Primary Nursing Diagnosis

Ineffective airway clearance because of weakened cough effort

OUTCOMES. Respiratory status: Gas exchange and ventilation; Oral health

INTERVENTIONS. Airway insertion; Airway management; Airway suctioning; Oral health promotion; Respiratory monitoring; Ventilation assistance

U PLANNING AND IMPLEMENTATION Collaborative

Management of ALS is focused on the treatment of symptoms and rehabilitation measures. No specific treatment for the disease exists that will influence the underlying pathophysiology.

REHABILITATION. Rehabilitation aids are available to overcome the effects of muscular disability and to support weakened muscles. A planned program of exercise helps patients function for a longer period of time.

AIRWAY MANAGEMENT. Supporting the patient's airway and breathing becomes essential as the disease progresses. The patient's deteriorating respiratory status may eventually require mechanical ventilation. If a ventilator is being used at home, patient and significant others will need instructions on ventilatory management.

NUTRITION. When the patient can no longer maintain nutrition, enteral or parenteral feedings may be initiated. Long-term nutritional management may require a gastrostomy or cervical esophagostomy.

72 Amyotrophic Lateral Sclerosis

Pharmacologic

Highlights

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