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What is peripheral neuropathy?
denotes damage to nerves of the peripheral nervous system
Name 3 kinds of neuropathies.
- 1. mononeuropathy
- 2. polyneuropathy
- 3. viseralneuropathy
What is mononeuropathy?
is a type of neuropathy that only affects a single nerve
What causes mononeuropathy?
- often the cause is a localized trauma or infection
- most common is physical compression of the nerve, (eg carpal tunnel syndrome)
- interruption of blood supply (ischemia),
Name some common mononeuropathies?
- carpal tunnel syndrome
- “foot falling asleep” is a mild form of mononeuropathy
What is polyneuropathy?
- neurological disorder that occurs when many nerves throughout the body malfunction simultaneously.
- acute or chronic
What are some manifestations of polyneuropathy?
- freq hands and feet are affected
- sensory – decreased ability to feel hot/cold,
- alt. or impaired sensation
- impairment in autonomic systems
What causes polyneuopathy?
- autoimmune reactions
- certain drugs
- diabetes mellitus (most common)
- excessive use of alcohol
What are some treatments for polyneuropathy?
- treat the underlying disease
- pain medications
- physical therapy
What is trigeminal neuralgia?
- chronic disease
- involving CN V (opthalmic/maxillary/mandibular)
- usually middle to late life
- pressure on nerve causes pain
What is visceral neuropathy?
impairment of the autonomic system nervers
What organs does visceral neuropathy affect?
- Autonomic neuropathy can affect any of these organ systems:
- lungs, blood vessels, bone, adipose tissue, sweat glands, gastrointestinal system and genitourinary system.
What are some s/s of visceral neuropathy?
- depends on area of ANS involvement
- can be:
- loss of sense of bladder or bowel fullness
- orthostatic hypotension (fainting when standing up)nausea
- sluggish movement of the small intestine
- urinary frequency, urgency, incontinence and retention
What are some of the organs affected by visceral neuropathy?
heart, lungs, blood vessels, bone, adipose tissue, sweat glands, gastrointestinal system and genitourinary system. Autonomic neuropathy can affect any of these organ systems.
What are some collaborative treatments for peripheral disorders?
- effects usually not reversible
- non specific treatment,
- but meds may help (neurontin, lyrical, cymbalta)
- nsg care aimed at prevention:
- properly fitted shoes,
- no bare feet,
- assess skin of foot daily
- toenails professionally cut
- check temp of eater with hand or thermometer before putting feet in water
What are some s/s of trigeminal neuralgia?
- severe facial pain
- trigger zones
- usually one sided
- brief; seconds – minutes
- remission can be a long period of time,
What causes trigeminal neuralgia?
- cause is unknown
- might be:
- flu, trauma, infection, pressure on the nerve
What meds are used to treat trigeminal neuralia?
- 1. carbamazepine (Tegretol)
- 2. gabapentin (Neurotin)
- 3. anticonvulsants
What are some other treatments for trigeminal neuralgia?
- keep journal to find triggers
- possible triggers include:
- chewing, cold, wind, shave, washing, putting on cream, etc.
What surgery is done for trigeminal neuralgia?
- sever nerve but this leaves no sensation in cheek
What is Bell's palsy?
- facial paralysis resulting from a dysfunction of the cranial nerve VII (the facial nerve)
- inability to control facial muscles on the affected side
- most common acute mononeuropathy
Who usually gets Bell's palsy?
20 - 60 year olds
What causes Bell's palsy?
- No readily identifiable cause
- sometimes occurs with other disease processes,
- inflammatory condition leads to swelling of the facial nerve that block the nerve functioning
What are some s/s of Bell's palsy?
- facial drooping on the affected half
- unilateral paralysis
- Facial palsy: unable to control:
- blinking and closing the eyes,
- smiling, frowning, lacrimation,
- salivation, flaring nostrils
- raising eyebrows,
What is the prognosis for Bell's palsy?
- usuall self limiting, 3 weeks – 6 month
- most recover completely
- sometimes residual s/s,
- sometimes sever residual s/s
What meds are used for Bell's palsy?
- anti inflammatory(prednisone)
What are some nursing considerations for Bell's palsy?
- self care
- prevent injury -chewing and biting mouth parts
- maintain nutrition
- artificial tears – eyes can't blink or protect itself,
- massage for pain
- sometime physical therapy