1. The client/caregiver can define amyotrophic lateral sclerosis or Lou Gehrig disease.
    1. It is a motor neuron disease affecting nerves of brain and/or spinal cord with progressive degeneration.
    2. Death frequently occurs from respiratory failure in 2 to 5 years.
    3. The onset of the disease usually occurs in middle age.
  2. The client/caregiver can list signs and symptoms of disease.
    1. Muscle weakness and atrophy
    2. Cramping
    3. Incoordination of hand and fingers
    4. Slurred speech
    5. Loss of reflexes
    6. Difficulty swallowing
    7. Fatigue
    8. Spasticity of muscles
  3. The client/caregiver can list measures to promote independence and maintain muscle strength.
    1. Participate in physical and occupational therapy as ordered.
    2. Plan activities with rest periods to avoid overexertion.
    3. Use adaptive devices to promote independence in activities of daily living.
    4. Use assistive devices to promote mobility (i.e., wheelchair, lift chair, and walker).
  4. The client/caregiver can list measures to meet nutritional needs due to difficulty swallowing.
    1. Adjust diet consistency as needed.
    2. Use a high-calorie, high-protein diet.
    3. Allow ample time for eating.
    4. Sit in upright position to eat, and do not lie down after eating.
    5. Discuss use of feeding tube when unable to take food by mouth.
    6. Keep suction equipment nearby.
    7. Weigh weekly.
  5. The client/caregiver can list measures to promote communications.
    1. Speech therapy
    2. Communication boards or alternative methods of communication
    3. Cognitive abilities are not altered.
    4. Encourage client to participate in plan of care and urge expressing feeling to condition.
    5. Encourage client to plan for future, such as advance directives, living will, and hospice.
  6. The client/caregiver can list measures to avoid complications.
    1. Avoid people with upper-respiratory infections to prevent infection.
    2. Provide good skin care and positioning to prevent breakdown.
    3. Provide good oral care.
  7. The client/caregiver can state possible complications.
    1. Respiratory infection
    2. Respiratory failure
    3. Use of mechanical ventilation
    4. Injury
    5. Aspiration pneumonia

Resources

ALS Associationwww.alsa.org
National Institute of Neurological Disorders and Strokewww.ninds.nih.gov/disorders/amyotrophiclateralsclerosis
Support groups for client and caregiver
Agencies for help in provision of home care
Sources of financial assistance
Counseling

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. St. Louis: Mosby Inc.Canobbio, M. M. (2006). Mosby’s handbook of patient teaching. St. Louis: Mosby Inc.Cohen, B. J., & Taylor, J. J. (2005). Memmler’s the human body in health and disease (10th ed.). Philadelphia: Lippincott Williams & Wilkins.Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott

Credits

Client Teaching Guides for Home Health Care, 2nd ed.© 2008 Jones and Bartlett Publishers, Inc.www.jbpub.com

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