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ALS Concept Map

Disease Patho

Patho

Motor neurons in the brainstem & spinal cord gradually degenerate idiopathically. Dead motor neurons cannot make or send singals to muscles, causing electric & chemical signals to not reach the muscles causing denervation and lack of stimulation

Medications

Treatment

Treatment options are limited. There is not cure

Riluzole given P.O or through PEG tube - reduces damage to motor neurons by decreasing release of glutamate, slowing progression of disease

Edaravone given IV or P.O - exact MOA is yet to be discovered however it is a free radical scavenger

signs & symptoms

Clinical Manifestations

-dysphagia

-spontaneous clenching & biting

-dysarthria of lips, tongue & pharynx

-layrngospams

-tachypnea, dyspnea, orthopnea

-absent abdominal reflexe

-stiffness

-muscl cramps

-difficulty writing

-foot drop

-muscle atrophy

-fasciculation

There is no one test to diagnose ALS, it is mostly done througb process of elimination

usual diagnostics performed are

-MRI of head neck & lower spine

-EMG to test nerve conduction

-urinalysis

-spinal tap

Diagnostics

Adverse Reactions

The end result of ALS is inevitable

, before death almost every person with ALS may experience

-muscle wasting

-dysphagia

-aspirtion pneumonia

Labs

Some labs to look at would be

-an increased creatinine kinase level which could indicate sign of muscle damage

Nursing Considerations

-facilitate commmunicaion between the patient and family

-reduce risk for aspiration

-early identification of respiratory insufficiency

-decrease pain from muscle weakness

-decrease risk for fall

-provide diversional activities like reading and companionship

-guide patient in use of moderate-intense endurance-type exercises for trunk & limbs to help reduce spacisity

-discuss advanced directives & artificial methods of ventiliation with patient & family

Teaching

resources

Resources

for ALS, H. C. (2021). Patient education: Learning about ALS. Massachusetts General Hospital. https://www.massgeneral.org/neurology/als/patient-education

Harding, M., Kwong, J., Roberts, D., Hagler, D., & Reinisch, C. (2020). Lewis’s medical-surgical nursing: Assessment and management of clinical problems (11th ed.). Elsevier, Inc.

What is Als?. The ALS Association. (n.d.). https://www.als.org/understanding-als/what-is-als

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