Mora, Miguel Fonzy B.

BSN 3YB-9
plasmapheresis AUTOIMMUNE DISEASES
thymectomy
Parkinson’s Disease Huntington’s Disease Multiple Sclerosis Amyotrophic lateral Sclerosis Myasthenia gravis Guillain Barre
Syndrome
progressive disorder with genetic condition that progressive, progressive chronic autoimmune a rare disorder where
degeneration of the nerve causes the progressive demyelinating dse of neurodegenerative disease disorder that causes the body’s immune
cells in the basal ganglia degeneration of nerve the CNS that affects nerve cells in the weakness and rapid system attacks the
 cells in the brain,  brain and spinal cord, causing fatigue of voluntary peripheral nervous
resulting in generalized affecting movement, results in impaired loss of muscle control. muscles due to a system. It can range
disorder on muscular fx cognitive functions, and transmission of nerve breakdown in nerve- from mild weakness to
emotions. impulses muscle communication. severe paralysis and
can affect breathing.
Most people recover,
but some have lasting
effects
 Dopamine GABA & Ach demyelination Motor neurons Antibodies demyelination

men > women men=women women > men men > women women > men men > women
AGE older population: 50 y.o. 35 & 45 years; 10% are onset 50-60 y.o. young adult females can affect anyone. It
some @ 30 y.o. children (under 40) and older can strike at any age
males (over 60) more (although it is more
frequently in young frequent in adults and
women (age 20 and 30) older people)
men aged 50 and older
CAUSE Loss of nerve cells in the Glutamine Unknown; may also be The exact cause of ALS is still Autoimmune unknown. However, it is
part of the brain a slow-growing virus not known. For about 10% of thought to be caused by
(Substantia niagra) building block for people with ALS, a genetic destroying acetylcholine a problem with the
protein cause can be identified. For receptor sites on the immune system, where
Idiopathic abnormally collects in the rest, the cause is not postsynaptic membrane the body’s natural
(postencephalitic, toxic, the cell nucleus, known. of the defense against illness
arteriosclerotic, traumatic, causing cell and infection mistakenly
or drug induced) death. (Overexcitation of nerve cells neuromuscular junction. attacks the nerves. In
by neurotransmitter • Voluntary muscles are most cases, GBS
glutamate) affected (CN) occurs a few days or
weeks after an
infection.
DXTIC TESTS - MRI - MRI - MRI - Unspecified Tensilon test - Unspecified
- Ultrasound - CT - Evoked - Electromyography EMG - Spinal tap
- PET scans potentials test (EMG) Blood test - Nerve
May show atrophy of - Lumbar - Nerve conduction -w/ anti-acetylcholine conduction
- Single-photon caudate nuclei puncture or study (NCS) receptor antibodies velocity
emission spinal tap - MRI - EMG
tomography - Blood test
(SPECT)
 - Dopamine
transporter scan
(DAT)

S/SXS 3 cardinal signs: - Cognitive 1. Visual disturbances 1. Progressive weakness of 1. Ptosis, diplopia, and 1st sx: clumsiness
tremors, rigidity, problems (1st s/s) muscles dysphagia ascending, symmetrical
bradykinesia - Depression 2. Impaired sensation 2. Dysarthria, dysphagia 2. Extreme muscle motor weakness in > 1
- stumbling and 3. Impaired motor 3. Spasticity weakness, increased limb
clumsiness function 4. Fasciculations with 
Others: masklike face, - involuntary 4. Impaired cerebellar 5. Respiratory insufficiency activity and reduced cranial nerve
stooped posture, movements of function 6. DTRs becomes brisk with rest involvement:
propulsive gait the body 5. Euphoria / mood * 25% of patients: weakness 3. Masklike facial dysphagia
- mood swings swings starts in the muscles expression 
and personality 6. Retention / 4. Weak voice, paralysis ascnt to the
changes Incontinence / hoarseness resp muscles
- problems Constipation 
swallowing, 7. Sexual impotence in absent DTRs
speaking and male
breathing
- difficulty
moving
NURSING Provide safety = side rails Prevent injury and Provide bed rest Provide intellectual stimulating Monitor respiratory Maintain adequate
MANAGEMENT up; handlebars in possible skin during exacerbation. activities, because the client status and ability to ventilation.
toilet; no scatter rugs breakdown typically experiences no cough and deep • Check individual
Protect the client from cognitive deficits and retains breathe adequately. muscle groups every 2
•Increase mobility Keep patient as close injury by providing mental abilities. hrs.
Physical therapy: to upright as possible safety measures. Monitor for respiratory • Check gag swallowing
active & while feeding. Provide client and family failure. ability.
passive ROM Place an eye patch on teaching. • Monitor vital signs and
exercises; stretching and Stabilize patient’s head the eye for diplopia. Maintain suctioning and observe for signs
warm gently with one hand Promote measures to emergency equipment periods of hypertension
baths; while feeding Monitor for potential enhance body image. at the bedside. fluctuating with
complications such as hypotension,
Assistive devices: If client The nurse needs to urinary tract infections, Promote client and family Monitor vital signs. tachycardia,
"freezes," educate and support calculuses, decubitus coping as the client and his arrhythmias.
the patient and family ulcers, respiratory tract family deal with the poor Monitor speech and • Administer
•Improve communication as they adjust to the infections, and prognosis and the grieving swallowing abilities to corticosteroids as
abilities lifestyle changes that contractures. process prevent aspiration. ordered.
•Maintain adequate are required. • Administer
nutrition Promote regular Provide referrals. Encourage the client to antiarrhythmic agents
elimination by bladder Maximize functional abilities sit up when eating. as
and bowel training. ordered.
Regular moderate Assess muscle status. • Prevent complications
exercise can reduce Encourage Instruct the client to of immobility.
stiffness and tremors. independence. conserve strength. • Promote comfort
 • Promote optimum
As the disease Assist the client to Plan short activities that nutrition (pureed foods)
progresses, the patient establish a regular coincide with times of
and family will require exercise and rest maximal muscle
more assistance with program. strength.
activities of daily living,
emotional support, and Instruct the client to Monitor for myasthenic
potential financial balance moderate and cholinergic crises.
concerns. activity with rest
periods. Administer
anticholinesterase
Assess the need for medications as
and provide assistive prescribed.
devices.
Instruct the client to
Initiate physical and avoid stress, infection,
speech therapy. fatigue, and over-the
counter medications.

Instruct the client to

wear a Medic-Alert
bracelet.

Inform the client about

services from the
Myasthenia Gravis
Foundation.