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Fundamentals of Nursing

Summary

Fundamentals of NursingSummary

Summary

23.1 Foundations of Neuromuscular Functioning

The neuromuscular system is the combination of the neurological system and the musculoskeletal system working together effectively. The neurological system is composed of the brain, spinal cord, and peripheral nerves. The musculoskeletal system is made up of bones, muscles, and various connective tissues. Signals from the neurological system send messages to the musculoskeletal system to cause responses and reactions to external and internal stimuli to maintain homeostasis and protect the body from injury. The primary functions of the neuromuscular system include essential body movement, posture control, breathing, and maintenance of homeostasis.

23.2 Factors Affecting Neuromuscular Functioning

Several diagnostic tests can be used to help diagnose neuromuscular disorders or rule out other conditions that may be causing similar symptoms. These tests include blood tests, electromyography (EMG), radiographic imaging, nerve condition velocity testing, muscle biopsies, and genetic tests. Used in combination, these tests can help narrow down which specific disorder, among the many different types of neuromuscular conditions, the patient is experiencing, all of which have varying clinical manifestations and prognoses. Common disorders that impair the neuromuscular system include Charcot-Marie-Tooth disease, congenital myopathy, muscular dystrophy, amyotrophic lateral sclerosis, multiple sclerosis, cerebral palsy, and spinal cord injuries. Although these disorders are different in many ways, they typically all involve similar symptoms of neuromuscular impairment including loss of balance; muscle weakness, stiffness, and atrophy; pain; and breathing, swallowing, and vision impairment.

23.3 Considerations for Care of Neuromuscular Impairment

Nursing considerations for patients with neuromuscular impairment include physical needs such as maintaining respiratory function, promoting mobility, implementing pain management strategies, ensuring optimal nutrition, and monitoring elimination and skin integrity. Beyond the physical needs, it is also important for nurses to consider the emotional needs of the patient because these disorders can negatively impact overall quality of life. Additionally, it is important for nurses to collaborate with other members of the healthcare team to ensure optimal patient outcomes. This typically involves collaboration with specialty consults including dieticians, occupational and physical therapists, social workers, and speech therapists, among others. Environmental considerations for patients with neuromuscular conditions involve maintaining a safe environment because these patients are at higher risk for falls and injury. Some interventions for maintaining a safe environment include removing clutter from the room, ensuring bed alarms are on, and keeping the bed in the lowest and locked position.

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