Neuro Disorder - Guillain-Barre' Syndrome; Meningitis; Huntington's Disease

pivukuci's version from 2015-10-02 20:20

Section 1

Question Answer
What is Guillain-Barre' Syndrome It's a postviral illness cause by a Upper Respiratory Illness or Gastroenteritis resulting in ascending paralysis beginning with lower extremities.
Risk factorsSurgery ; Rabies, or swine influenza vaccination; viral illness; Hodgkin's disease or other malignant disease; Lupus Erythematosus
Clients History would includeMinor febrile illness 1-4wks, tingling and numbness (paresthesia) in legs; progression of symptoms to arms, trunk and finally face; stiffness & pain in calves
Clinical Symptoms of Guillain-Barre' Syndromeprogressive motor weakness in more than one limb; sensory loss in legs spread to arms; dysphagia, difficulty chewing & talking; Paralysis of the ocular, facial and oropharyngeal muscles; loss of position sense; diminished or absent deep tendon reflexes
First SymptomsClumsiness,
Causes of Guillain-Barre' Syndromeunknown
Diagnostic Test ResultsCSF analysis ; Normal WBC; elevated protein count and in severe disease increased CSF pressure; Electromyography show repeated firing of the same motor unit instead of widespread
TreatmentFluid volume replacement; Plasmapheresis; Possible Tube feeding; adequate caloric intake; exercise to prevent contractures; possible trach; possible gastrostom or jejunotomy feeding
Nursing Intervention for Guillai-Barre' SyndromeAssess musculoskeletal status to determine progression of muscle weakness; Assess resp status; monitor vitals; establish means of communication; reposition q2hr; encourage cough/deep breathing; apply compression stocks; observe for s/s of complications
ComplicationsURI, Aspiration, Constipation, Urinary Retention; Thrombophlebitis; Pressure Ulcers; Contractures; Muscle Wasting; life threatening respiratory/cardiac compromise
Drug TherapyIV beta-adrenergic blockers; Parasympatholytics; IV immune globulin
Patient TeachingExplain disorder, testing and treatment plan; teach about medications; describe s/s of complications; refer to foundation for additional info and support

Section 2

Question Answer
What is Meningitisinflammation of brain and spinal cord meninges; can affect all three meningeal membranes - dura mater, arachnoid membrane and pia mater
Causes of MeningitisBacterial infection (Neisseria Meningitidis & Streptococcus Pneumoniae); Fungal infection; Protozoal infection; Secondary to another bacterial infection like Pneumonia; Skull fracture; penetrating head injury; lumbar puncture; ventricular shunting; Viral infection
Pathophysiology of MeningitisInflammation of pia-arachnoid and subarachnoid space progresses to congestion of adjacent tissues. Nerve cells are destroyed; ICP increases because of exudates
Effects of ICPengorged blood vessels, disrupted blood supply, edema of the brain tissue, thrombosis, rupture and acute hydrocephalus
Complications of MeningitisVisual impairment, optic neuritis; cranial nerve palsies; deafness; paresis or paralysis; Endocarditis; Coma; Vasculitis; Cerebral infarction; Seizures
History would includeheadaches; fever; N&V; weakness; Myalgia; Photophobia; confusion, delirium & seizures
Clinical Symptoms of MeningitisMeningismus; Rigors; profuse sweating; Kernig's and Brudzinski's sign; declining LOC; cranial nerve palsies; Rash (with meningococcemia) signs of ICP
Clinical Symptoms in infants
Nursing Intervention for Meningitismaintain airborne isolation; assess pain level; encourage active ROM; maintain adequate nutrition and hydration; provide skin/mouth care; assess neuro status; monitor vitals & I&O
Patient Teaching Explain disorder; testing; treatment plan; Explain the contagious risk for close contact; demonstrate exercise to promote muscle strength &mobility; teach about polysaccharide meningococcal vaccine and pneumococcal vaccine
Drug Therapyoxygen; antipyretics; antibiotics; antiarrhythmics; osmotic diuretics; anticonvulsants

Section 3

Question Answer
What is Huntington's Disase disorder passed down through families in which certain nerve cells in the brain waste away, or degenerate.
Clinical Symptoms of Huntington's DiseaseAntisocial behaviors; Hallucinations; Irritability; Moodiness ; Restlessness or fidgeting ;Paranoia ; Psychosis
Abnormal and unusual movements includeHead turning to shift eye position ; Facial movements, including grimaces ; Slow, uncontrolled movements; Quick, sudden, sometimes wild jerking movements of the arms, legs, face, and other body parts; Unsteady gait
Symptoms in childrenRigidity; Slow movements ; Tremor
Nursing Interventions for Huntington's Disease
Drug Therapy co-enzyme Q10 may also help slow down the course of the disease.


Question Answer
What is Parkinson's DiseaseA disease where insufficient Dopamine is being produced by the basal ganglia
Clinical Symptoms of Parkinson's Disease
Personality Changes Parkinson's Disease
Nursing Interventions for Parkinson's Disease
Drug Therapy


Question Answer
What is Huntington's Disease (Chorea)degenerative disease presenting with a gradual onset of involuntary jerking movement (Chorea) and a progressive decline in mental ability, resulting in behavioral changes and dementia.


Question Answer
A score of 7 or less indicates on the Glasgow Coma ScaleCOMA
Clients with scores greater than 8 have a prognosis forrecovery
Neuro vital sign adressesspupil size ; limb movement ; blood pressure, temperature, pulse, respirations
Observe forbladder for fullness, auscultate lungs, monitor cardiac status
Common disorder in Comatose clientsParalytic Ileus
Safety features for immoblized clientsprevent skin breakdown frequent turning; adequate nutrition; prevent aspiration with slow; monitor Neuro signs to detect ICP; ROM to prevent contractures/deformities; prevent respiratory complications (turning, position for optimal drainage)


Question Answer
Unconscious Client - Gastric GavageBegin feeding when GI peristalsis returns; High Fowlers position; after feeding, irrigate tube with tepid water and clamp tube; feeding too fast causes diarrhea, gastric distension, pain & feeding too slow causes possible obstruction of flow