Chronic Neurologic Conditions

Question 1

This powerpoint is called Chronic Neurologic Conditions, but we are mainly are going to talk about Multiple Sclerosis

Question 2

what is multiple sclerosis characterized by ?

Answer 2

disseminated demyelination of the nerve fibers of brain and spinal cord

Question 3

multiple sclerosis is a what?

Answer 3

chronic, progressive, degenerative disorder of the CNS

Question 4

it mainly affects women more than man, and usually diagnosed during early adulthood-middle adulthood
and typically will be more progressive during your 50s

Question 5

what is the cause of multiple sclerosis ?

Answer 5

unknown

Question 6

what are some possible factors that can cause ms?

Answer 6

infection
smoking
physical injury
emotional stress
excessive fatigue
pregnancy
poor state of health
genetic component

Question 7

what is the patho behind ms?

Answer 7

there is a damage to the myelin sheaths of neurons in brain and spinal cord

impulses still occur but are very slowed

communication between the body and brain are slower

Question 8

what is the onset of clinical manifestations for ms?

Answer 8

often symptoms is insidious and it progressively graduals up in symptoms

typically symptoms are very vague and patients dont seek medical attention until the disease is far too gone and symptoms are more frequent

Question 9

what is the first symptoms of ms? (3)

Answer 9

visual changes
-blurred/double vision
- red green color distortion
- blindness in one eye

Question 10

what is motor manifestations ?

Answer 10

weakness or paralysis of limbs, trunks and head

spasticity of muscles

scanning speech

Question 11

what is sensory manifestations for ms?

Answer 11

numbness and tingling
pain
decreased hearing
vertigo and tinnitus
chronic neuropathic pain
(dull pain that doesn’t go away)

Question 12

what is the big sign of ms for sensory manifestations ?

Answer 12

Lhermitte signs

Question 13

what is the Lhermitte signs mean?

Answer 13

flexing the neck, bend chin towards chest, they feel electrical shocks goin down their back and legs

Question 14

what is some cerebellar manifestations?

Answer 14

nystagmus
ataxia
dysarthria
dysphagia
fatigue

Question 15

what are some bowel and bladder function and emotion for manifestations for ms?

Answer 15

constipation
variable urinary problems
anger, depression, euphoria

Question 16

what does spastic (unihbitied bladder ) mean ?

what does flaccid hypotonic bladder mean ?

Answer 16

need to pee but there is nothing there

bladder doesn’t contract, so need to pee isn’t there and just fill up until you pee on yourself

Question 17

what are some cognitive manifestations ?

Answer 17

short term memory attention
planning issues
issues word finding
information processing

Question 18

there is no diagnostic studies for ms, so instead we try to what ?

Answer 18

mri
- two inflammatory demyelination lesions at least 2 different locations

Question 19

is there a cure for ms ?

Answer 19

nope so we instead try to manage symptoms and progression

Question 20

what are some medications we are use for ms ? (3)

Answer 20

immunomodulators
steroids
muscle relaxants

Question 21

remember when a patient is on immunodulators we tell them what ?

Answer 21

avoid crowds
avoid pregnancy
flu and pneumonia shots

Question 22

why do we recommend exercise for ms?

Answer 22

decreases spasticity
increase coordination
retains muscles

Question 23

nursing assessment
subjective data
- health history
- ask about presence of signs/symptoms of ms

objective data
- apathy, inattentiveness
- pressure ulcers
- scanning speech
- tremor
- nystagmus
- ataxia
- spasticity

nursing diagnoses
- impaired physical mobility
- difficulty coping
- urinary rendition
- lack of knowledge

Question 24

nursing planning notes
Overall goals are that patient will

• Maximize neuromuscular function
• Maintain independence in activities of daily living for as long as possible
• Manage fatigue
• Optimize psychosocial well-being
• Adjust to the illness
• Decrease factors that precipitate exacerbations

Question 25

Help patient identify triggers and develop ways to avoid them or decrease their effects

Reassure patient during diagnostic phase
Assist patient in dealing with anxiety and grief caused by diagnosis

During acute exacerbation, prevent complications of immobility

Focus teaching on building general resistance to illness

Avoid fatigue, extremes of hot and cold, exposure to infection

Question 26

Teach patient

Good balance of exercise and rest

Minimize caffeine intake

Nutritious, well-balanced meals

Treatment plan
- Medication management

Teach
- Self-catheterization if necessary

• High-fiber diet to relieve constipation
• Emotional adjustments
• Lifestyle changes

Question 27

Evaluation
Expected outcomes are patient will

• Maintain or improve muscle strength and mobility
• Use assistive devices appropriately for ambulation and mobility
• Maintain urinary continence
• Make decisions about health and lifestyle modifications to manage MS