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 Difficulty swallowing Loss of bowel or bladder control Dysphasia or aphasia Dysphagia 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 Quadriplegia Paralysis and loss of sensory function in legs. 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 Rheumatoid Arthritis Most common. Joint stiffness, pain, and swelling, lack of motion. Osteoarthritis Rheumatoid Arthritis Chronic. More common in 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 Open Skin is intact 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