Neurological Disorders (Multiple Sclerosis, Myasthenia Gravis, Guillain-Barré Syndrome) for Certified Emergency Nursing (CEN)

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Study Tools For Neurological Disorders (Multiple Sclerosis, Myasthenia Gravis, Guillain-Barré Syndrome) for Certified Emergency Nursing (CEN)

Example Care Plan_Multiple Sclerosis (MS) (Cheatsheet)

Multiple Sclerosis Pathochart (Cheatsheet)

Multiple Sclerosis Patho (Image)

Multiple Sclerosis Symptoms (Image)

Multiple Sclerosis Symptoms (Mnemonic)

Multiple Sclerosis Interventions (Picmonic)

Multiple Sclerosis Assessment (Picmonic)

Myasthenia Gravis Pathochart (Cheatsheet)

Example Care Plan_Myasthenia Gravis (MG) (Cheatsheet)

Myasthenia Gravis (Image)

Myasthenia Gravis Assessment (Picmonic)

Assessment of Guillain-Barre Syndrome (Mnemonic)

Outline

Neurological Disorders (Multiple Sclerosis, Myasthenia Gravis, Guillain-Barré Syndrome)

Definition:

Neuron dysfunction delays messages to muscles

Neuron:

Primary component of nervous system
Myelin sheath – allows electrical impulses to transmit quickly and efficiently
Neurotransmitters
Excitatory: norepinephrine, acetylcholine
Inhibitory: serotonin, dopamine, GABA

Multiple sclerosis-

Definition:

Autoimmune condition
Attacks CNS
Demyelination of axon

Clinical manifestations:

Changes in sensation in the arms, legs, and face
Complete or partial vision loss, double vision
Weakness, unsteady gait/balance

Interventions:

Steroids
Immunosuppressants
Antineoplastics

Myasthenia Gravis: (mouth to ground)

Definition:

Autoimmune disease of the neuromuscular junction
Decreased receptor sites for acetylcholine binding

Clinical manifestations:

Slowed innervation → muscle fatigue
Weak eye muscles → ptosis
Weak pharyngeal muscles → dysphagia
Impaired verbal communication
Weak respiratory muscles → respiratory paralysis

Guillain-Barré: (from ground to brain)

Definition:

Acute peripheral neuropathy causing ascending weakness
Autoimmune disease
Damage to the myelin sheath

Clinical manifestations with disease progression:

Tingling in the extremities
Loss of deep tendon reflexes
Symmetric paralysis beginning in lower extremities and moving upward

Interventions:

25% require mechanical ventilation
Care is supportive

Evaluation | Patient Monitoring | Education:

Fall risk!
Impaired ADLs
Continuously monitor and treat as indicated
Be prepared to support airway!
Monitor patient response/outcomes, and modify nursing care plan as appropriate
If positive patient outcomes are not demonstrated, reevaluate assessment and/or plan of care

Linchpins: (Key Points)

Multiple Sclerosis – Demyelination of axon, overall weakness
Myasthenia Gravis (mouth to ground), neuromuscular junction, decreased receptor sites for acetylcholine (excite) binding
Guillain-Barré (from ground to brain) acute peripheral neuropathy, myelin sheath damage

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Transcript

For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/

References:

Emergency Nurses Association. (2017) Emergency Nursing Core Curriculum, 7th Edition. PA: Saunders
Raschke-Deichstetter, N. (2017). Neurologic Emergencies. In CEN Online Review. Emergency Nurses Association.