Transcript Ch 34, Nervous & Musculoskeletal

MNA
Mosby’s Long Term Care Assistant
Chapter 39
Nervous System and Musculo-Skeletal Disorders
Nervous System Disorders
Stroke - CVA
Loss of oxygen to the
brain
Ruptured vessel or
obstructed vessel
Brain cells die
Brain damage occurs
Nervous System Disorders
TIA – Transischemic
Attack
Temporary or short
term loss of blood
supply to brain
Mini stroke
Warning sign of
impending stroke
Nervous System Disorders
Stroke
Warning Signs:
Sudden numbness or paralysis on one
side of the body
Visual disturbance
Sudden loss of balance or dizziness
Sudden severe headache
Nervous System Disorders
Stroke
Risk Factors:
Age – older
at greater
risk
Nervous System Disorders
Stroke
Risk Factors:
Family history –
your risk
increases if your
immediate family
as had a stroke
Nervous System Disorders
Stroke
Risk Factors:
Race – blacks
are at a greater
risk than other
groups
Nervous System Disorders
Stroke
Risk Factors:
Hypertension –
high blood
pressure
increases your
risk of stroke
Nervous System Disorders
Stroke
Risk Factors:
Heart Disease –
hx of
atherosclerosis or
heart attack
increases your risk
Nervous System Disorders
Stroke
Risk Factors:
Smoking –
damages blood
vessels.
Increases B/P.
Nervous System Disorders
Stroke
Risk Factors:
Diabetes –
damages blood
vessels.
Increases B/P
Nervous System Disorders
Stroke
Risk Factors:
High cholesterol –
fatty material build
up on wall of
arteries. Causes
obstruction.
Nervous System Disorders
Stroke
Risk Factors:
Obesity – at risk
for high B/P, heart
disease, diabetes,
high cholesterol
Nervous System Disorders
Stroke
Hemiplegia –
paralysis on
one side of the
body.
Nervous System Disorders
Stroke
Difficulty speaking
Dysphasia or aphasia
Difficulty
swallowing
Dysphagia
Loss of bowel or
bladder control
Incontinence
Nervous System Disorders
Stroke – Care of
Semi fowlers
Turn Q2
Assistive devices
ROM
Rehab starts immediately
Encouragement!
Nervous System Disorders
Parkinson’s
Disease
Slow, progressive,
chronic
Area of brain
controlling muscle
movement is
effected
Nervous System Disorders
Parkinson’s Disease
Tremors
Rigid stiff muscles
Stooped posture
Impaired balance
Mask like expression
Nervous System Disorders
Parkinson’s
Disease : Care of
Exercise
PT
Drugs
Nervous System Disorders
Multiple Sclerosis
Chronic
Myelin in brain and
spinal cord is
destroyed
Nerve transmission
cannot be sent
Nervous System
Disorders
Multiple Sclerosis
Vision problems
Muscle weakness
Balance problems
Partial or complete
paralysis
Nervous System Disorders
Multiple Sclerosis –
Care of
Remain as active as
possible
Skin care
ROM
Nervous System Disorders
Amyotrophic Lateral
Sclerosis - ALS
Lou Gehrig’s Disease
Attacks nerve cells that
control voluntary muscles
Usually 40-60 years old
No cure
Usually die 3-5 years after
onset
Nervous System Disorders
TBI - Traumatic Brain
Injury
Sudden trauma damages
brain
Spinal cord injuries likely
Some permanent damage
is likely
Disability depends on
severity of injury
Nervous System Disorders
Spinal Cord Injuries
Paraplegia
Paralysis and loss of sensory
function in legs.
Quadriplegia Paralysis and loss of sensory
function in arms, legs,
trunk.
Nervous System Disorders
Spinal Cord Injuries Care of
Prevent falls
Keep bed in low position
Call light within reach
Turn Q2
ROM
Skin care
Musculoskeletal Disorders
Arthritis
Inflammation
of the joints
Arthritis
Osteoarthritis Most common.
Joint stiffness, pain,
and swelling, lack of
motion.
Rheumatoid Chronic. More common in
Arthritis
women. Ages of 20 -50
Arthritis
Patient care
Pain relief
Heat applications
Exercise
Proper positioning
Weight control
Fall prevention
Musculoskeletal Disorders
Osteoporosis
Brittle, porous bones
Older men and
women are at risk
Lack of estrogen
causes bon changes
Musculoskeletal Disorders
Osteoporosis
Prevention:
Calcium supplements
Exercise
No smoking
Good body mechanics
Musculoskeletal Disorders
Fractures
Broken bone
Closed
Skin is intact
Open
Bone has
come thru the
skin
Musculoskeletal Disorders
Fractures
Casts
Do not cover with blankets
Turn Q2
Keep dry
Elevate extremity
Report unusual S&S
Musculoskeletal Disorders
Fractures
Traction
Reduces and
immobilizes fractures
Steady pull from 2
directions keeps bone
straight
Musculoskeletal Disorders
Fractures
Traction
Skin Tx – applied to skin with boot,
wrap or tape
Skeletal Tx – applied to bone with
wires or pins
Cervical Tx – tongs applied to skull
Musculoskeletal Disorders
Fractures
Traction Care
Good skin care
Good body alignment
Keep weights off floor
Report unusual S&S
Musculoskeletal Disorders
Fractures
Hip Fx –
Prosthesis – used to
repair hip fx
Common in elderly
Healing is slower
Rehab needed
Musculoskeletal Disorders
Fractures
Hip Fx Care –
Good skin care
TC&DB
Trochanter Rolls to
prevent hip
adduction
Musculoskeletal Disorders
Loss of Limb
Amputation – removal of all
or part of an extremity
Diabetes is a common cause
Lack of circulation can cause
tissue to die (gangrene)
Musculoskeletal Disorders
Loss of Limb
Fitted with a
prosthesis
Stump – end of
remaining limb
Phantom pain- pain
in the missing part