Nurs 3366 - Diagnosis of BA and Degenerative Brain Diseases

How do you diagnose a BA?

acronym - BE FAST

• Balance: Watch for sudden loss of balance

• Eyes: Check for vision loss

• Face: Look for uneven smile

• Arms: Check if one arm is weak

• Speech: Listen for slurred speech

• Time: If the answer to any of the above questions is yes, time is important.

  Immediately, call 911 or go to the nearest hospital emergency room

What are immediate interventions in medical setting for BA?

• BP management (this is part of managing CPP)—not too high or low

• HOB (head of bed) up at least 30 degrees - promotes venous return

What is the intervention for Hemorrhagic BA?

surgical intervention for certain types of hemorrhagic strokes

What is the intervention for Ischemic BA?

thrombolytic drugs (clot-busters) - must be within 3-4.5 hours of start of incident (“with a brain attack, time is brain!”

What are the types of Alzheimer’s disease?

• Familial Alzheimer’s (FAD)—inheritance-linked–can be early onset or late

• non-hereditary (AKA sporadic)-- late onset—70% of cases

What is the cause of Alzheimer’s disease?

improperly encoded protein called amyloid → end result the abnormal amyloid forms plaque-like material called senile plaques

• causes neurofibrillary tangle - microtubules of neurons in the brain become distorted and twisted

What is the clinical manifestation of Alzheimer’s disease?

dementia—a type of forgetfulness that is different from normal

What is Parkinson’s Disease?

basal ganglia dysfunction disease that causes depletion in dopamine

What is the patho of Parkinson’s disease?

1. normal basal ganglia function is based on balance of 2 neurotransmitters dopamine & acetylcholine

2. the effects of acetylcholine (ie, cholinergic effects) are excitatory and the effects of dopamine are inhibitory

3. a decrease in dopamine tips the scales of balance towards cholinergic,

   excitatory activity - increased cholinergic effect

What are the S&S of Parkinson’s Disease?

hypertonia - overall rigidity, mask-like face

• cog-wheel rigidity” of forearm

• dysarthria - difficulty forming words

• dysphagia - difficulty swallowing

dyskinesia - involuntary facial & trunk movements such as “Parkinson’s tremor”

• pattern of alternating movements between thumb & forefinger

  described as “pill-rolling”

• “basal ganglion gait” AKA “Parkinsonian gait”—stooped, shuffling posture; decreased arm swing

What is the treatments of Parkinson’s disease?

• give medication containing dopamine (L-dopa)

• anticholinergic medications (benadryl)

What is the Patho of Multiple Sclerosis?

autoimmune dzs

• person’s own T-cells attack a myelin protein in brain neurons

• his degeneration is known as demyelination - causes hardening(sclerosis)

What are the S&S of Multiple sclerosis?

asymmetric, since plaques are unevenly distributed in brain

• paresthesia - numbness and tingling

• ataxia--staggering gait

• bladder control problems