Treatments for Shy-Drager Syndrome
Treatments for Shy-Drager Syndrome
The list of treatments mentioned in various sources
for Shy-Drager Syndrome
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Symptomatic
- Antiparkinsonian medication
- L-dopa
- Treatments for orthostatic hypotension:
- Feeding tube - if feeding or swallowing difficulties require.
- Breathing tube - for breathing difficulty.
Shy-Drager Syndrome: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Shy-Drager Syndrome may include:
Discussion of treatments for Shy-Drager Syndrome:
Orthostatic hypotension in Shy-Drager syndrome is
treatable, but there is not known effective treatment for the progression
central nervous system degeneration. The general treatment course is aimed
at controlling symptoms. Antiparkinsonian medication, such as L-dopa, may
be helpful. To relieve low blood pressure while standing, dietary
increases of salt and fluid may be beneficial. Medications to elevate
blood pressure, such as salt-retaining steroids, are often necessary, but
they can cause side effects and should be carefully monitored by a
physician. Alpha-adrenergic medications, non-steroidal anti-inflammatory
drugs, and sympathomimetic amines are sometimes used. Sleeping in a
head-up position at night reduces morning orthostatic hypotension. An
artificial feeding tube or breathing tube may be surgically inserted for
management of swallowing and breathing difficulties.
(Source: excerpt from
NINDS Shy-Drager Syndrome Information Page: NINDS)
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Hypotension:
Treatment
(In a Page: Signs and Symptoms)
-
Orthostatic hypotension: Increase salt and water intake; pharmacologic treatment for moderate to severe disease may include fludrocortisone acetate, sympathomimetic agents, NSAIDs, caffeine, and erythropoietin
-
Volume depletion: Fluid replacement based on existing deficiencies (e.g., saline, dextrose, potassium, packed red blood cells)
-
Remove offending medications, compensate for medication needs
-
Adrenal insufficiency requires stress doses of IV hydrocortisone (100 mg IV every 6 hours)
-
Patient education (e.g., rise slowly from sitting to standing)
>
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Orthostatic hypotension [Postural hypotension]:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If you detect orthostatic hypotension, quickly check for tachycardia, an altered level of consciousness (LOC), and pale, clammy skin. If these signs are present, suspect hypovolemic shock. Insert a large-bore I.V. line for fluid or blood replacement. Take the patient’s vital signs every 15 minutes, and monitor his intake and output. Encourage bed rest.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Blood pressure decrease [Hypotension]:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If the patient's systolic pressure is less than 80 mm Hg, or 30 mm Hg below his baseline, suspect shock. Quickly evaluate the patient for a decreased LOC. Check his apical pulse for tachycardia and his respirations for tachypnea. Also, inspect the patient for cool, clammy skin. Elevate the patient's legs above the level of his heart, or place him in Trendelenburg's position if the bed can be adjusted. Then start an I.V. line using a large-bore needle to replace fluids and blood or to administer drugs. Prepare to administer oxygen with mechanical ventilation, if necessary. Monitor the patient's intake and output and insert an indwelling urinary catheter to accurately measure urine output. The patient may also need a central venous line or a pulmonary artery catheter to facilitate monitoring his fluid status. Prepare for cardiac monitoring to evaluate cardiac rhythm. Be ready to insert a nasogastric tube to prevent aspiration in the comatose patient. Throughout emergency interventions, keep the patient's spinal column immobile until spinal cord trauma is ruled out.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Orthostatic hypotension [Postural hypotension]:
Emergency Interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If you detect orthostatic hypotension, quickly check for tachycardia, altered level of consciousness (LOC), and pale, clammy skin. If these signs are present, suspect hypovolemic shock. Insert a large-bore I.V. for fluid or blood replacement. Take the patient’s vital signs every 15 minutes, and monitor his intake and output.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Blood pressure decrease [Hypotension]:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient’s systolic pressure is less than 80 mm Hg, or 30 mm Hg below his baseline, suspect shock immediately. Quickly evaluate the patient for a decreased LOC. Check his apical pulse for tachycardia and respirations for tachypnea. Also, inspect the patient for cool, clammy skin. Elevate his legs above the level of his heart, or place him in Trendelenburg’s position if the bed can be adjusted. Then start an I.V. line using a large-bore needle to replace fluids and blood or to administer drugs. Prepare to administer oxygen with mechanical ventilation if necessary. Monitor the patient’s intake and output, and insert an indwelling urinary catheter for the accurate measurement of urine. The patient may also need a central venous line or a pulmonary artery catheter to facilitate monitoring of fluid status. Prepare for cardiac monitoring to evaluate cardiac rhythm. Be ready to insert a nasogastric tube to prevent aspiration in the comatose patient. Throughout emergency interventions, keep the patient’s spinal column immobile until spinal cord trauma is ruled out.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Decorticate posture [Decorticate rigidity, abnormal flexor response]:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Obtain vital signs and evaluate the patient’s level of consciousness (LOC). If his consciousness is impaired, insert an oropharyngeal airway, and take measures to prevent aspiration (unless spinal cord injury is suspected). Evaluate the patient’s respiratory rate, rhythm, and depth. Prepare to assist respirations with a handheld resuscitation bag or with intubation and mechanical ventilation if necessary. Also, institute seizure precautions.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Hypotension, orthostatic:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Monitor the patient’s fluid balance by carefully recording his intake and output and weighing him daily. To help minimize orthostatic hypotension, advise the patient to change his position gradually. Elevate the head of the patient’s bed, and help him to a sitting position with his feet dangling over the side of the bed. If he can tolerate this position, have him sit in a chair for brief periods. Immediately return him to bed if he becomes dizzy or pale, or displays other signs of hypotension.
Always keep the patient’s safety in mind. Never leave him unattended while he’s sitting or walking; evaluate his need for assistive devices, such as a cane or walker.
Prepare the patient for diagnostic tests, such as hematocrit, serum electrolyte and drug levels, urinalysis, 12-lead electrocardiogram, and chest X-ray.
Patient teaching
The patient with diabetes or another condition that can lead to autonomic dysfunction should be made aware of the acute drop in blood pressure that can occur with positional changes. Inform the patient that, should the problem occur, he’ll need to avoid volume depletion and perform positional changes gradually instead of suddenly. (See Performing preambulation exercises, page 181.)
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Decorticate posture [Decorticate rigidity, abnormal flexor response]:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Monitor neurologic status and vital signs every 30 minutes to 2 hours. Be alert for signs of increased ICP, including bradycardia, increasing systolic blood pressure, and widening pulse pressure.
Patient teaching
Instruct the patient and his family about the signs and symptoms of decreased LOC and seizures. Explain to the family or caregiver how to keep the patient safe, especially during a seizure. Discuss quality of life concerns, if appropriate. Provide referrals to other health care services and professionals, as indicated.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Orthostatic hypotension:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If you detect orthostatic hypotension, quickly check for tachycardia, altered level of consciousness (LOC), and pale, clammy skin. If these signs are present, suspect hypovolemic shock. Insert a large-bore I.V. line for fluid or blood replacement. Take the patient’s vital signs every 15 minutes, and monitor his intake and output.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Decorticate posture:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Obtain vital signs and evaluate the patient’s level of consciousness (LOC). If consciousness is impaired, insert an oropharyngeal airway and take measures to prevent aspiration (unless spinal cord injury is suspected). Evaluate the patient’s respiratory rate, rhythm, and depth. Prepare to assist respirations with a handheld resuscitation bag or with intubation and mechanical ventilation. Also, institute seizure precautions.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Orthostatic hypotension [Postural hypotension]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor intake and output and weigh the patient daily.
▪ Elevate the head of the bed, and help the patient to a sitting position with feet dangling over the side of the bed; if tolerated, have him sit in a chair for brief periods.
▪ Evaluate the patient's need for assistive devices, such as a cane or walker.
▪ Prepare the patient for diagnostic tests, such as hemoglobin level and hematocrit, serum electrolyte and drug levels, urinalysis, 12-lead electrocardiogram, and chest X-ray.
Patient teaching
▪ Advise the patient to change his position gradually.
▪ Show the patient how to use the call bell and tell him to call for assistance when getting out of bed or a chair.
▪ Explain the importance of maintaining an adequate fluid intake.
▪ Explain prescribed medications and their adverse effects.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Blood pressure, decreased [Hypotension]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Check the patient's vital signs frequently to determine if low blood pressure is constant or intermittent.
▪ If blood pressure is extremely low, assist in the insertion of an arterial catheter to allow close monitoring of pressures; alternatively, a Doppler flowmeter may be used.
▪ Prepare the patient for laboratory tests, which may include urinalysis, routine blood studies, an electrocardiogram, and chest, cervical, and abdominal X-rays or computed tomography scans.
▪ Administer fluid, blood products, and medication as ordered to improve blood pressure.
Patient teaching
▪ Advise the patient with orthostatic hypotension to stand up slowly from a sitting or lying position.
▪ For the patient with vasovagal syncope, discuss how to avoid triggers.
▪ Emphasize the importance of dangling the feet and rising slowly when getting out of bed.
▪ Explain diagnostic tests and procedures.
▪ Explain the underlying disorder and treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Decorticate posture [Decorticate rigidity, abnormal flexor response]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Assess the patient frequently to detect subtle signs of neurologic deterioration.
▪ Monitor his neurologic status and vital signs every 30 minutes to 2 hours.
▪ Be alert for signs of increased ICP, including bradycardia, an increasing systolic blood pressure, and a widening pulse pressure.
Patient teaching
▪ Explain the signs and symptoms of decreased LOC and seizures to the patient and his family.
▪ Discuss the patient's and family's quality-of-life concerns.
▪ Explain to the family how to keep the patient safe, especially during a seizure.
▪ Explain to the patient or family his diagnosis and the treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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