SclerosisParkinsonsAlzhemiersHuntington disease

peripheral nervous systemM.G. - Myasthenia GravisA.L.SG.B. - Guillain-Barré Syndrome

Highlighted are the Most Tested TEST TIP• NO drugs or interventions will CURE these conditions• We can only treat to prevent progression

Promote Independence All Neuro Disease Patients

Never do All ADLsGait training

1st - Teach Gait trainingThen offer Cane, then Walker, last wheelchair

Memory Trick: • MS - Myelin Sheath destruction • MS - Muscle Spasm & Stiffness • MS - Mellow out & Stay cool (no sun) Teach: • Balance exercise & rest • AVOID 4 Ss = Trigger Flare Ups • S - Stress (exercise, surgery, injury) - Don’t over exercise • S - Sickness or Sepsis - Stay healthy & free from infections • S - Smoking - use smoking cessation • S - Sun & Extreme heat (hot tub, bath, sauna) Pharmacology • IVIG - acts as bait - the body attacks this substance instead of the nerves. • Cyclosporine - immunosuppressive think “CycloSPARIN”- spares the body from attacking itself

(autoimmune disease - body attacks itself)

Memory Trick: • MG - MYasthenia Gravis • MG - DRY-asthenia Gravity Dry body & Weak muscles - like Loads of Gravity weighing down the body. AVOID the 4 S’s = Trigger Flare Ups (see above)

Myasthenic crisis: respiratory arrest! Airway protection (safety with swallowing) • Intubation set up - BEDSIDE • BEFORE meals: Give pyridostigmine (anticholinesterase drug) NCLEX TIP • Encourage semi-solid foods

Pharmacology Neostigmine: given to treat the dry. Think Stigmine adds Secretions.

(autoimmune disease - body attacks itself)

Patho: Low dopamine - HIGH acetylcholine 3 Key Signs for NCLEX 1. Shuffling gait & Decreased arm swinging NCLEX TIP 2. Pill rolling - looks like rolling a pill between fingers 3. Tremors at rest - lots of jittery movements Memory Trick: You can’t jump ROPE if you got low DOP - improved movement with more dopamine.

Pharmacology • LevoDOPA & CarbiDOPA Leaves more DOPAmine in the body & Carbidopa helps conserve MORE dopamine • AVOID protein - can block absorption Memory Trick: LEAVE the protein with LEVOdopa

Patho: Brain damage resulting in Dementia “daMage to the brain” Signs & symptoms: VERY forgetful & loss of reality Key Point • Safety: NO rugs, LOCK everything • Location: Lock doors leading outside! • Communication: Distract & REDIRECT from reality REdirect any Dementia clients who get easily frustrated

Key Point • Passed on by Genetics • Only requires 1 parent! • Recommend Genetic counseling

Memory Trick HuntingTON - One parent needed to pass on the disease

• Dysphagia - Difficulty swallowing • Dysphasia - Difficulty speaking • Priority finding - Increased respiratory secretions

Patho: clients get RAPID ascending paralysis from the legs up eventually reaching the respiratory system which ultimately kills the patient!Memory Trick: Ground up barees - paralysis from the legs up Respiratory failure (early signs)

• Inability to cough NCLEX TIP • Inability to lift the head or eyebrows NCLEX TIP

M.S. - Multiple Sclerosis Parkinson’s Disease

Huntington Disease

M.G. - Myasthenia Gravis

A.L.S. (Amyotrophic Lateral Sclerosis)

Alzheimer’sG.B. - Guillain-Barré Syndrome