Midterms_Multiple Sclerosis

Question 1

a chronic, progressive, non-
contagious, degenerative disease of the CNS
characterized by demyelination of the neurons.

Answer 1

Multiple Sclerosis

Question 2

.This is described as the ________ of the
brain, spinal cord, and optic nerve’s white matter
and usually occurs as small patches

Answer 2

demyelination

Question 3

what age does MS usual happen?

Answer 3

20 and 40

Question 4

Causes disruption of electrical messages from
the brain to the peripheral nervous system.
_____________ findings are abnormal

Answer 4

Electroencephalogram

Question 5

A lumbar puncture indicates ______

Answer 5

increased gamma
globulin, but the serum globulin level is
normal.

Question 6

Other possible factors:
(may help destroy axons and myelin sheath)

Answer 6

A. trauma
B. Anorexia
C. toxins
D. Nutritional deficiencies
E. Vascular lesions -
F. Anorexia nervosa

Question 7

More prevalent in the _____

Answer 7

Northern latitudes and
among Caucasians

Question 8

defined as damage to the
myelin, the protein, and lipid-rich substance that
serves as a cover to the neural fibers of the
brain spinal cord.

Answer 8

Demyelination

Question 9

Due to demyelination, there is a disruption in the
_______the affected nerve fibers are scarred because of the inflammatory reactions.-

Answer 9

nerve transmissions,

Question 10

This is described as the demylination of the
________,_______, _________
and usually occurs as small patches

Answer 10

brain, spinal cord, and optic nerve’s white matter

Question 11

Results in disordered transmission of nerve impulses Inflammatory changes lead to the scarring of the affected nerve fibers.

Answer 11

Demyelination

Question 12

Signs and Symptoms of MS
(BUV DMS IV)

Answer 12

Body weakness and fatigue
● Unusual reflexes, either hyperactive or absent
● Visual disorders may be nystagmus ( impaired
double vision)
● Dysarthria and dysphagia
● Motor disturbances (incoordination and tremor)
● Sensory dysfunctions (paresthesias, impaired
sense of position and vibration, reduced deep
sensation)•
● Impaired urinary functions (frequency,
incontinence,hesitancy, retention, urgency) •
● Behavioral patterns ( depression, emotional
lability,disturbed cognition)

Question 13

Diagnostic test for MS

Answer 13

Cerebrospinal fluid (CSF) analysis

Question 14

Cerebrospinal fluid (CSF) analysis reveals…

Answer 14

elevated protein level,increased white blood cells.

Question 15

Electrophoresis of CSF shows

Answer 15

increased myelin basic protein and IgG bands.

Question 16

Supporting Diagnostic Tests Include

Answer 16

electroencephalography, evoked potential studies, computed tomography (CT) scan, and magnetic resonance imaging(MRI)

Question 17

helpful in visualization of the lesions on the white matter of the central nervous system

Answer 17

.Magnetic Resonance Imaging

Question 18

Nursing Diagnosis (ISAAS)

Answer 18

1. Impaired physical mobility related to fatigue and weakness.
2. Sensory-perceptual alteration
3. Altered urinary elimination
4. Altered family processes
5. Sexual dysfunction

Question 19

Medical Management
1. ACUTE CASES

Answer 19

Corticosteroids or adrenocorticotropic hormone

Immunosuppressive agents

Beta-interferon (Betason)

Question 20

Meds

is necessary to minimize inflammation and reduce the extent of exacerbation or relapse.

Answer 20

Corticosteroids or adrenocorticotropic hormone

Question 21

Meds

provides stabilization throughout the course of the condition

Answer 21

Immunosuppressive agents

Question 22

Meds

for relieving quick-advancing symptoms for some patients

Answer 22

Beta-interferon (Betason)

Question 23

Meds Chronic Cases

Answer 23

Antispasmodic agents

Amantadine (Symmetrel)

Antidepressant drugs and counseling

4. Anticholinergics

Question 24

Meds

Antispasmodic agents such as ________ , ___________, __________ Muscle Spasms are managed by physical therapy, neural block surgery.

Answer 24

Baclofen(Lioresal),Dantrolene (Dantrium) and Diazepam(Valium).

Question 25

Meds for reducing fatigue

Answer 25

Amantadine (Symmetrel)

Question 26

Meds for bladder control; intermittent catheterization to facilitate drainage

Answer 26

Anticholinergics

Question 27

Other medical managements:

Answer 27

Stool softeners, Carbamazepine (Tegratol) Phenytoin (Dilantin)

Question 28

Meds like suppositories and bulk laxatives for bowel movement

Answer 28

Stool softeners

Question 29

Meds for dystonia

Answer 29

Carbamazepine (Tegratol)

Question 30

Meds for for pain syndromes

Answer 30

Phenytoin (Dilantin) and perphenazine with amitriptyline (Triavil

Question 31

physicians generally prescribe _________ to reduce tissue edema during acute exacerbation.

Answer 31

steroid therapy

Question 32

______________for weakness are prescribed.

Answer 32

Muscle stretching for spastic muscles and selective strengthening exercises

Question 33

COMPLICATIONS

Answer 33

Respiratory disorders ● Respiratory, bladder and blood infections ● Complications resulting from immobility ● Speech, voice and language disorders - dysarthria

Question 34

NURSING MANAGEMENTS

Answer 34

A. STIMULATING MOTOR FUNCTION B. REDUCING FATIGUE C. ENHANCE SENSORY FUNCTION D. MAINTAINING URINARY ELIMINATION

Question 35

STIMULATING MOTOR FUNCTION

Answer 35

Instruct to perform everyday exercises that are both helpful to strengthen and stretch the muscles. ● Teach how to perform stretch-hold-relax activities to reduce muscle spasms and contractures. ● Before muscle stretching, apply ice packs to minimize spasm. ● Advise to take frequent rest periods and avoid muscle fatigability as much as possible. Encourage them to do activities and ambulate as tolerated. ● Instruct on the proper use of assistive devices such as braces,canes and walkers.

Question 36

B. REDUCING FATIGUE

Answer 36

Inform about fatigue and how it is an integral symptom of multiple sclerosis. ● Make a plan of activities for each day. Make Sure There Are Enough rest periods in between activities. ● Encourage us to use techniques that conserveenergysuchassitting while doing some activities and pushing or pulling objects instead of lifting them up.

Question 37

ENHANCE SENSORY FUNCTION

Answer 37

Recommend to make use of an eye patchif experiencing double vision. ● Orient to the surroundings; keep personal belongings and furniture on fixed arrangement. ● Advise making use of other senses to compensate for reduced sensation. ● Provide a clutter-free and safe environment.

Question 38

D. MAINTAINING URINARY ELIMINATION

Answer 38

Ensure adequate hydration to prevent urinary tract infection and stones. ● Use a catheter to expel retained urine. ● Set up on a bladder training program to lessen incontinence episodes.

Question 39

DOCUMENTATION GUIDELINES

Answer 39

1. Pain meds accurate instructions 2. Instructions about adequate bladder and bowel elimination. 3. notify the primary caregiver any exacerbation or sudden worsening of the condition. 4. be sure that she or he has access to a telephone support network 5. stress, fatigue, and being overheated stimulate 6. contact community agencies such as the MS Society for use of sachin-home equipment as beds and wheelchairs and home maintenance support. 7. home care agency for home supervision

Question 40

DISCHARGE AND HOME HEALTHCARE GUIDELINES

Answer 40

Be sure the patient understands any pain medication prescribed, including dosage, route, action, and side effects. ● Be sure the patient understands the need for adequate bladder and bowel elimination. ● Instruct the patient to notify the primary caregiver any exacerbation or sudden worsening of the condition. If the patient has difficulty speaking or communicating,be sure that she or he has access to a telephone support network or some other means of calling for assistance when she or he is at home alone for any length of time. ● Be sure the patient understands that stress, fatigue, and being overheated stimulate exacerbations. Teachthepatienthow to avoid situations that produce these reactions. ● Be sure the patient knows how to contact community agencies such as the MS Society for use of sachin-home equipment as beds and wheelchairs and home maintenance support. ● Determine whether a home care agency is needed to provide home supervision and ongoing physical therapy support.