Neurology Diseases: Parkinson’s, MS, MG & ALS Nursing Goals

Whether it’s Parkinson’s disease, myasthenia gravis, multiple sclerosis, or amyotrophic lateral sclerosis, the nursing goals for all clients are the same – to maintain healthy well-being. The pathophysiology will not matter for as long as the client’s healthy lifestyle is adequately addressed because the issues will not be reversed.

The chief nursing goals when taking care of clients with neurological issues are the following:

  1. Maximizing motor function
  2. Maintaining activities of daily living (ADL)
  3. Prevent depression
  4. Maintain airway, breathing, and circulation (ABC)

Let’s discuss each goal below.

Motor Function

One of the primary goals for clients suffering from neurological disorders is maximizing their motor function. Since neurology problems are favorite NCLEX® topics, here’s a scenario:

When dealing with Parkinson’s disease, myasthenia gravis, or multiple sclerosis clients, as a nurse, should you help them with their ADLs, or would you give them assistive devices so they can help themselves and become more independent?

Since the priority nursing goal is to maximize motor function, the best possible answer is to allow the clients to be as independent as possible. Nurses should try not to do everything for the clients especially if they are living inside a home care facility. However, if they are completely unable to perform the task, assisting them is fine.

Activities of Daily Living

As mentioned, it is essential that clients who have neurological dysfunctions practice their full potential with their ADLs. Whether it’s getting dressed, combing their hair, tying their shoelaces, or brushing their teeth, nurses should allow their clients to do all these activities with less or no intervention whatsoever; unless the clients are totally incapable of doing so.

Depression

Because the conditions are irreversible, the psychosocial aspect must be taken into great consideration because clients tend to fall into depression knowing that their situation is not going to get any better. Furthermore, due to their diminished motor functions, clients are bound to think that they are useless, which increases their depressive mood. For this reason, it is essential that clients are given independence when it comes to their ADLs and activities that can improve their social skills.

Airway, Breathing, and Circulation

Lastly, and the most important goal, is making sure that the client’s airway, breathing, and circulation are not compromised. When developing a care plan, the nurse in charge should prioritize the ABCs.  Difficulty swallowing can lead to choking and can block airway; therefore, ventilation must be on standby.

Summary

As a summary, the nursing goals with clients who have neurological disorders like Parkinson’s disease, myasthenia gravis, multiple sclerosis, and amyotrophic lateral sclerosis should primarily focus on their independence and motor functions, but most importantly, their ABCs and psychosocial status.

Effective nurses must not only focus on their clients’ pathophysiology and diagnosis but their overall well-being as well especially when taking care of clients with neurological issues.

For our next topic, we’ll be focusing on the four conditions mentioned here, their pathophysiology, causes, and treatments. And for more useful nursing-related lectures and videos, check out our Simple Nursing website and YouTube channel.

Neurology Review: A Quick Rundown of Myasthenia Gravis and ALS

In this neurology review, we’ll be determining what myasthenia gravis and ALS is.

Myasthenia Gravis (MG)

This condition affects the functions of the peripheral nervous system and not the central nervous system which is composed of the brain and spinal cord. The peripheral nervous system is mostly comprised of the muscles and nerves that control the lungs and body movement.

Trivia: Walt Disney created the dwarf, Sleepy, who is a character from Snow White and the Seven Dwarves as a tribute to one of his good friends who has had myasthenia gravis.

And Sleepy’s character is an accurate representation of people who have myasthenia gravis because this condition is manifested as severe muscle weakness that can affect the eyes (droopiness), the lungs, the face, and the throat.

Acetylcholine

The major factor that is affected in myasthenia gravis is a chemical called acetylcholine. Acetylcholine is a potent neurotransmitter that helps the neurons to communicate and thereby, creating a normal body reaction. Due to ineffective secretion of acetylcholine, the body can develop myasthenia gravis.

Signs and Symptoms

People who have myasthenia gravis would appear like gravity is making a huge pull on parts of the client’s body, specifically on the face. The apparent signs and symptoms are:

  • Drooping of the eyelids
  • Difficulty swallowing and chewing
  • Muscle weakness
  • Airway and diaphragm issues.

Since difficulty swallowing is included in the manifestations, as a nurse, you have to watch out for aspiration precautions; which is always a huge factor when answering a myasthenia gravis question in your major exams.

Myasthenia gravis is not a progressive disease and mostly occurs due to some triggering factors which would prompt this response.

Amyotrophic Lateral Sclerosis (ALS)

Amyotrophic lateral sclerosis (ALS) is also known as Lou Gehrig’s disease. This condition is considered as the worst neurological disease that a person can get. Why? For the following reasons:

  • ALS is incurable.
  • ALS has no remissions.
  • ALS is depressing.
  • ALS clients have a life expectancy of about three to five years.

A Prisoner of Your Own Body

The scary part about having ALS is that it’s a disease which makes the client feel like a prisoner of his or her own body. This is because, with ALS, the motor neurons become sclerotic and stiff. While the sensory neurons are still intact and you still think and feel normally, your body cannot move due to motor neuron destruction.

The 3 D’s of ALS

To easily distinguish ALS from the other neurological diseases, you have to remember the three D’s, namely:

  • Dysarthria – difficulty moving
  • Dysphagia – difficulty swallowing
  • Drooling

Complications Leading to Death

As mentioned, ALS affects the motor neurons as they become sclerotic and stiff. Though the brain is still functioning and the senses are still intact, the motor functions are compromised to the point of uselessness. ALS is quite a depressing condition because, aside from feeling trapped in their bodies, clients are also given a life sentence of three to five years.

The progression of this disease will eventually create a domino effect of complications like lung dysfunction and infection, and clients are required to go on a vent to facilitate mechanical breathing.  

Clients with ALS don’t die from the disease itself but from the failure of organs to perform their responsibilities.

So, what are some goals for nurses in taking care of the client with neurological diseases? We’ll get into that on our next lecture. So, check it out on our SimpleNursing website or YouTube channel.