Listening for Wealthy Affiliate input, Progress on Nurse Becca Blog

byNnurseBecca

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Updated 6 years ago

NEUROMUSCULAR ANOMALIES

How do nerve cells work?

Nerve anatomy creates the physiology or functions which nerves carry out. The inner part of the cell is the nucleus that is endowed with coding that is its program to perform the work of your nervous system. The outer layer of the motor cell is the myelin sheath, which helps carry signals. Nerves help deliver feeling hot, cold, pain, and pressure messages to the brain. Nerves also carry the message of how the body responds to these signals. Your nervous system balances and produces the awareness of your body in relation to space. This is known as proprioception. Proprioception is the understanding or perception of whether you are sitting or standing or suspended upside down.

How do muscle fibers work?

Just like the shape and structure of nerve cells help them work as such, muscle fibers are formed in such a way to perform the way muscles are supposed to.

This diagram shows the connection of muscle with nerve, that anatomy combined performs the function or neuromuscular physiology.

The electrical signals from energy made by mitochondria in cells carry along the nerve to your muscles and creates contractions that perform movement. Some of the movement is intentional, that is your somatic system, and the unintended movement is your autonomic system performing brainless operations.

When there is a problem

Whether it is a rare or common complication with the nerve and muscle functions, it often results in similar outcomes, restrictions and sequelae.

Myasthenia Gravis, when the nerve signal gets interrupted between the muscle and nerve.
Multiple Sclerosis
CIDP and variants POEM Syndrome, MADSAM Disease
CMT Charcae Marie Tooth Syndrome and variants
Cerebral Palsy
Traumatic Brain Injuries
Seizures
strokes, the brain attack
Quadriplegia and other paralysis
Alzheimers is a disease of the brain and central nervous system.
Multiple sclerosis
Parkinsons
Huntington's
Congenital complications
Audiology and nerve dysfunction of the ear
Botulinium toxin

This list only includes first hand patient experience. There are many other types of nerve and muscle problems not listed here. All of the anomolies interrupt the normal flow of energy from nerves to parts of the body and affect some or all ability to perform sensory. They impede some or all ability to create movement.

Nervous System is still debated, and in the process of discovery. The Sympathetic part does not feel sorry for you, rather it activates fight/flight emergencies. Parasymathetic used to include your gut smooth muscle, which has grown a tab of its own as the ENS (enteral nervous system). These are autonomic nerves that work automatically. A disruption between the signal between nerve and muscle is a problem that requires interventions regardless of where it occurs within the body.

Role of therapies

Skilled Nursing

Skilled needs include home bound wound care, medication management, pain control, tracheostomy and ventilator, Parenteral nutrition, infusion teaching and administration, medical and surgical rehabilitation, coordination of ancillary disciplines:

PT/OT/ST/MSW

Physical therapy-work outs and physical training

Occupational therapy-use of adaptive products, equipment and techniques to adapt to health impairments

Speech therapy- Did you know the hidden super power of speech therapy? They do not just help people practice talking with mashed potatoes in their mouth. For example, they are heros when modifying diet to someone who is unable to swallow properly after a stroke. This prevents them from choking or silently aspirating stomach contents into the lungs.

Medical social work- assists in adapting to loss of function requiring therapies. They provide social, spritual and emotional resources and coordinate living will, power of attorney, as well as advocacy.

Home Health is certified for 2 month periods if the interdisciplinary team can progress on planned objectives by meeting measurable milestones.

In-Home Care has a separate niche, they provide care in the home in specific time increments through the day or night and if needed, 24 hour care.

Hospice 101: Many families and individuals have a very tough time when making a decision whether to use hospice care at the end of life for comfort measures. Sometimes families disagree or are in denial that the loved one is knockin on heaven's door. Denial is a stage of grief! Grief is complicated when someone is frozen in one stage with ongoing depression. Hospice combats complicated death with support, and the support continues after the loss of a loved one. During the process of death, the medical team helps prioritize comfort and provides hospital beds, medication, wound care and many other skilled needs. The treatment plan shifts, to focus on quality of life and prevention of complicated recovery from a death of someone you love.

Immunoglobulins

Dig SCIG!

Immunoglobulins are liquid medicine made from blood plasma. The intravenous route has its disadvantages, leading to new subcutaneous immunoglobiulns that can be given in the skin instead of veins.

Ports can also help to alleviate venous access difficulty, less frequently a PICC line can be used.

Peripheral IV has some pitfalls. It takes proper understanding and continuous update of skill, knowledge and best practice because IV medications are more prone to error. Many people with the rare disorders have or develop complications with IV access. The veins are also innervated! Could you guess which part of the nervous system regulates the innervation of veins?

Toxic Torts

Damages are sought in court cases regarding toxic torts. This occurs when a chemical has caused personal injury toward people that was preventable or undisclosed. An example is asbestos or agent orange. Others include exposure to carcinogens, such as the blood pressure medications that are recalled.

Some toxic torts will cause irreparable harm to nerve and muscle cells.

Fall Prevention

Regardless of the etiology, any neuromuscular impairment requires attention to preventing injury related to falls. Standards are changing to incorporate a universal fall prevention approach that considers every person a fall risk. The over use of fall alarms is debated due to the risk of pressure ulcers or restraint of the patient. As well as alarm fatigue of caregivers. Using a standard precaution approach is developed to avoid missing a fall risk. This prevents failing to acknowledge all who require medical attention will have diagnosis or treatment that inherently ncreases risk of falls.

One very highly litigated topic is falls. This results in constant pressure for the health care team to do everything in their power to prevent falls. Still, falls occur regardless of every prevention and precaution known to man. Some people will require 1 to 1 care for prevention of falls. This will greatly decrease the incedence and severity of injuries.

Changes of technology

The evolution of technology makes it possible for reversing paralysis. Treatment or reversal of once incurable ailments are emerging. As a few elite patients of mine have gone from completely paralyzed to walking each day. I could hardly believe seeing someone go from needing a hoyer lift to driving a car after infusions to help the nerve cells.

Current studies progress about paralysis reversal involving non differentiated cells that are given a special treatment to become a nerve cell and then reinfused in increments after pooling the precurser cells. These are autologous infusions, that means the product comes from the patient. It is very sci-fi idea to imagine. The fat is extracted from stomach, then the undeveloped cells are extracted from this to be used in the experiment- I mean treatment. It is still in stages of developmemt, but there has been reversal of diaphragm paralysis. The diaphram is a muscle that is needed in order to breathe. People with diaphragm paralysis often require a ventilator, but it is possible to treat with discoveries recently made.

Technology can revolutionize the way medications are prescribed. Now you can get a buccal swab to identify the set of enzymes that tells you which medications your body can tolerate. The results are nearly 100% accurate, and consist of composites for psychotropics, anesthesia, antibiotics, opioids, and this technology will continue to grow. It seems natural that the if you can check for anaphylaxis (certain risk of sudden death), this will soon be a common diagnostic. The price of this is expensive, but some insurances do pay for it, and the good news is that you should only need to get the swab one time. That would eliminate many unnecessary and dangerous medications.

Studies continue to reverse paralysis, and products related to all the medical needs of people with paralysis. Studies continue involving genetics in medicine and results will entail new standards of care.

Innovating Care

Point blank: our health system needs to involve nurses who actively practice at the bedside in making the policies.

Goals for care planning can be revised to reflect new products, standards and individual needs that are ever changing. Nurses are required for this process.

Nurses are natural innovators, and can collaborate in many respects to help achieve the best outcomes for patients and the greater communities they serve. An ongoing investigation of new requirements, standards and best practice is needed for patient safety and quality of life.

A cornerstone of integration is for health care consumers to report needs to providers, this reciprocates the plan of action to incorporate diverse needs within the community.

Community Conclusion

The community can impact care, and has an integral role to adapt to changing health systems, products and standards.

When the community plays primary role of shaping our health care with communication, we have the ability to make changes to benefit all and adapt for ensuring better outcomes.

Here is some teaching Im scribbling about. Revisions to come, but Im looking for feedback on my draft.

I hope my notes find you well!

Thank you & kind regards,

Nurse Becca