Exam 3 review updated
Spinal cord injury interventions on the field
Stabilize the spine, make sure airway is patent
Stay with the patient
... [Show More] Do not leave
Ask for help
Diagnostic tests for MG, GB, MS
Multiple sclerosis:
Mri (to identify Plaques or lesions in the brain and white (round areas, which is
inflammation). Lumbar puncture shows Oligoclonal bands present in the CSF fluid.
Medications: baclofen, cholinergics, atropine, alpha interferon, plasma pheresis, IG g,
Baclofen:
is a skeletal muscle relaxant used to decrease spasticity and improve bowel and
bladder function (In Multiple sclerosis and , ALS) , Reduces contractions.
Assess muscle spasticity before and periodically Observe for drowsiness, dizziness, or
ataxia
Instruct patient to change positions slowly to minimize orthostatic hypotension
Avoid alcohol or other CNS depressant or alcohol
AntiCholinesterance: meds that block the enzymes that causes ACH reuptake(i.e. MG)
Edrophonium, Neostigmine, and pyridostigmine
Take everyday at the same time. 30 min. before meals to increase muscle strength and to
prevent aspiration. Start in the AM.
Monitor for cholinergic crisis
Alpha interferon: such as Interferon beta-1a (Avenox)
prevents relapsing (Multiple sclerosis ) (numbing of the immune system)
It causes Flu-like symptoms and monitor for S&S on infection
Plasmapheresis:
Re-transfusion of plasma. Removing the antibodies via centrifuge.
Watch out for S&S of hypovolemia
IVIGG: (Immunoglobulin G) Neutralizes antibodies. This is a transfusion. To not destroy the
myelin.
(MS, GB)
GUillian-Bare syndrome: prognosis, pathophysiology, treatments, s/s, nursing interventions
Prognosis: most people regain the strength, recovery may take up to 1-2 years.
( Depending of the regeneration of the Schwann cells)
Pathophysiology: Attack of the immune system to the myelin sheath after a viral
infection such as campylobacter jejuni, cytomegalovirus, Epstein-Barr virus,
Mycoplasma pneumoniae, Haemophilus influenzae, and HIV.
S/S:
Begins with muscle weakness and diminished reflexes of lower extremities
Weakness begins in the legs and may progress upwards
Cranial nerve demyelination can result in:
1. Optic nerve- blindness
2. Glossopharyngeal and vagus nerve clear secretions
3. Vagus nerve- cardiac instability- including tachycardia, bradycardia,
hypertension, orthostatic hypotension.
4. Miller- Fisher variant: includes paralysis of the ocular muscles, ataxia, areflexia
muscle
5. weakness, paresthesia, and ascending paralysis. Biggest issue is Respiratory.
Diagnosis:
Present with symmetrical weak [Show Less]