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MCC Med Surg Neuro Notes, Study notes of Nursing

MCC Nursing Med Surg Neuro Notes

Typology: Study notes

2021/2022

Uploaded on 05/16/2025

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NEURO
AUTOIMMUNE &
NEUROMUSCULAR
1-Multiple sclerosis
2-Myasthenia Gravis
3-Parkinsons
# 1 MULTIPLE SCLEROSIS
-AUTOIMMINE
-EXASERBATION &
REMISSION
-disease that affects CNS, vision,
muscles, coordination, fall risk,
over time total loss.
-immune system attacks myelin
sheath between spinal chord
and muscle. Nerve impulses are
unable to get to muscle and
person looses function
-more exacerbations leads to
worse MS
-affects women
MS ASSESSMENT
-can progress slowly with remission
or rapidly with lots of exacerbation
-MUSCLES: fatigue, depression,
weakness, numbness, loss of
coordination, balance, spasticity
-EYES: optic nerves affected, blurry
vision, diploplia, scotoma (patchy
blindness), blindness
-PAIN- from lesions on sheath
-FATIGUE- depression, loss of
function, meds
-SPASTICITY: ataxia, loss of bladder ,
bowel, sexual function
AT FIRST:
VISUAL CHANGES (diplopia)
FATIGUE: pt. can’t hold arms up,
can’t do their hair or regular
ADL’s are exhausting
COORDINATION ISSUES: pt.
states they are off balance,
clumsy
SPEECH: messing up words,
dysarthria
INCONTINENCE: suddenly out of
nowhere they pee themselves,
the bed bowel and bladder
issues
DIAGNOSTIC TESTS
-Scans looking for scarring on
myelin sheath
-rule out other things with
blood testing
-spinal tap for biomarkers
MS TREATMENT
MEDS
MTHOTREXATE: DMARD,
immunosuppressant
-kills all cells
-can kill baby in pregnancy
BIRTH CONTROL
CORTICOSTEROIDS: for acute
exacerbations
EDUCATION
-you need to be on birth control
to not conceive
-conserve energy, use assistive
devices
-nutrition, exercise, get cleared
to dirve, visual testsing
GRIEF
-deal with depression
-anticipatory grieving over not
being able to get pregnant/
have kids
MS VS MG (both nervous system)
MS= whole body + extremities
(eyes, speech, B&B, extremities)
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NEURO

AUTOIMMUNE &

NEUROMUSCULAR

1-Multiple sclerosis

2-Myasthenia Gravis

3-Parkinsons

# 1 MULTIPLE SCLEROSIS

-AUTOIMMINE

-EXASERBATION &

REMISSION

-disease that affects CNS, vision, muscles, coordination, fall risk, over time total loss. -immune system attacks myelin sheath between spinal chord and muscle. Nerve impulses are unable to get to muscle and person looses function -more exacerbations leads to worse MS -affects women MS ASSESSMENT -can progress slowly with remission or rapidly with lots of exacerbation -MUSCLES: fatigue, depression, weakness, numbness, loss of coordination, balance, spasticity -EYES: optic nerves affected, blurry vision, diploplia, scotoma (patchy blindness), blindness -PAIN- from lesions on sheath -FATIGUE- depression, loss of function, meds -SPASTICITY: ataxia, loss of bladder , bowel, sexual function AT FIRST: VISUAL CHANGES (diplopia) FATIGUE: pt. can’t hold arms up, can’t do their hair or regular ADL’s are exhausting COORDINATION ISSUES: pt. states they are off balance, clumsy SPEECH: messing up words, dysarthria INCONTINENCE: suddenly out of nowhere they pee themselves, the bed bowel and bladder issues

DIAGNOSTIC TESTS

-Scans looking for scarring on myelin sheath -rule out other things with blood testing -spinal tap for biomarkers MS TREATMENT MEDS MTHOTREXATE: DMARD, immunosuppressant -kills all cells -can kill baby in pregnancy BIRTH CONTROL CORTICOSTEROIDS: for acute exacerbations EDUCATION -you need to be on birth control to not conceive -conserve energy, use assistive devices -nutrition, exercise, get cleared to dirve, visual testsing GRIEF -deal with depression -anticipatory grieving over not being able to get pregnant/ have kids MS VS MG (both nervous system) MS= whole body + extremities (eyes, speech, B&B, extremities)

MG= body core only (face, torso, respiratory, throat)

MYASTHENIA GRAVIS

(MG)

AUTOIMMUNE

EXASERBATION & REMISSION

-our own antibodies attack the impulses to our voluntary muscles causing weakness -AFFECTS BODY CORE -face, torso, respiratory -affects middle aged women, is induced by stress -affects MOTOR neurons only not sensory. Doesn’t affect coordination GRAVE WEAKNESS

  1. Eyes
  2. Face
  3. Throat
  4. Lungs

ASSESSMENT

HARD TO SWALLOW: choking when eating, cant swallow, regurgitations, aspirations, impaired ventillation HARD TO BREATH: weak lungs, labored breathing, aspirations into lungs WEAKNESS: I’m not feeling myself, im middle aged and shouldn’t feel this way, im tired, weak and under stress in my life FACE: droopy eye lid & mouth, visual issues INTERVENTIONS -speech evaluation -swallow studies -NPO, thickened liquids -sitting up for drinking/ eating -lower chin to swallow

MYASTHENIA CRISIS

Dysphagia, dysarthria, ptosis, diplopia, respiratory decline, -patient will need intubation with ventilation and be put into the ICU

EDUCATION

-WATCH OUT FOR CRISIS- can lead to serious respiratory issues that could lead to intubation which can lead to secondary issues like infection -teach the patient to GO TO THE HOSPITAL if they start to feel it exasperating because they can easily loose their airway -TEACH that TRIGGERS may lead to this and you will need to be intubated

TREATMENT

Cholinesterase Inhibitors PYRIDOSTIGMINE (Mestonin) a muscle strengthener given for Myasthenia gravis and after anesthesia. Given to strengthen muscles under voluntary control CORTICOSTEROIDS: for acute exaserbations