Unit 2: Assessment & Interventions for MS & ALS

Question 1

Patient History:
What do we want know about Sxs r/t MS

Answer 1

Sx Progression (timeline, severity, frequency)
Aggravating factors (fatigue, stress, overexertion, temp. changes)

Question 2

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
Intention Tremors

Answer 2

MS

Question 3

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
Muscle Atrophy

Answer 3

ALS

Question 4

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
Parasthesias

Answer 4

MS

Question 5

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
Muscle weakness, Dysarthria, + Dysphagia

Answer 5

BOTH!

Question 6

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
Visual disturbances (acuity + perception), Nystagmus, Diplopia (double vision)

Answer 6

MS
(ALS doesn’t affect vision!)

Question 7

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
Respiratory failure

Answer 7

ALS (Major cause of death!!)

Question 8

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
Bladder dysfunction

Answer 8

MS
(ALS doesn’t affect bladder function!)

Question 9

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
Highest risk for Depression

Answer 9

MS :(

Question 10

What are the 3 main complications r/t MS?

Answer 10

1. Infection (asp. pneumonia, UTI, urosepsis)
2. Paralysis
3. Mood changes (depression)

Question 11

What are the 3 main complications r/t ALS?

Answer 11

1. Paralysis
2. Respiratory Failure
3. Infection (asp. pneumonia)

Question 12

What are the 4 Tx goals for MS?

Answer 12

(1) Prevent exacerbations
(2) Optimize function
(3) Sx Management
(4) Modify disease’s effects on immune system

Question 13

What are the 3 Tx goals for ALS?

Answer 13

(1) Slow Progression
(2) Optimize Function
(3) Ensure Comfort

Question 14

Why are pts with MS more susceptible to infection? (3)

Answer 14

Treated with immunomodulators
Bladder dysfunction (UTI, urosepsis)
Dysphagia (asp. pneumonia)

Question 14

Why are pts with MS more susceptible to infection? (3)

Answer 14

Treated with immunomodulators
Bladder dysfunction (UTI, urosepsis)
Dysphagia (asp. pneumonia)

Question 15

Why are pts with MS more susceptible to infection? (3)

Answer 15

Treated with immunomodulators
Bladder dysfunction (UTI, urosepsis)
Dysphagia (asp. pneumonia)

Question 16

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
Implement Fall Precautions + Pressure Injury Prevention

Answer 16

BOTH!
Immobility an issue for boooooth

Question 17

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
ROM exercises, Rest + Activity balance, Avoid rigorous activity

Answer 17

MS
Hyperthermia worsens mobility, fatigue, + vision

Question 18

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
Swallow evaluation

Answer 18

BOTH!

Question 19

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
Enteral nutrition

Answer 19

ALS

Question 20

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
Self-catheterization, Bladder Pacemaker

Answer 20

MS

Question 21

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
BIPAP, Trach, Vent, Diaphragmatic Pacemaker

Answer 21

ALS

Question 22

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
Drug therapy aimed at Sx Mx + altering Immune system

Answer 22

MS

Question 23

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)?
Drug therapy aimed at slowing progression

Answer 23

ALS

Question 24

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)? Eye-tracking board

Answer 24

ALS

Question 25

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)? Neurosurgery (Deep brain stimulation, Thalamotomy)

Answer 25

MS

Question 26

Multiple Sclerosis (MS) or Amyotrophic Lateral Sclerosis (ALS)? Palliative/Hospice care Consult

Answer 26

ALS :(