1. MNA Mosby’s Long Term Care Assistant Chapter 39 Nervous System and Musculo-Skeletal Disorders

2. Nervous System Disorders
Stroke - CVA
Loss of oxygen to the brain
Ruptured vessel or obstructed vessel
Brain cells die
Brain damage occurs

3. Nervous System Disorders
TIA – Transischemic Attack
Temporary or short term loss of blood supply to brain
Mini stroke
Warning sign of impending stroke

4. 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

5. Nervous System Disorders
Stroke
Risk Factors:
Age – older at greater risk

6. Nervous System Disorders
Stroke
Risk Factors:
Family history – your risk increases if your immediate family as had a stroke

7. Nervous System Disorders
Stroke
Risk Factors:
Race – blacks are at a greater risk than other groups

8. Nervous System Disorders
Stroke
Risk Factors:
Hypertension – high blood pressure increases your risk of stroke

9. Nervous System Disorders
Stroke
Risk Factors:
Heart Disease –
hx of atherosclerosis or heart attack increases your risk

10. Nervous System Disorders
Stroke
Risk Factors:
Smoking – damages blood vessels. Increases B/P.

11. Nervous System Disorders
Stroke
Risk Factors:
Diabetes – damages blood vessels. Increases B/P

12. Nervous System Disorders
Stroke
Risk Factors:
High cholesterol – fatty material build up on wall of arteries. Causes obstruction.

13. Nervous System Disorders
Stroke
Risk Factors:
Obesity – at risk for high B/P, heart disease, diabetes, high cholesterol

14. Nervous System Disorders
Stroke
Hemiplegia – paralysis on one side of the body.

15. Nervous System Disorders
Stroke
Difficulty speaking
Difficulty swallowing
Loss of bowel or bladder control
Dysphasia or aphasia
Dysphagia
Incontinence

16. Nervous System Disorders
Stroke – Care of
Semi fowlers
Turn Q2
Assistive devices
ROM
Rehab starts immediately
Encouragement!

17. Nervous System Disorders
Parkinson’s Disease
Slow, progressive, chronic
Area of brain controlling muscle movement is effected

18. Nervous System Disorders
Parkinson’s Disease
Tremors
Rigid stiff muscles
Stooped posture
Impaired balance
Mask like expression

19. Nervous System Disorders
Parkinson’s Disease : Care of
Exercise PT
Drugs

20. Nervous System Disorders
Multiple Sclerosis
Chronic
Myelin in brain and spinal cord is destroyed
Nerve transmission cannot be sent

21. Nervous System Disorders
Multiple Sclerosis
Vision problems
Muscle weakness
Balance problems
Partial or complete paralysis

22. Nervous System Disorders
Multiple Sclerosis – Care of
Remain as active as possible
Skin care
ROM

23. Nervous System Disorders
Amyotrophic Lateral Sclerosis - ALS
Lou Gehrig’s Disease
Attacks nerve cells that control voluntary muscles
Usually years old
No cure
Usually die 3-5 years after onset

24. 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

25. 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.

26. Nervous System Disorders
Spinal Cord Injuries -Care of
Prevent falls
Keep bed in low position
Call light within reach
Turn Q2
ROM
Skin care

27. Musculoskeletal Disorders
Arthritis
Inflammation of the joints

28. Arthritis Osteoarthritis Rheumatoid Arthritis Most common.
Joint stiffness, pain, and swelling, lack of motion.
Osteoarthritis
Rheumatoid Arthritis
Chronic. More common in women. Ages of

29. Arthritis Patient care Pain relief Heat applications Exercise
Proper positioning
Weight control
Fall prevention

30. Musculoskeletal Disorders
Osteoporosis
Brittle, porous bones
Older men and women are at risk
Lack of estrogen causes bon changes

31. Musculoskeletal Disorders
Osteoporosis
Prevention:
Calcium supplements
Exercise
No smoking
Good body mechanics

32. Musculoskeletal Disorders
Fractures
Broken bone
Closed
Open
Skin is intact
Bone has come thru the skin

33. Musculoskeletal Disorders
Fractures
Casts
Do not cover with blankets
Turn Q2
Keep dry
Elevate extremity
Report unusual S&S

34. Musculoskeletal Disorders
Fractures
Traction
Reduces and immobilizes fractures
Steady pull from 2 directions keeps bone straight

35. 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

39. Musculoskeletal Disorders
Fractures
Traction Care
Good skin care
Good body alignment
Keep weights off floor
Report unusual S&S

40. Musculoskeletal Disorders
Fractures
Hip Fx –
Prosthesis – used to repair hip fx
Common in elderly
Healing is slower
Rehab needed

41. Musculoskeletal Disorders
Fractures
Hip Fx Care –
Good skin care
TC&DB
Trochanter Rolls to prevent hip adduction

42. 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)

43. Musculoskeletal Disorders
Loss of Limb
Fitted with a prosthesis
Stump – end of remaining limb
Phantom pain- pain in the missing part