Reproductive
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Decreased testosterone production/size of testes in males; Changes in prostate gland in males; Decreased secretion of female hormones/menopause; Vaginal changes in females; Sexual dysfunction both se
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Guillain-Barre
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ALS (Lou Gehrig’s)
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Myasthenia Gravis
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What is
This?
Auto-Immune or not?
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A PNS disorder, acute inflammatory demyelinating polyneuropathy, rapidly progressing flaccid paralysis.
Auto-immune
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Rapidly progressing fatal CNS disease that affects voluntary muscle control, leads to death of the cells resulting in the brain losing the ability to initiate and control muscle movement
Affects the diaphragm and chest wall resulting in respiratory failure and need for placement of an artificial airway and ventilator support, does not impair the senses or ability to think.
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Neuromuscular junction disorder that results in the body’s immune system attacking healthy cells
Auto-immune
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What are the risk factors/Causes it?
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Cause: infection by virus or bacteria usually respiratory or GI
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No known cause but environment and genetic plays a role
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No known risk factor
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How do you Diagnose?
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Lumbar puncture to obtain CSF (findings include elevated protein)
Electro myography reveals slowed nerve conduction velocity soon after the patient develop paralysis
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Both upper and lower motor neuron damage that cannot be attributed to other causes
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Serological test
Electro myography
Edrophonium (Tensilon)- Anticholinesterase
IVP, (Diarrhea, Bradycardia)
Antidote: Atropine
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What are the signs and symptoms?
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How do you treat?
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Nursing Considerations
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Cardiac Rhythms
Rhythm
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What is it?
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What causes it?
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S/S and Diagnose
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Treatment
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Normal Sinus Rhythm
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Sinus Bradycardia
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Rate less than 60 bpm
Normal P wave preceding each QRS complex
Regular atrial and ventricle rhythms
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Normal in a well-conditioned heart, example, athletes
Increased intracranial pressure, increased vagal tone due to straining during defecation,
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Administer atropine for symptoms of low cardiac output
Pacemaker
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Sinus Tachycardia
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Rate more than 100 bpm
Atrial and ventricular rhythms are regular
Normal P wave preceding each QRS complex
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Beta-adrenergic blockers or calcium channel blockers for symptomatic patients
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PVC
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Atrial and ventricular rhythm is regular
QRS complex premature, usually followed by a complete compensatory pause
QRS complexes are wide and distorted, usually less than 0.14 second
Premature QRS complexes occurring singly, in pairs, or in threes, alternating with normal beats, focus from one or more sites.
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Heart failure; old or acute myocardial ischemia, infraction or contusion
Caffeine, tobacco, or alcohol use.
Psychological stress, anxiety, pain
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Potassium chloride IV if PVS induced by hypokalemia.
Magnesium sulfate IV if PVC induced by hypomagnesemia.
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PAC
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Premature, abnormal-looking P waves that differ in configuration from normal P waves
QRS complexes after P waves except in very early or blocked PACs
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May prelude supraventricular tachycardia.
Stimulates, hyperthyroidism, COPD, infection and other heart diseases.
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Usually n
Older Adult
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Cancer
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Cardiovascular changes
Cardiac conduction is affected by the decrease in the number of pacemaker cells in the SA node with age. By age 60, the number in the pacemaker is decreased SA node. In advancing age, there is an increase in elastic and collagenous tissue in all parts of the conduction system. Fat accumulates around the SA node, sometimes it produces a partial or complete separation of the node from the atrial musculature. Cardiac output is unaffected by age.
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What is This?
Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body. Cancerous tumors spread into, or invade, nearby tissues and can travel to distant places in the body to form new tumors (a process called metastasis). Cancerous tumors may also be called malignant tumors. Benign tumors do not spread into, or invade, nearby tissues. When removed, benign tumors usually do not grow back, whereas cancerous tumors sometimes do.
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Respiratory changes
Alveoli lose their shape and become baggy. The diaphragm over time become weaker, decreasing the ability to inhale and exhale, this happens when exercising. Ribcage bones become thinner and the shape changes, which makes it less able to expand and contract with breathing.
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What are the risk factors/Causes it?
The most common risk factors for cancer include aging, tobacco, sun exposure, radiation exposure, chemicals and other substances, some viruses and bacteria, certain hormones, family history of cancer, alcohol, poor diet, lack of physical activity or being overweight.
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Gastro changes
Alterations in taste and smell, gastric motility, intestinal overgrowth and changes in gastro hormone release are the basis of the physiological anorexia of aging. Alterations in swallowing lead to silent aspiration. Changes in gastro function can lead to constipation and fecal incontinence. Changes in probiotics can lead to diarrhea and altered immune system. In the liver, aging is associated with delayed drug metabolism.
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How do you Diagnose?
The doctor does a biopsy to diagnose cancer. A biopsy is a procedure in which the doctor removes a sample of tissue. A pathologist looks at the tissue under
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Multiple Sclerosis
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Parkinson’s Disease
|
Bell’s Palsy
|
What is
This?
Auto-Immune or not?
|
A neurologic disease resulting in impaired and worsening function of voluntary muscles. Affecting nerve cells in the brain and spinal cord.
Auto-Immune
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Progressively debilitating disease affecting motor function. Overstimulation of the basal ganglia by acetylcholine, dopamine is decreased
Not Auto Immune
|
Muscle weakness on one side of the face.
Inflammation of the cranial nerve # 7
Recovery 3 weeks- 9 months (some patient may have residual affects)
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What are the risk factors/Causes it?
|
Caused by a genetic, immune mediated attack or infection that destroys myelin.
Risks: Age between 20-40, females, family history, association with interleukin 7 and interleukin 2 receptor genes, viruses and infectious agents, living in a cold climate, physical injury, emotional stress, pregnancy, fatigue, overexertion
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Risks: Onset findings age 40-70, males, genetic predisposition, environmental toxins, chemical solvents, chronic use of antipsychotic medications.
Complications: pneumonia, aspiration, dementia
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Causes: reactivation of herpes, acute demyelination like Guillain Barre, viruses
Risks: Age, pregnancy, patients with diabetes or hypothyroidism
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How do you Diagnose?
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There is no single test to diagnose MS. A thorough physical and neurologic examination that includes MRI imaging and blood test, combined with a careful study of an individual’s medical history.
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What are the signs and symptoms?
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Decrease in cognitive function
Blurred vision
Incontinence and urinary urgency
Muscle spasms
Dizziness
Depression
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How do you treat?
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Corticosteroids
Plasma exchange
Interferon beta medications
Fingolimod (Gilenya)
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Nursing Considerations
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