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Amyotrophic Lateral Sclerosis 2010

TABLE OF CONTENTSTABLE OF CONTENTS

I . IntroductionI. Introduction 11

II. Objectives.II. Objectives. 22

III . Committees III. Committees 33

Heads of CommitteesHeads of Co mmittees 44

Program Committee ....Program Committee .... 55

Budget Committee Budget Committee 77

Physical Arrangement Committee .Physical Arrangement Committee . 88

Food Committee Food Committee 1010

Documentation Committee .Documentation Committee . 1212

IV. Seminar ..IV. Seminar .. 1313

Amyotrophic Lateral Sclerosis .Amyotrophic Lateral Sclerosis . 1414

Introduction ..Introduction .. 1515

Incidence and Prevalence ...Incidence and Prevalence ... 1616

Causes .Causes . 1717

Risk Factors ...Risk Factors ... 1818

AnatomyAnatomy 1818

Symptoms Symptoms 1919

Complications Complications 2020

Pathophysiology Pathophysiology 2121

Tests and Diagnosis .Tests and Diagnosis . 2222

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Treatment and Drugs ..Treatment and Drugs .. 2323

Therapy .Therapy . 2424

Coping and Support ...Coping and Support ... 2424

V. Visual Aids V. Visual Aids 2626

VI. Seminar Peripherals VI. Seminar Peripherals

Finances Finances

The Receipts The Receipts

Food Stubs Food Stubs

Invitat ion .Invitat ion .

The Preparation The Preparation

Just Before the Seminar .Just Before the Seminar .

The Seminar .The Seminar .

The Speaker .The Speaker .

The Seminar Adviser .The Seminar Adviser .

Intermission Numbers, Food Distr ibutionIntermission Numbers, Food Distr ibution

Giving of Cert if icates Giving of Cert if icates

After the Seminar After the Seminar

VII. Registrat ion .VII. Registrat ion .

VIII . Letters .VIII . Letters .

IX. Poster .IX. Poster .

XI. Cert if icates ...XI. Cert if icates ...

XII . Evaluation XII. Evaluation

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INTRODUCTION

As new trends in the field of healthcare continue in advancement, we as future nurses are

highly valued by our institution. We are guided to develop new ways and strategies to fully equip

us with the core knowledge and skills that we may use in variety of settings.

In the aspect of rendering nursing care to the diversity of population, one good focus is to

care for the elderly. Many theories have emerged and suggested for the complexity and a number

of considerations to be applied for these clients. Moreover, we are expected as Filipino nurses to

maintain our outstanding characteristics as being caring, hospitable and true advocates of our

clients.

In line with this objective, our class BSN 4D2-3 had conducted a profound seminar

regarding one of the degenerative disorders of the aging populationthe Amyothropic Lateral

Sclerosis. The seminar entitled Major Major Malas Pag Muscle Moy Manigas which was held

on December 1, 2010 at 4:00-7:00 pm aimed to endow awareness of the necessary information

and essential interventions which are crucial for providing care for the population affected by said

condition.

It is the disorder which was named after the famous baseball player in New York named

Lou Gehrig. The unexplained progression of his inability to play the game and his remarkable

death on 1941 paved the way to the diagnosis of the neurological disease and numerous

researches regarding it. The ethicality of conducting experiments of the nervous system to

understand it fully further complicates the advances in combating the disorder. It is on our hands

as future members of the healthcare profession that we could make lives of those ALS victims a

more alleviated, prolonged and pleasing one.

Thus, we are dared to maximize our potentials and enhance our skills so that we could be

efficient and effective providers of quality care and advocates of clients capable of using critical

thinking and nursing judgment founded on the standards of nursing practice to address the

concerns of the aging population.

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OBJECTIVESOBJECTIVES

I . General ObjectiveI . General Objective

The seminar is purposely conducted toThe seminar is purposely conducted to be able to impart the essent ialbe able to impart the essent ial

k n ow l ed g e, co mp e ten ce an d s k il l s t o t h e s t ud ent s r ega rdi n g t h e ca re fo r k n ow l ed g e, co mp e ten ce an d s k il l s t o t h e s t ud ent s r ega rdi n g t h e ca re fo r

pat ients wi th Amyotrophic Lateral Sclerosis .pat ients wi th Amyotrophic Lateral Sclerosis .

II . Specific ObjectivesII . Specific Objectives

At the end of the seminar, the students are expected:At the end of the seminar, the students are expected:

A.A. To b e ab le t o i d en t ify t h e mani f es t at i on s, p a th o ph y si o lo gi ca lTo b e ab le t o i den ti fy t h e mani f es t at i on s , p a th o ph y si o lo g ica l

processes , management and prevent ion of the disorder .processes , management and prevent ion of the disorder .

B.B. To be ab le to p rov ide appropr ia te hea l th t each ing and counse l ingTo be ab le to p rov ide appropr ia te hea l th t each ing and counse l ing

so tha t the pa t i en t and fami ly may dec ide i f they may sub jec t theso tha t the pa t i en t and fami ly may dec ide i f they may sub jec t the

pat ient for l i fe-extending procedures .pat ient for l i fe-extending procedures .

C.C. To be ab le to render qua l i ty nurs ing care fo r pa t i en t s who suf fer To be ab le to render qua l i ty nurs ing care fo r pa t i en t s who suf fer

from the disorder.from the disorder.

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COMMITTEESCOMMITTEES

HEADS OFHEADS OF

COMMITTEESCOMMITTEES

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PROGRAM COMMITTEEPage6

Mr. Arman Candelaria,RN

Seminar Adviser

Paguirigan, MarjorieHead of Program

Committee

Villafranca, Fleance

Dominique

Head of Budget Committee

Tancasis, Alonica CherriHead of Physical

Arrangement Committee

Azores, Mae Ann A

Head of DocumentationCommittee

Ramos, Hazel

Head of Food Committee


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Ayuson, Maricris

Paguirigan, Marjorie

Head

Bandayrel, Jessie

Equina, Kimverlyn

Ibrahim, Aisah Mababa, Romeo

Dalay, Marc Eusebio


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BUDGET COMMITTEE

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Trinidad, Wilma

Mababa, RomeoMarquez, Jan Tracy

Villafranca, Fleance DominiqueHead


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Cabrillos, Glecyryll Pascua, Charlotte Jeniffer

Sacnanas, Jenny Mae Villegas, Alexander


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PHYSICAL ARRANGEMENT

COMMITTEE

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Tancasis, Alonica Cherri

Head

Callangan, Diana Mae

Marcos, Arvel Kate Mendoza, Marcel

Laungayan, JanilynIreneo, Esparagoza

Alboria, Rose Ann


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Pascual, Ronn Carlo Quinto, Mark Alron

Robrigado, JoelRinchon, Suyin Anne

Romualdo, Rachelle Salmasan, Phoebe Grace

Salonga, Virginia Lyn

Trinanez, Mary Grace


FOOD COMMITTEE

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Ramos, Hazel

Head

Castro, Jhonalyn Lirio, Rose Ann

Suyat, Amethyst AlyannaRabago, Christopher Noel

Angeles, Bea LuisaDiomampao, Ma. Angelique


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Punzalan, Anna


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DOCUMENTATION

COMMITTEE

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Azores, Mae Ann

Head

Angara, Grace

Roa, Juma

Cudilla, Che

Jagonia, Edelee Juan, Jill Dianne

Valeza, Elaine Grace


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RESEARCHRESEARCH

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AMYOTROPHICAMYOTROPHIC

LATERALLATERAL

SCLEROSISSCLEROSIS

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INTRODUCTIONINTRODUCTION

Amyotrophic lateral sclerosis (ALS) is a serious neurological disease that

causes muscle weakness, disability and eventually death. ALS is often called Lou

Gehrig's disease, after the famous baseball player who died of it in 1941. An inherited

form of the disease occurs in 5 to 10 percent of the cases. But in the vast majority of

cases, doctors don't yet know why ALS occurs in some people and not in others. ALS

often begins with muscle twitching and weakness in an arm or leg, or with slurring of

speech. Eventually, ALS affects your ability to control the muscles needed to move,

speak, eat and breathe.

ALS is a neurological disorder that affects the motor neurons in the brain and

spinal cord. It is characterized by neurofilament buildup and diseased nerve fibers that

result in a loss of control of an individual's voluntary muscles. As motor neurons die, the

muscles weaken and atrophy. Early symptoms of ALS vary with each individual but may

include unusually decreased endurance, stiffness and clumsiness, muscle weakness,

slurred speech, and difficulty swallowing. Other manifestations include tripping,

decreased grip, abnormal fatigue of the arms and/or legs, muscle cramps and twitches

and excessive laughing or crying.As the disease progresses, patients gradually lose the

use of their hands, arms, legs, and neck muscles, ultimately becoming paralyzed.

Speech or swallowing may be lost or at least difficult. However, thinking ability,

bladder, bowel, and sexual function, and the senses (sight, hearing, smell, taste, and

touch) are unaffected. (Oregon Health Sciences University ALS/Neuromuscular/MDA

Clinic)

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INCIDENCE AND PREVALENCE

ALS is one of the most common neuromuscular diseases worldwide, and people

of all races and ethnic backgrounds are affected. One in 200,000 people develop ALS

each year. ALS most commonly strikes people between 40 and 60 years of age, but

younger and older people can also develop the disease. Men are affected slightly more

often than women.

"Familial ALS" accounts for approximately 5%10% of all ALS cases and is

caused by genetic factors. Of these, approximately 1 in 10 are linked to a mutationin copper/zinc superoxide dismutase (SOD1), an enzyme responsible for scavenging free

radicals. A recent study has identified a gene called FUS ("Fused in Sarcoma", ALS6) as

being responsible for 1 in 20 cases of ALS.

Although the incidence of ALS is thought to be regionally uniform, there are three

regions in the West Pacific where there has in the past been an elevated occurrence of

ALS. This seems to be declining in recent decades. The largest is the area

ofGuam inhabited by the Chamorro people, who have historically had a high incidence

(as much as 143 cases per 100,000 people per year) of a condition called Lytico-Bodig

disease which is a combination of ALS, Parkinsonism, and dementia. Two more areas of

increased incidence are the Kii peninsula of Japan and West Papua.

Although there have been reports of several "clusters" including three American

football players from the San Francisco 49ers, more than fifty soccerplayers in Italy

three soccer-playing friends in the south of England, and reports of conjugal (husband

and wife) cases in the south of France, these are statistically plausible chance events.

Although many authors consider ALS to be caused by a combination of genetic and

environmental risk factors, so far the latter have not been firmly identified, other than a

higher risk with increasing age.

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http://en.wikipedia.org/wiki/Copperhttp://en.wikipedia.org/wiki/Zinchttp://en.wikipedia.org/wiki/Superoxide_dismutasehttp://en.wikipedia.org/wiki/Enzymehttp://en.wikipedia.org/wiki/Free_radicalhttp://en.wikipedia.org/wiki/Free_radicalhttp://en.wikipedia.org/wiki/FUShttp://en.wikipedia.org/wiki/Guamhttp://en.wikipedia.org/wiki/Chamorrohttp://en.wikipedia.org/wiki/Lytico-Bodig_diseasehttp://en.wikipedia.org/wiki/Lytico-Bodig_diseasehttp://en.wikipedia.org/wiki/American_footballhttp://en.wikipedia.org/wiki/American_footballhttp://en.wikipedia.org/wiki/San_Francisco_49ershttp://en.wikipedia.org/wiki/Football_(soccer)http://en.wikipedia.org/wiki/Football_(soccer)http://en.wikipedia.org/wiki/Copperhttp://en.wikipedia.org/wiki/Zinchttp://en.wikipedia.org/wiki/Superoxide_dismutasehttp://en.wikipedia.org/wiki/Enzymehttp://en.wikipedia.org/wiki/Free_radicalhttp://en.wikipedia.org/wiki/Free_radicalhttp://en.wikipedia.org/wiki/FUShttp://en.wikipedia.org/wiki/Guamhttp://en.wikipedia.org/wiki/Chamorrohttp://en.wikipedia.org/wiki/Lytico-Bodig_diseasehttp://en.wikipedia.org/wiki/Lytico-Bodig_diseasehttp://en.wikipedia.org/wiki/American_footballhttp://en.wikipedia.org/wiki/American_footballhttp://en.wikipedia.org/wiki/San_Francisco_49ershttp://en.wikipedia.org/wiki/Football_(soccer)http://en.wikipedia.org/wiki/Football_(soccer)


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CAUSES

In ALS, the nerve cells that control the movement of your

muscles gradually die, so your muscles progressively weaken and

begin to waste away. Up to one in 10 cases of ALS is inherited. But

the remainder appears to occur randomly.

Researchers are studying several possible causes of ALS, including:

Free radicals . The inherited form of ALS often involves a mutation in a gene

responsible for producing a strong antioxidant enzyme that protects your cells

from damage caused by free radicals the byproducts of oxygen metabolism.

Glutamate . People who have ALS typically have higher than normal levels of

glutamate, a chemical messenger in the brain, in their spinal fluid. Too much

glutamate is known to be toxic to some nerve cells. Glutamate is a protein

constituent used by motor neurons to communicate with one another and

abnormally high levels of glutamate have been found in the cerebrospinal fluid of

some patients with ALS. Treatment with a glutamate-inhibiting drug has shown a

modest effect in prolonging life in ALS victims.

Autoimmune responses. Sometimes, a person's immune system begins attacking

some of his or her body's own normal cells, and scientists have speculated that

such antibodies may trigger the process that results in ALS.

A number of hypotheses have been put forth, but in most cases no evidence has

been found to support them. Researchers once thought that ALS might be caused by the

same virus that causes polio and that exposure to polio would increase the risk of ALS.

Another conjecture was that an environmental toxin might cause ALS, but the nearly

uniform incidence of ALS worldwide suggests this is not the case. Some physicians

have suggested that ALS is an autoimmune disease where antibodies attack and kill the

motor neurons. However, aggressive autoimmune therapies have been tried and have

failed to alter the course of ALS.

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RISK FACTORS

ALS risk factors may include:

Heredity. Up to 10 percent of the people who have ALS

inherited it from their parents. If you have this type of ALS, your children have a

50-50 chance of developing the disease.

Age. ALS most commonly occurs in people between the ages of 40 and 60.

Sex. Before the age of 65, more men than women develop ALS. This sex

difference disappears after age 70.

Geography. People living in Guam, West New Guinea and parts of Japan have an

increased risk of developing ALS. Dietary factors may be to blame.

Military service. Recent studies indicate that people who have served in the

military are at higher risk of ALS.

ANATOMY

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The brain and the spinal cord are cold the central nervous

system. The nerves in the body such as the arms, chest, legs, abdomen

and pelvis, make up the peripheral nervous system. The brain is similar

to a very complex computer that processes input from our senses and

then tells the body how to respond, by talking or moving.

The main cells that make up the brain and spinal cord are called the neurons. The

neurons are the thinking cells of the brain. They communicate with each other by sending

signals through wires called axons.

Neurons that control our muscles are called motor neurons. The impulses sent by

axons of motor neurons cause the muscles to contract which helps us to adapt in our

environment by talking, walking, chewing and running.

SYMPTOMS

Early signs and symptoms of ALS include:

Difficulty lifting the front part of your foot and toes (foot drop)

Weakness in your leg, feet or ankles

Hand weakness or clumsiness

Slurring of speech or trouble swallowing

Muscle cramps and twitching in your arms, shoulders and tongue

Muscle atrophy is the major symptom

The disease frequently begins in your hands, feet or limbs, and then spreads toother parts of your body. As the disease advances, your muscles become progressively

weaker until they're paralyzed. It eventually affects chewing, swallowing, speaking and

breathing.

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COMPLICATIONS

As the disease progresses, people with ALS experience one or moreof the following complications:

Breathing problems

ALS eventually paralyzes the muscles needed to breathe. Some devices to assist your

breathing are worn only at night and are similar to devices used by people who have sleep apnea.

In the latter stages of ALS, some people choose to have a tracheostomy and use the full-time help

of a respirator that inflates and deflates their lungs.

The most common cause of death for people with ALS is respiratory failure, usually

within three to five years after symptoms begin.

Eating problems

When the muscles that control swallowing are affected, people with ALS can develop

malnutrition and dehydration. They are also at higher risk of aspirating food, liquids or secretions

into the lungs, which can cause pneumonia. A feeding tube can reduce these risks.

Dementia

People with ALS are at higher risk of developing:

o Frontotemporal dementia

o Alzheimer's disease

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PATHOPHYSIOLOGYPATHOPHYSIOLOGY

A. Cu/Zn superoxidase Dismutase-Related Neuro degeneration

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B. Glutamate-mediated Neurodegeneration

TESTS AND DIAGNOSIS

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Amyotrophic lateral sclerosis is difficult to diagnose early because it may appear

similar to several other neurological diseases. Tests to rule out other conditions may

include:

Electromyogram. This test measures the tiny electrical discharges produced in

muscles. A fine wire electrode is inserted into the muscles that your doctor wants

to study. An instrument records the electrical activity in your muscle as you rest

and contract the muscle. This test is mildly uncomfortable for most people.

Nerve conduction study. For this test, electrodes are attached to your skin above

the nerve or muscle to be studied. A small shock is passed through the nerve to

measure the strength and speed of nerve signals.

MRI. Using radio waves and a powerful magnetic field, MRI can produce

detailed images of your brain and spinal cord. It involves lying on a movable bed

that slides into a tube-shaped machine, which makes loud thumping and banging

noises during operation. Some people feel uncomfortable in the confined space.

Spinal tap (lumbar puncture). This test analyzes the fluid surrounding your

brain and spinal cord (cerebrospinal fluid). You typically lie on your side with

your knees drawn up to your chest. A local anesthetic is injected in an area over

your lower spine to reduce any discomfort from the procedure. Then a needle is

inserted into your spinal canal, and fluid is collected.

Blood and urine tests. Analyzing samples of your blood and urine in the

laboratory may help your doctor eliminate other possible causes of your signs and

symptoms.

Muscle biopsy. If your doctor believes you may have a muscle disease rather than

ALS, you may undergo a muscle biopsy. In this procedure, a small portion of

muscle is removed while you're under local anesthesia and is sent to a lab for

analysis.

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TREATMENTS AND DRUGS

Because there's no reversing the course of amyotrophic lateral sclerosis,

treatments mainly involve efforts to slow the progression of symptoms and make you

more comfortable and independent. Sometimes ALS goes into remission and some ALS

patients experience to be diagnosed with ALS and then suddenly the ALS goes into

remission.

Medications

The drug riluzole (Rilutek) is the first and only medication approved by the Food and

Drug Administration for slowing ALS. The drug appears to slow the disease's

progression in some people, perhaps by reducing levels of glutamate a chemical

messenger in the brain.

The doctor may also prescribe medications to provide relief from:

Muscle cramps

Constipation

Fatigue

Excessive salivation

Excessive phlegm

Pain

Depression

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THERAPY

Physical therapy. A physical therapist can recommend low-impact exercises to

maintain muscle strength and range of motion as long as possible, helping the

patient to preserve a sense of independence.

Occupational therapy. An occupational therapist can help the patient become

accustomed to a brace, walker or wheelchair and may be able to suggest devices

such as ramps that make it easier for him to get around.

Speech therapy. Because ALS affects the muscles which is used in speaking,

communication becomes an issue as the disease progresses. A speech therapist

can help teach techniques to make speech more clearly understood. Later in thedisease, a speech therapist can recommend devices such as speech synthesizers

and computers that may help the patient to communicate.

COPING AND SUPPORT

Learning that a person has amyotrophic lateral sclerosis can be devastating. The

following tips may help the client and the family cope:

Take time to grieve. The news that the client has a fatal condition that will rob

him of his mobility and independence is often nothing less than shocking. If a

client is newly diagnosed, he and his family will likely experience a period of

mourning and grief.

Be hopeful. Some people with amyotrophic lateral sclerosis live much longer

than the three to five years typically associated with this condition. Some live 10

years or more. Keeping hope alive is vital for people with ALS.

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Think beyond the physical changes. ALS doesn't typically affect the intellect or

spirit. Many people with amyotrophic lateral sclerosis lead rich, rewarding lives.

Try to think of ALS as only one part of life, not the entire identity.

Join a support group. A patient may find comfort in sharing concerns in a

support group with others who have ALS. Family members and friends helping

with care also may benefit from a support group of others who care for people

with amyotrophic lateral sclerosis. Find support groups in the area by talking to

medical practitioner or by contacting the ALS Association.

Make decisions now about future medical care. Planning for the future allows

the client to be in control of decisions about his life and his care. With the help of

a doctor or hospice nurse, he can decide whether or not you want certain life-

extending procedures. And he can determine where he wants to spend his final

days. Talking about these issues isn't easy. But facing anxieties about the future

may help better enjoy life today.

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VISUAL AIDSVISUAL AIDS

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SEMINARSEMINARPERIPHERALSPERIPHERALS

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FINANCESFINANCES

FOOD STUBSFOOD STUBS

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EXPENSES Php 3499.50

0

899

170.75

493

1936.75

Food Committee Program Committee

Documentation Committee Budget Committee

Physical Arrangement


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THE RECEIPTSTHE RECEIPTS

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INVITATIONINVITATION

THETHE

PREPARATIONSPREPARATIONS

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JUSTJUST

BEFOREBEFORE

THETHE

SEMINAR..SEMINAR..Page39


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THE SEMINARTHE SEMINAR

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THE SPEAKERTHE SPEAKER

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THE SEMINAR ADVISERTHE SEMINAR ADVISER

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INTERMISSION NUMBERSINTERMISSION NUMBERS

FOOD DISTRIBUTIONFOOD DISTRIBUTION

GIVING OF CERTIFICATESGIVING OF CERTIFICATES

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AFTER THE SEMINARAFTER THE SEMINAR

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REGISTRATIONREGISTRATION

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LETTERSLETTERS

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POSTERSPOSTERS

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CERTIFICATESCERTIFICATES

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EVALUATIONEVALUATION

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