MS Flashcards

1
Q

Chronic neurological =

A

no cure

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2
Q

Multiple Sclerosis

A

A chronic, progressive, degenerative disorder of the central nervous system

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3
Q

MS characterized by

A

segmental demyelination of nerve fibers of brain and spinal cord
remission and exacerbation

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4
Q

Cause of MS

A

unknown
related to genetics, infection, and immunity (possible environment early in life)
mostly women btw 20-50
- pregnancy
excessive fatigue, poor health
injury, stress

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5
Q

More progressive MS when dx at age greater than 50 due to

A

comorbidities

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6
Q

What celebrities do you think of when you hear MS?

A

Selma Blair
Kristina Applegate

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7
Q

Why does MS take longer to dx

A

do not notice till worsen s/s by compensation

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8
Q

The onset of MS is

A

insidious and gradual
vague
s/s intermittently over months or years
- not enough to seek medical help

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9
Q

The overall trend of MS

A

progressive deterioration in neurologic function
- remission and exacerbations

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10
Q

MS s/s

A

Intention tremors = trying to grab something it gets worse
Spastic Bladder = bladder retraining
speech impediment
, tremors, dizzy, LOC, limb weak, attention deficit, vision loss, tingling and prickling pain

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11
Q

Relapsing-remitting:

A

patients tend to experience an attack or series of attacks (exacerbations) followed by complete or partial remission.

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12
Q

Primary progressive:

A

disease shows progression from onset with occasional plateaus and temporary minor improvements.

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13
Q

Secondary Progressive:

A

chronic, progressive form of the disease where, unlike the RRMS stage, there are no real periods of remission, only breaks in attack duration with no real recovery from symptoms although there may be minor relief

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14
Q

S/S 1st common of MS

A

visual loss (blindness, double vision, blind in one eye)
facial numbness
gait difficulties need assistive device
then motor, sensory, mind, and anger

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15
Q

As an MS pt gets older, the disease becomes more

A

progressive

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16
Q

The average life expectancy after the onset of MS symptoms is

A

25 years

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17
Q

Sensory Manifestations of MS

A

Numbness and tingling
Pain
Tremor intention

↓ Hearing, Vertigo and tinnitus
Chronic neuropathic pain
Lhermitte’s sign

18
Q

Motor Manifestations of MS

A

weakness or paralysis of limbs and trunk
spastic and slow speak

19
Q

Bladder issues related to MS

A

constipation
spastic and flaccid bladder
sexual dysfunction

20
Q

Emotional state of MS

A

Angry
depressed

21
Q

Dx of MS

A

no definitive
based primarily on history, clinical manifestations, & results of diagnostic tests
MRI= plagues, inflammation, damage
Increase in immuno G

22
Q

For Dx of MS

A

at least 2 inflammatory demyelinating lesions in at least 2 different locations within the CNS (spine and brain)
= damage attack occurring at diff times (greater than 1 month)
- rule out

23
Q

MS Tx

A

no cure
goal= delay progression of disease, manage chronic symptoms, & treat acute exacerbations**

early intervention is most effective

24
Q

Disease-Modifying Drugs
tx as soon as dx

A

*Interferon beta-1a (Rebif, Plegridy, Avonex)
Decrease future of disability, mechanism of actions, lesions, and relapses
*Interferon bet-1b (Betaseron, Extavia)
*Glatiramer acetate
*Teriflunamide (Aubagio)
injections

25
Q

Interferon Beta

A

naturally occurring glycoprotein with antiviral, antiproliferative, and immunomodulatory actions

26
Q

Drug Therapy for MS is given to

A

Reduces the frequency and severity of attacks
Reduces the number and size of lesions detectable with MRI
reduce relapses
Delays progression of disability

27
Q

Interferon Beta adverse effects and interactions

A

flu-like
hepatotoxicity
myelosuppression
injection reactions
depression
suicidal

28
Q

All MS pts need to take

A

immunomodulators

29
Q

Immunosuppressant

A

Mitoxantrone ( Novantrone)

30
Q

Mitoxantrone ( Novantrone)

A

More toxic** than Immunomodulators
Produce greater suppression of immune function
HELPS WITH RELASPSES
Not primarily against progressive
Increase clinical attack rate

31
Q

Most tx for MS are also used in

A

CA

32
Q

Mitoxantrone

A

Myelosuppression*
Cardiotoxicity*
Fetal harm*
Reversible* hair loss, injury to GI mucosa, nausea & vomiting, amenorrhea, allergy symptoms, and blue-green tint to urine & sclera – not harmful

33
Q

Myelosuppression s/s

A

fever
chills
cough
immediately call HCP

34
Q

Corticosteroids for MS

A

Prednisone & methylprednisolone

35
Q

Prednisone & methylprednisolone

A

Helpful in treating acute exacerbations
Reduce edema and acute inflammation at the site of demyelination
Therapeutic plasma exchange and IV immunoglobulin G
If stop working = IBIG given too

36
Q

What other drugs would be given to MS pts besides for MS?

A

manage symptoms
bladder, bowel, depression, fatigue, spasticity

37
Q

Meds for spasticity and neuropathic pain are

A

GABA

38
Q

A pt with MS is prescribed with Interferon Beta, What is the priority for teaching at this time?
a) Provide information about myelosuppression
b) symptoms of hepatotoxicity
c) Educate about self-injection technique
d) blue tint of urine or skin

A

c) Educate about self-injection technique

39
Q

The nurse cares for a pt who is receiving Mitxandrone it is most important for the nurse to assess the pt for what?

A

elevate temperature
due to myelosuppression infection

40
Q

MS: Nursing Interventions

A

Promote physical mobility
Prevent injury
Enhance bowel & bladder control
Enhance communication
Improve sensory & cognitive function
Teach about medications
Educate family and support systems

41
Q

MS can also use what activity therapy

A

water therapy
support groups so they are not alone

42
Q

MS psychological interventions

A

anger anxiety depression
acceptance