Symptomatic treatment and rehabilitative measures are employed to support the patient and improve the quality of life. "Performance of the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS) in multicenter clinical trials."
Rationale: These medications decrease spasticity, which interferes with mobility. Use closed-ended questions requiring only a “yes” or “no” response. Encourage the patient to chew thoroughly and eat slowly.
Rationale: These increase self-esteem and ability to communicate. "Excellent inter-rater, intra-rater, and telephone-administered reliability of the ALSFRS-R in a multicenter clinical trial."
(2010). Discuss the need for sufficient fluids with meals. Provide information on ALS support group: This organization provides patients and families with information, resources, and equipment loans to support quality of life. The ALSAQ-5 is the shorter version the original ALSAQ-40 Scale. Rationale: These measures can promote functioning and delay a more costly and complicated pharmacological approach to symptom management. The ALSFRS-R measures activities of daily living (ADL) and global function for patients with Amyotrophic Lateral Sclerosis (ALS). 12-question scale with 5 possible responses each (0-indicates unable to 4-indicates normal ability). The ALSFRS-R is easy to administer face-to-face or via telephone. Mexiletine in Sporadic Amyotrophic Lateral Sclerosis; This research study is to find out whether the drug mexiletine works to calm over-excited nerves and brain cells in people with ALS.
Implement transcutaneous nerve stimulation of the diaphragm as indicated. Items for the questionnaire were designed to supplement the standard outcome measures of mortality, muscle strength and pulmonary function in clinical trials of ALS. Our hottest nursing game is out now in the App Store. Promote measures to prevent respiratory infection, Threat to or change in health status, socioeconomic status, independence, Expressed concern about changes in life events. Announcement!! ALS is a progressive disease, which means it gets worse over time. Amyotroph Lateral Scler 8(1): 42-46. Patient maintains optimal physical mobility within limits of disease. ALSFRS-R does not assess behavior such as motivation or disinhibition. Diagnostic testing: electromyography, muscle biopsy, pulmonary function. Rationale: Patients have major self-care problems.
The ALSFRS-R measures activities of daily living (ADL) and global function for patients with Amyotrophic Lateral Sclerosis (ALS). Coordinate speech therapy consultation as appropriate to evaluate swallowing. Instruct the patient to use high Fowler’s position during and after meals.
Aspiration is a common problem.
Rationale: Supplemental oxygen may reduce the work of breathing. Rationale: Hydration keeps secretions thin; warm liquids loosen secretions. Rationale: If increased distress is noted, the patient may need hospitalization and artificial ventilation.
The signs and symptoms presented depend on the location of the affected neuron. Archives of Neurology 53(2): 141-147. (2) Give an unhurried, attentive appearance; be aware of defense mechanisms used (denial, regression). Rationale: These tests are done to rule out other muscle diseases. . As the disease progresses, the patient may need an assistive caregiver. Suggest the use of supportive measures (e.g., medications, clergy, social services, support groups). Encourage participation in activities and in occupational or recreational therapy. Completion of data collection will likely be high secondary to the ease of test administration. Rationale: Coordinated home care services can promote quality of life and help the patient remain in the home setting as long as desired. Pulmonary changes tend to reflect restrictive rather than obstructive problems. Rationale: Splints and braces may be indicated to support weakened muscles. Assess knowledge of the disease process, diagnostic tests, and treatment outcome.
Rationale: Nonpharmacological methods can promote quality of life.
Rationale: These procedures prevent atelectasis. Cognitive ability, orientation, and thought processes are unaffected by the disease process, even though the patient may be unable to communicate verbally.
Rationale: This approach helps the patient and family maintain a sense of normalcy. The ALSFRS-R provides a physicians-generated estimate of patient’s degree of functional impairment, which can be evaluated serially to objectively assess any response to treatment or progression of disease. Observe for signs or symptoms of infection (change in sputum color, amount, character; increased white blood cell count).
The cause of sporadic ALS is not well understood, but may be due to a combination of environmental and genetic risk factors. Rationale: The patient with ALS experiences progressive weakness and lack of coordination of the muscles that control speech. These behaviors are not consistent with the patient’s mood. Rationale: Discussion will assist in determining whether fears are based in reality. Rationale: Supplemental measures may be required to maintain adequate nutritional state and weight. (2004). Find it on PubMed. The patient can use a variety of “low-tech” and “high-tech” devices to facilitate communication. The sensitivity of ALSFRS scores to change in 53 patients’ statuses over time was assessed in this two phased trial.
Assess weight loss; inquire about weight gain or loss over the recent weeks or months. They are understandably anxious about what the future holds for them. In the absence of a respiratory infection, most ALS patients need assistance in removing oral-pharyngeal secretions using a mushroom-tipped or Yankauer suction catheter. Elevate head of bed and change the patient’s position every 2 hours and as needed. Rationale: Prior methods may be inadequate to handle this life-threatening disease.
Rationale: Many patients have been exposed to media information that causes frustration, fear, and anxiety. Note signs and symptoms, including nonverbal communication. Provide accurate information about the disease, medications, tests or procedures, and self-care. The patient needs to have access to an array of services. Anticipate the need for a nasogastric or gastrostomy tube. Encourage deep breathing exercises and use of incentive spirometry. ALSFRS-R assesses fine motor and gross motor skills, but this is not equivalent to ADL performance. Find it on PubMed, Miano, B., Stoddard, G. J., et al.
This can be very desirable for ALS patients that may have difficulty attending a clinic secondary to limitations in mobility and overall progressive decline in patients’ statuses due to the nature of the disease. Rationale: Attention to social or “fun” activities can enhance both physical and emotional states. The ALS CNTF Treatment Study (ACTS) was a 9-month trial in 36 centers in the US and Canada. Patient maintains effective airway clearance as evidenced by clear lung sounds, productive coughing, and normal respiratory rate. Rationale: This minimizes effort, conserves energy, and decreases anxiety.
Anxiety and emotional liability may impair social interactions. "Alsfrs-R." Amyotroph Lateral Scler Other Motor Neuron Disord 5 Suppl 1(S1): 90-93. As a nurse, we have the opportunity to heal the heart, mind ,soul and body of our patients, their families and ourselves. Impaired mobility related to muscle wasting, weakness, and spasticity, Impaired communication related to impairment of the muscles of speech, High risk for aspiration related to impaired muscles of swallowing, Ineffective breathing pattern related to impaired muscles of breathing. Do you see an error or have a suggestion for this instrument summary?
Rationale: This organization provides patients and families with information, resources, and equipment loans to support quality of life. Decreased intake of nutrients can contribute to weakness and fatigue. 93% of clinicians rated a 50% change in decline was very meaningful (score of 7). Rationale: This is known as pseudobulbar affect. Toll-Free U.S. Rationale: Noninvasive techniques can be used successfully to support respiratory function.
Rationale: Decreased salivation makes swallowing of certain foods difficult. (2007). Imbalanced Nutrition: Less Than Body Requirements. Rationale: Continuity promotes development of a therapeutic relationship.
Brooks, B., Sanjak, M., et al.