Multiple Sclerosis Flashcards
Pathophysiology
-progressive demyelination of the CENTRAL NERVOUS SYSTEM
- can vary and have different patterns
- consists of relapses and remitting
S/S
- fatigue
- weakness
- numbness
- difficulty in coordination
- loss of balance
- pain
- visual disturbances
Risk Factors
- women ages 20-40
- greater prevalence in: Europe, New Zealand, Australia, Norther US, Canada
- may have genetic predisposition or onset after viral infection
- environmental risks: obesity, lack of vitamin d exposure, increased salt intake during teenage years
Interferon B-1a and Interferon B-1b
- subQ or IM
- s/e: flu-like s/s, leukopenia, HA, depression, skin necrosis, liver issues
Glatiramer acetate
- subQ
- reduces rate of relapse in relapsing-remitting type
- s/e: flushing, unpleasant s/e but they go away
Teriflunomide, Fingolimod, Dimethyl furmarate
oral, disease modifying
IV methyl prednisone followed by oral prednisone
- treats acute exacerbations + shortens duration of relapse
- oral to taper
- s/e: mood swings, weight gain, electrolyte imbalances
Tx for Muscle Spasms
- baclofen
- benzodiazepines (diazepam, etc.)
- tizanidine
- dantrolene
Tx for Fatigue
- amantadine
- pemoline
- dalfampridine
Tx for Ataxia
- BB (propanol, etc.)
- gabapentin
- benzodiazepines (clonazepam, etc.)
Medications for Bowel and Bladder Control
- anticholinergics
- alpha-adrenergic blockers
- antispasmodics
Nursing Diagnosis
- IMPAIRED MOBILITY associated w/ weakness, muscle paresis, spasticity, increased weight
- RISK FOR FALLS associated w/ sensory and visual impairment, lower extremity weakness
- FATIGUE associated w/ insufficient energy
- DIFFICULTY COPING associated w/ uncertainty of course of MS
Patient Education
- promoting physical mobility (gait training and rehab)
- preventing falls (assistive devices)
- managing fatigue (sleep hygiene)
- strengthening coping mechanisms (family support)
Progressive-Relapsing Type
- Rare
- steady decline since onset with superimposed attacks
Secondary-Progressive Type
initial relapsing-remitting MS that suddenly begins to have decline w/o periods of remission
Primary-Progressive Type
steady increase in disability w/o attacks
Relapsing-Remitting Type
- most common
- unpredictable attacks which may or may not leave permanent deficits followed by periods of remission