Nursing Care of the Patient with Neurological Disorders: ALS & Guillain-Barre

A collection of vocabulary flashcards based on key concepts related to nursing care of patients with neurological disorders, specifically focusing on ALS and Guillain-Barré Syndrome.

Amyotrophic Lateral Sclerosis (ALS)

A relentlessly progressive, presently incurable neurodegenerative disorder that causes muscle weakness, disability & eventually death.

Median survival for ALS patients

3-5 years; 10% can live 10 years or more.

Most common presentation of ALS

Asymmetric limb weakness.

Symptoms of upper extremity weakness in ALS

Hand weakness or shoulder girdle muscles.

Initial weakness characteristic of lower extremity ALS

Foot dorsiflexion (foot drop).

Spread of ALS symptoms

Initially spreads within the segment of onset and then to other regions in a relatively predictable pattern.

Common clinical manifestations of ALS

Fatigue, dysarthria, dysphagia, muscle atrophy, spasticity.

Fasciculations

Twitching of face or tongue associated with ALS.

Life-threatening issue in ALS

Respiratory muscle weakness.

Cognitive status in ALS patients

Patients remain cognitively intact while physically deteriorating.

Riluzole

FDA approved medication for ALS that extends survival time.

Exercise recommendation for ALS patients

Moderate intensity endurance-type exercises for trunk and limbs.

Purpose of physical therapy in ALS

Reduces spasticity.

Communication support for ALS patients

Speech therapy consult can be helpful.

Patient positioning in ALS care

Maintain NPO due to major risk for aspiration.

Pain assessment in ALS care

Important due to muscle weakness.

Injury risk management for ALS patients

Minimize risk for injury.

Role of diversional activities in ALS care

Helps facilitate patient and family anticipatory grieving.

Guillain-Barré Syndrome (GBS)

Acute, immune-mediated polyneuritis with progressive, symmetric muscle weakness.

Common presentation timeline for GBS

Patients usually present a few days to a week after onset of symptoms.

Symptom variability in GBS

Weakness can range from mild difficulty walking to nearly complete paralysis.

Common sensory symptoms in GBS

Paresthesia in hands and feet.

Pain symptoms in GBS

Pain in back and extremities experienced by 66% of patients.

Dysautonomia in GBS

Occurs in 70% of cases, including tachycardia and labile blood pressure.

Progression of GBS symptoms

Progresses over a period of about 2 weeks.

Nadir in GBS patients

By 4 weeks, 90% of GBS patients have reached nadir.

Diagnosis of GBS

Combination of history, physical exam, and CSF analysis.

CSF analysis in GBS diagnosis

Shows increased protein and normal WBC count after one week of onset.

Nerve conduction studies in GBS

Valuable for confirming diagnosis and determining prognosis.

Physical assessment in GBS care

Routine monitoring of disease progression.

Mechanical ventilation in GBS

15-30% of patients require this due to progression.

Vital signs monitoring in GBS

Frequent checks for blood pressure changes and autonomic changes.

Nutritional interventions in GBS care

Critical due to potential for swallowing difficulties.

Pain management in GBS

Addressing neuropathic pain symptoms.

Support provided to families in GBS

Encouragement and dealing with variable recovery concerns.

Plasmapheresis

Therapy that removes circulating antibodies and response modifiers in GBS.

IV immune globulin (IVIG) treatment in GBS

Administered for 5 days within 4 weeks of onset.

Prognosis for GBS patients

95% survive and 75% completely recover.

Residual weakness in GBS

25-30% may have residual weakness after 3 years.

Relapse risk in GBS

About 3% may suffer a relapse of muscle weakness and tingling many years post initial attack.

Primary mechanism of action for riluzole

Extends survival time, does not cure ALS.

Evolution of symptoms in GBS

Symptoms typically progress over approximately two weeks.

Intervention for cognitive support in ALS

Facilitate communication through therapy.

Common predictors of GBS onset

Often preceded by viral infection, immunization, trauma, or surgery.

Symptoms indicating respiratory compromise in ALS

Weakness of respiratory muscles.

Focus areas for ALS patient care

Physical, cognitive, and emotional support to enhance quality of life.

Physical therapy considerations in ALS

Evaluate and guide activity levels based on progression.