Multiple Sclerosis

Question 1

What is an immune mediated disorder of the CNS in which immune cells attack the myelin sheath around nerve cells causing decreased transmission of nervous signals?

Answer 1

Multiple sclerosis

Question 2

What is the purpose of the myelin sheath?

Answer 2

Protects the nerve and increases the efficiency of electrical impulses along the neuron membranes

Question 3

Axon damage and lack of myelin disrupts nerve impulses in the CNS causing neurological symptoms like what?

Answer 3

Muscle weakness, visual disturbances and balance/coordination probs

Question 4

What makes a true exacerbation of MS?

Answer 4

Last at least 24hrs and must be separated from the previous attack by at least 30days

Question 5

Fatigue, paresthesia, lack of coordination/balance, unsteady gait, tremors, bladder and bowel dysfunction, visual disturbances, dizziness, sexual dysfunction, pain, cognitive dysfunction, depression, anxiety, and muscle spasticity or weakness in 1+ limbs are all what?

Answer 5

Common s/s

Question 6

Speech disorders, swallowing probs, hearing loss, seizures, breathing probs, itching, MS hug (a sensation of a tight band around abd), and partial or complete paralysis are all what?

Answer 6

Less common s/s

Question 7

MRI for lesions, lumbar puncture for CSF sample, evoked potential tests for measuring electrical activity and blood tests to rule out infection are all what?

Answer 7

Diagnostics

Question 8

Avonex, Betaseron, Extavia, Rebif are what classification of meds for MS that reduce # of inflamed cells that cross blood brain barrier?

Answer 8

Beta interferons

Question 9

Side effects to beta interferons are?

Answer 9

Reaction in inj. site, liver damage and mood changes

Question 10

Nursing responsibilities of beta interferons?

Answer 10

Assessing liver function and CBC for baseline parameters and q3mon to test side effects, assessing inj. site and monitoring changes in the pts condition and function for efficacy

Question 11

What med blocks the immune systems attacks on myelin?

Answer 11

Glatiramer acetate (Copaxone)

Question 12

Side effects of Glatiramer acetate (Copaxone)?

Answer 12

Flushing, chest pain or heart palpations

Question 13

What med traps immune cells in lymph nodes making them unable to access the CNS?

Answer 13

Fingolimod (Gilenya)

Question 14

Side effects of Fingolimod (Gilenya)?

Answer 14

Bradycardia, diarrhea, cough and HA

Question 15

What med interferes w/ the movement of immune cells across blood brain barrier?

Answer 15

Natalizumab (Tysabri)

Question 16

Side effects of Natalizumab (Tysabri)?

Answer 16

Increases their risk of developing fatal brain infection so given to pts who can’t tolerate other treatments 1st

Question 17

What med is an immunosuppressant that’s only used to treat advanced MS bc of cardiovascular and other serious side effects?

Answer 17

Mitoxantrone (Novantrone)

Question 18

What med is a pyrimidine synthesis inhibitor that inhibits the function of lymphocytes; may cause serious liver damage?

Answer 18

Teriflunomie (Aubagio)

Question 19

What med inhibits immune cells and have antioxidant properties that protect the nerves from damage?

Answer 19

Dimethyl Fumarate (Tecfidera)

Question 20

Side effects of Dimethyl Fumarate (Tecfidera)?

Answer 20

Flushing and GI events

Question 21

what med reduces spasticity in pts w/ a variety of disorders?

Answer 21

Baclofen (Lioresal)

Question 22

What rehabilitation may be necessary for MS?

Answer 22

PT/OT, speech/language, vocational

Question 23

Impaired physical mobility, functional urinary incontinence, constipation, fatigue, bathing self-care deficit, hopelessness, disturbed body image, caregiver role strain, ineffective role performance, sexual dysfunction, and ineffective coping are all what?

Answer 23

Diagnosis