1. history of a cold or GI upset in the last month
2. Complaints of double vision and drooping eyelids
3. Fatigue, progressive muscle weakness, and twitching.
4. Loss of sensation below the level of the umbilicus.
2. Wrong. Myasthenia Gravis
4. Wrong. Spinal cord injury.
1. Discuss a percutaneous gastrostomy tube.
2. Explain how a fistula is accessed.
3. Provide an advance directive.
4. Refer to a PT for leg braces.
1. Electromyelogram (EMG).
2. Muscle biopsy.
3. Serum creatine kinase enzyme (CK).
4. Pulmonary function test.
2. Correct. Biopsy confirms changes consistent with atrophy and loss of muscle fiber, characteristics of ALS.
3. Wrong. CK may or may not be elevated.
4. Wrong. This only confirms pulmonary involvement, not a diagnosis.
1. Disuse syndrome?
2. Altered body image.
3. F/E imbalance.
4. Alteration in pain.
2. Wrong. Client does not usually have a change in body image.
3. Wrong. ALS does not affect kidneys/circ.
4. Wrong. ALS is not painful.
1. Elevate HOB 30 degrees.
2. Administer oxygen via nasal cannula.
3. Assess lung sounds.
4. Obtain a pulse ox reading.
2. Correct. Oxygen should be given immediately to help alleviate the difficulty breathing. Oxygenation is a priority.
3. Wrong. Assessment won’t help client to breathe.
4. Wrong. Pulse ox will not alleviate resp distress.
1. “It must be scary to think you might get ALS.”
2. “No, the disease is not genetic or contagious.”
3. “ALS does have a genetic factor and runs in families.”
4. “If you are exposed to the same virus, you could get it.”
2. Wrong. Incorrect information.
3. Correct. There is a genetic factor with ALS that is linked to a chromosome 21 defect.
4. Wrong. Not virus related, though possible environmental factors.