Atención de enfermería en esclerosis lateral amiotrófica

Abstract

Introduction: The skeletal muscle system has its respective functional and structural unit which is the Motor Unit. One of the neurodegenerative diseases of motor neurons is Amyotrophic Lateral Sclerosis, mainly affecting the upper and lower motor neurons, blocking the synapse, which impedes the movements; At present, there is no specific etiology; it is classified in Sporadic and Family; in our country it is within the rare or orphan pathologies. Complications are the most outstanding after the onset of symptomatic development, therefore, problems such as: invasive mechanical ventilation by tracheostomy due to respiratory failure, speech loss, others such as gastrostomy due to swallowing disorders, among others, are inevitable. The treatment of choice is Riluzole and Edaravone, a medicine that is not commercialized in Ecuador and other South American countries, which is why its treatment is usually for the management of symptoms. The importance of applying the Process of Nursing Care in these patients in relation to Marjory Gordon's model, is that it allows us to have a holistic view of the alterations of each one of its functions and thus provide individualized care that covers all their needs. One of the priority patterns altered in these patients is that of activity and rest. Case Presentation: A 43-year-old patient was admitted to the Intensive Care Unit with Diagnosis of Amyotrophic Lateral Sclerosis for 4 years, Arterial Hypertension, Late Nosocomial Pneumonia, and Respiratory Insufficiency for 6 days, requiring Mechanical Ventilation; with P / A: 126/78 mmHg; FC: 74 bpm; Temperature: 35.8ºC; FR: 12 rpm. General Objective: To analyze the complications presented by the 43-year-old patient with Amyotrophic Lateral Sclerosis in relation to a clinical case through bibliographic review and to elaborate a proposal for the Nursing Care Process. Method: The search of bibliographic information updated 5 years ago (2013-2018) of scientific articles published in the databases of the university, data from journals such as: MEDLINE, PUBMED, Dialnet, Scielo, Redalyc and online tool NNconsult was carried out. Results: According to the study of the electromyogram indicates neuron involvement of the anterior horn of the cord; presented complications such as: invasive mechanical ventilation due to respiratory failure through tracheostomy, others such as gastrostomy, cystostomy; which shows great coincidence with the studies of Amyotrophic Lateral Sclerosis: update carried out by Zapata et al 2016, Sanjuán et al 2014, Bucheli et al 2014. At the level of hospital institutions, they lack a nursing model and in terms of the care process Nursing students have a deficit of knowledge of standardized language management of nursing diagnoses. Conclusions: Amyotrophic Lateral Sclerosis is a pathology with a fatal outcome; In Ecuador and other South American countries, Riluzole is not marketed, the drug of choice for the treatment of this disease. Its low prevalence leads to a lack of knowledge of this pathology in most health professionals since there are not many studies conducted; In addition, the application of nursing care must be supported in a nursing model in relation to NANDA, NIC and NOC.