MS: Guillain-Barre Syndrome

GUILLAINE-BARRE SYNDROME (GBS) – CNS disorder characterized by bilateral, symmetrical, polyneuritis leading to ascending muscle weakness/paralysis.

MS: Myocardial Infarction

MYOCARDIAL INFARCTION

• Death of myocardial cells from inadequate oxygenation, often caused by sudden complete blockage of a coronary artery
• Characterized by localized formation of necrosis (tissue destruction) with subsequent healing by scar formation & fibrosis
• Heart attack
• Terminal stage of coronary artery disease characterized by malocclusion, necrosis & scarring.

MS: COPD Chronic Obstructive Pulmonary Diseases

Chronic Obstructive Pulmonary Disease (COPD), also known as chronic obstructive lung disease (COLD), chronic obstructive airway disease (COAD), chronic airflow limitation (CAL) and chronic obstructive respiratory disease (CORD), is the occurrence of chronic bronchitis or emphysema, a pair of commonly co-existing diseases of the lungs in which the airways narrow over time. This limits airflow to and from the lungs, causing shortness of breath (dyspnea). In clinical practice, COPD is defined by its characteristically low airflow on lung function tests. In contrast to asthma, this limitation is poorly reversible and usually gets progressively worse over time. In England, an estimated 842,100 of 50 million people have a diagnosis of COPD.

MS: Hypothyroidism vs Hyperthyroidism

HYPOTHYROIDISM	HYPERTHYROIDISM
Decreased T3 and T4	Increased T3 and T4
Early Signs 1.        Weakness and fatigue 2.        Loss of appetite but (+) weight gain d/t increased lipolysis 3.        Dry skin 4.        Cold intolerance 5.        Constipation 6.        Menorrhagia Late Signs 1.        Brittleness of hair 2.        Non-pitting edema 3.        Hoarseness of voice 4.        Decreased libido 5.        Decreased vs 6.        Cns changes a.         Lethargy b.        Memory impairment c.         Psychosis	1.        Hyperphagia – increased appetite 2.        (+) weight loss d/t increased metabolism 3.        heat intolerance 4.        moist skin 5.        diarrhea 6.        increased VS 7.        CNS changes a.         Irritability b.        agitation c.         Tremors d.        Restlessness e.         Insomnia f.          Hallucinations 8.        Goiter 9.        Exophthalmos 10.     Amenorrhea
1.        Monitor STRICTLY VS, IO to determine presence of MYXEDEMA COMA a complication of severe hypothyroidism characterized by: a.         Severe hypotension b.        Bradycardia c.         Bradypnea d.        Hypoventilation e.         Hypoglycemia f.          Hyponatremia g.         Hypothermia 2.        Administer isotonic fluids as ordered 3.        Administer medications as ordered – thyroid hormones or agents (may cause insomnia and heat intolerance) 4.        Provide dietary intake low in calories to prevent weight gain 5.        Institute meticulous skin care 6.        Provide comfortable and warm environment 7.        Forced fluids	1.        Monitor VS and IO strictly to determine presence of THYROID STORM/Crisis 2.        Administer medications as ordered a.         Anti-Thyroid Agents: PTU à toxic effects is agranulocytosisà fever and chills, sore throat (throat CS pls!), leukocytosis (CBC pls!) b.        Methimazole (Tapazole) 3.        High calorie diet to correct weight loss 4.        Provide comfortable and cool environment 5.        Institute meticulous skin care 6.        Maintain side rails 7.        Bilateral eye patch to prevent drying of eyes 8.        Assist in surgical procedure: subtotal thyroidectomy PRE-OP Administer lugol’s solutions/ SSRI to promote decreased vasculature  and promote atrophy of the thyroid gland to prevent/minimize bleeding and hemorrhage POST-OP WOF signs of THYROID STORM à agitation, hyper-thermia, HPN. If (+) thyroid storm: administer anti-pyretics and beta-blockers; VS, IO and NVS strictly, siderails up, provide hypothermic blanket WOF: inadvertent or accidental removal of parathyroid gland à hypocalcemia or tetany [(+) trousseu’s signs, (+) chvostek’s Give Ca Gluc slowly to prevent arrhythmia and arrest WOF accidental laryngeal nerve damage à hoarness of voice à instruct client to talk immediately post-op à if (+) notify MD WOF signs of bleeding à (+) feeling of fullness at incision site, (+) soiled dressings at back or nape area, notify MD WOF signs of laryngeal spasm à DOB and SOB à prep trache set 9.        Hormonal Replacement therapy for life 10.     importance of FFup care 11.     wearing of medic-alert bracelet

PNLE December 2012 UPDATES: NLE TIPS - MEDICAL AND SURGICAL NURSING

Dec 2012 NLE TIPS MS (A) from Mark Fredderick Abejo

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NEXT: DECEMBER 2012 NLE TIPS - PSYCHIATRIC NURSING

PNLE December 2012 UPDATES: NLE TIPS - COMMUNITY HEALTH NURSING

Dec 2012 NLE TIPS CHD and CD from Mark Fredderick Abejo

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NEXT: DECEMBER 2012 NLE TIPS - MS NURSING