CHAPTER 5 Nervous System^217
INTERPRETING TEST RESULTS
- Electromyogram (EMG) shows fibrillation and fasciculation; motor conduc-
tion velocity normal or slightly slowed. - Elevated creatinine kinase due to muscle changes.
- Muscle biopsy shows lower neuron degeneration.
- Pulmonary function testing shows decreased vital capacity.
TREATMENT
- Maintain adequate nutrition.
- Consult with speech pathologist for potential swallowing difficulties.
- Administer spasmolytic agent specific for amyotrophic lateral sclerosis, which
reduces the transmission of glutamine across the neural synapse. Use of this
drug appears to slow the progression of the disease:- riluzole
- Administer medications to control symptoms.
- BIPAP (bi-level positive airway pressure) to assist respiration either at night-
time, intermittently as needed, or all day. - Refer to hospice for end-of-life care.
NURSING DIAGNOSES
- Impaired physical mobility
- Ineffective airway clearance
NURSING INTERVENTION
- Develop a method of communication within the patient’s capabilities—ver-
bal communication may not be possible; patient may not be able to use call
bell system. - Monitor vital signs—monitor respiratory function and cardiovascular status;
as muscular function decreases the respiratory muscles may be affected. - Monitor input and output.