MS and Parkinson's Disease

Created by lauzon15 

Upgrade to
remove ads

27 terms

Multiple Sclerosis

-Chronic, progressive, degenerative disorder of the central nervous system (CNS)
-Characterized by disseminated demyelination of nerve fibres of the brain and spinal cord
-Disease usually affects young to middle-aged adults
• Onset is between 15 and 50 years of age
• Women are affected more than men

15 and 50 years of age, women

What is the onset of MS? who does it affect more men or women?

o Loss of myelin
o Disappearance of oligodendrocytes
o Proliferation of astrocytes

Disease process consists of:

Myelin, glial, slow down, blocked, permanent

-_____ can regenerate, and symptoms disappear, resulting in a remission
-Myelin can be replaced by _____ scar tissue
-Nerve impulses ____ ____ without myelin
- With destruction of axons, impulses are totally _______ which results in _______ loss of nerve function

o Motor problems
o Sensory problems
o Cerebellar problems
o Emotional problems

Multiple Sclerosis: Clinical Manifestations (signs and symptoms)
•Vague symptoms occur intermittently over months and years
•Disease may not be diagnosed until long after the onset of the first symptoms Which include:

o Relapsing-remitting
o Benign
o Primary-progressive
o Secondary-progressive
o Progression-relapsing

Clinical courses of MS are:

• Cerebral spinal fluid (CSF) analysis
o ↑ In oligoclonal immunoglobulin G
o Contains a higher number of lymphocytes and monocytes

Multiple Sclerosis: Diagnostic Studies
• Based primarily on history, clinical manifestations, and presence of multiple lesions over time measured by MRI
• Certain laboratory tests are used as adjuncts to clinical examination such as:

• Viral infections or vaccinations
• Residence in cold or temperate climates
• Physical and emotional stress
• Medications
• Elimination problems
• Weight loss, dysphagia
• Muscle weakness or fatigue, tingling or numbness, muscle spasms
• Blurred or lost vision, diplopia, vertigo, tinnitus
• Decreased libido, impotence
• Anger, depression, euphoria, isolation

What should you ask the client about their Health history?

o Objective data

These are all what kind of data collected by nurse for the client with MS:
 Apathy, inattentiveness
 Pressure ulcers
 Scanning speech
 Tremor
 Nystagmus
 Ataxia
 Spasticity
 Hyperreflexia
 ↓ hearing
 Muscular weakness
 Paresis
 Paralysis
 Foot dragging
 Dysarthria

o Impaired physical mobility
o Dressing/grooming self-care deficit
o Risk for impaired skin integrity
o Impaired urinary elimination pattern
o Sexual dysfunction
o Interrupted family processes

• Nursing Diagnosis of MS could include:

Nursing Implementation

These are all considered what in reference to MS
o Help client identify triggers and develop ways to avoid them or minimize their effects
o Reassure client during diagnostic phase
o Assist client in dealing with anxiety caused by diagnosis
o Prevent major complications of immobility
o Focus teaching on building general resistance to illness

Parkinson's Disease (PD)

-Disease of basal ganglia
-Diagnosis increases with age, with peak onset being in the sixth decade
-More common in men, ratio of 3:2

dopamine-producing, dopamine-acetylcholine, 80%

Parkinson's Disease: Etiology and Pathophysiology
•Pathological process of PD involves degeneration of ______ ______ neurons in substantia nigra of the midbrain
•Disrupts _______ _______ balance in basal ganglia
•Symptoms of the disease do not occur until __% of neurons in the substantia nigra are lost

Cerebellar manifestations
o Nystagmus
o Ataxia
o Dysarthria
o dysphagia
o Tremor
o Rigidity
o Bradykinesia
• Emotional manifestations
• Bowel and bladder functions may be impaired (Constipation, Spastic bladder:small capacity for urine results in incontinence, Flaccid bladder: large capacity for urine and no sensation to urinate)
• Progression may involve only one side of the body, initially
• Beginning stages may involve only mild tremor, slight limp, or ↓ arm swing
• Later stages may have shuffling, propulsive gait with arms flexed, and loss of postural reflexes

Parkinson's Disease: Clinical Manifestations (signs and symptoms) include:
•Onset is gradual and insidious

• Classic triad of PD
o Tremor
o Rigidity
o Bradykinesia

Tremor, Rigidity, Bradykinesia

•The Classic triad of PD are:
o Tremor
o Rigidity
o Bradykinesia

• Nonmotor symptoms
• As disease progresses, complications increase
• Dementia occurs in 40% of clients
• Dysphagia may result in malnutrition and aspiration
• General debilitation may lead to pneumonia, UTIs, and skin breakdown
• Orthostatic hypotension may occur
• Sleep disorders are common and potentially severe

Parkinson's Disease:Complications include:

o Depression, anxiety, apathy, fatigue, pain, constipation, impotence, short-term memory impairment

Nonmotor symptoms can include:

o Motor symptoms, weakness, akinesia, neurological problems, neuropsychiatric problems

As disease progresses, complications increase such as:

• No specific tests
• Based primarily on history, clinical manifestations...
• CSF analysis
o Increased in oligoclonal immuniglobulin
o Test for increase nerve conduction

Parkinson's Disease:Diagnostic Tests include:

Antiparkinsonian drugs, Levodopa with carbidopa (Sinemet), Coticosteroids: (Treat acute exacerbations by reducing edema and inflammation), Immnosuppresive therapy (Beneficial effects in client with progressive-relapsing)

Parkinson's Disease: Collaborative Care
• Drug therapy
Aimed at correcting imbalances of neurotransmitters within the CNS

o Health history (Past CNS damage, medications, Viral infections or vaccinations, Residence in cold temperate climates)
o Symptoms (Excessive salivation, dysphagia, constipation, incontinence, fatigue, sleep problems, diffuse pain, depression, mood swings, hallucinations)
*muscle weakness or fatigue
Blurred lost vision, diplopia, vertigo

Parkinson's Disease Nursing Management
• Nursing Assessment will include:

history and clinical features

What is the Diagnosis based solely on?


A Firm diagnosis can be made when at least __ of 3 characteristics of the classic triad (tremor, rigidity, and bradykinesia) are present

o Procedures aimed at relieving symptoms
o Used in clients who are usually unresponsive to drug therapy or have developed severe motor complications
o Ablation

Parkinson's Disease
• Some Surgical therapy include and are used when?:

o Megavitamin and diets consisting of low fat, gluten free food, and raw vegetables
o High protein..

Nutritional therapy for PD include:

o Relieve spasticity
o Increase coordination
o Train the client to substitute unaffected muscles for impaired ones

Physical therapy in PD clients is useful for:

• Nursing Diagnosis

These are all examples of what for PD?
o Impaired physical mobility
o Imbalanced nutrition: Less than body requirements
o Impaired verbal communication
o Deficient diversional activity

Please allow access to your computer’s microphone to use Voice Recording.

Having trouble? Click here for help.

We can’t access your microphone!

Click the icon above to update your browser permissions above and try again


Reload the page to try again!


Press Cmd-0 to reset your zoom

Press Ctrl-0 to reset your zoom

It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.

Please upgrade Flash or install Chrome
to use Voice Recording.

For more help, see our troubleshooting page.

Your microphone is muted

For help fixing this issue, see this FAQ.

Star this term

You can study starred terms together

NEW! Voice Recording

Create Set