A client is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on upper and lower motor neurons
The health care provider caring for this client will focus on which priority intervention for this client?
A) Ability to turn from side to side, thereby preventing skin breakdown
B) Ability to empty bladder completely, thereby preventing autonomic dysreflexia
C) Respiratory ventilation assessment and prevention of aspiration pneumonia
D) Assessment of lower extremities to prevent deep vein thrombosis
Ans: C
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Amyotrophic lateral sclerosis is a mixed upper motor neuron (UMN) and lower motor neuron (LMN) disorder. In the more advanced stages of ALS, muscles of the palate, pharynx, tongue, neck, and shoulders become involved, causing impairment of chewing, swallowing (dysphagia), and speech. Dysphagia with recurrent aspiration and weakness of the respiratory muscles produces the most significant acute complications of the disease. Airway/breathing is always the priority over bladder emptying; skin breakdown, and assessing for DVT.
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