Managing Movement Disorders: Spasticity, Clonus, and Muscle Tightness

Do you know how to help people with muscle tightness, spasticity, or clonus? And what if someone has more than one of these conditions at the same time?

Little information in the nursing literature.

 

In “Managing Movement Disorders: A Clinical Review,” their CE article in this month’s AJN, Rozina Bhimani and colleagues provide an excellent guide to the assessment and pathophysiology of, and treatment for, each of these conditions. There is very little in the nursing literature on their management, so this article by nurse experts who work with these symptoms every day is particularly enlightening and helpful.

The authors point out that muscle tightness, spasticity, and clonus are not always interpreted accurately by clinicians. This can lead to less-than-optimal treatment.

“Neuromuscular signs and symptoms occur across a multitude of diseases and injuries . . . . Successful symptom management requires effective communication about symptoms, yet there are often discrepancies between patient and provider descriptions of neuromuscular symptoms and manifestations.”

[…]

2018-12-06T14:36:23-05:00December 4th, 2018|Nursing|0 Comments
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40 Million and Counting: These Days, Every Month Is Family Caregiver Month

Family caregivers, unpaid and unsung.

Photo courtesy of AARP Public Policy Institute.

November is, among other things, the month designated as family caregiver month. These are the 40 million or so people who provide care to loved ones at home, often by themselves. This can range from the basic tasks of daily living that a loved one can no longer perform by themselves, like bathing, dressing, and eating, as well as complex nursing care involving injections, wound and ostomy care, and more.

Helping nurses help the helpers.

In this season of short days and family holidays, it seems like a good time to remind you of the free resources AJN has for nurses and for the caregivers whom you work with. We’ve developed these articles and teaching videos in a decade-long partnership with the AARP Public Policy Institute directed by Susan Reinhard, and with the Betty Irene Moore School of Nursing at the University of California-Davis.

Teaching videos and tip sheets to share with caregivers.

Each article covers the evidence behind what and how you should teach a caregiver on a particular topic and is associated with a video demonstrating techniques and procedures for the caregiver to follow. […]

2018-11-30T10:14:08-05:00November 30th, 2018|family caregiving, Nursing|1 Comment
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‘So Many Things a Pill Can’t Solve’: An Integrative Therapy Nurse in Acute Care

“I don’t think that people realize how powerful human touch can be.”

“This therapy is invaluable to me—not just physically, but for my mental state too.”

“I think that we as Americans need more of this [integrative] therapy because there are so many things that a pill can’t solve.”

This is some of the feedback offered by patients after massage therapy sessions at the Minneapolis Veterans Affairs Medical Center. In this month’s AJN, integrative therapy nurse Hallie Boyd describes how her program has become a vital part of symptom management on the spinal cord injury and disorders unit there.

Help for patients in coping with chronic pain.

As a staff nurse on this unit, Boyd had encountered many patients who were trying to cope with chronic pain. While the hospital had long educated nurses on the use of integrative modalities such as guided imagery, acupressure, and aromatherapy, it was difficult for them to employ these techniques on a regular basis during busy and unpredictable shifts.

So, while continuing her work on the spinal cord unit, Boyd returned to school to focus on hospital-based therapeutic massage for medically complex patients. Training alongside a diverse group of practitioners, she developed and refined the idea of a full-time integrative therapy nurse as part […]

2018-11-28T11:01:10-05:00November 28th, 2018|Nursing|1 Comment
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December Issue: Nurses’ Advance Care Planning–Related Beliefs, Managing Movement Disorders, Delegating, More

“When despair for the world grows in me…. I come into the peace of wild things who do not tax their lives with forethought of grief. I come into the presence of still water…. I rest in the grace of the world, and am free.”—Wendell Berry, as quoted in the December editorial

The December issue of AJN is now live. Here are some of the articles we’re pleased to have a chance to publish this month.

CE: Original Research: Advance Care Planning: An Exploration of the Beliefs, Self-Efficacy, Education, and Practices of RNs and LPNs

The authors of this study surveyed RNs and LPNs working in skilled nursing facilities to learn about the similarities and differences in their advance care planning–related beliefs, sense of self-efficacy, education, and practices.

CE: Managing Movement Disorders: A Clinical Review

This article discusses the pathophysiology and assessment of three different, common neuromuscular disorders—muscle tightness, spasticity, and clonus—as well as the treatment options for each.

Cultivating Quality: Creating a Culture of Mobility: Using Real-Time Assessment to Drive Outcomes

The authors describe how they implemented an intervention based on the use of three new assessment tools to promote awareness of the importance of early mobility among nurses and physical and […]

2018-11-26T08:38:54-05:00November 26th, 2018|Nursing|0 Comments
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Mental Health Nursing: Transcending the Limitations of Words

When I met Dorothy, she was always counting. Her chapped lips moved nonstop as she chanted random numbers. She’d increase the speed, as if that would help her to reach the end quickly—but since the numbers didn’t appear to be in any sensible order, this loomed before her like an impossible task…

The challenge of mental health nursing.

Illustration by Pat Kinsella. All rights reserved.

This month’s Reflections column, “Dimensions of Dorothy,” begins with this harrowing look at a woman in the grip of a mental health crisis. Author Maureen Bonatch goes on to poignantly describe how this illness can “steal someone’s identity and overwhelm their self-control.”

As a new nurse at the state psychiatric hospital, Bonatch definitely had a “new normal” to adjust to at work. As she observed the manifestations of severe mental illness, she also developed insight into why some had so few visitors: “It had to be difficult,” she writes, “to helplessly observe as an illness crept in to hold the person you knew and loved hostage.”

An inadequately valued area of nursing.

I […]

2018-11-20T10:07:55-05:00November 20th, 2018|mental illness, narratives, Nursing|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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