UNIT 2- MULTIPLE SCELORIS Flashcards
What is MS?
A chronic progressive degenerative disorder of the CNS, characterized by segmental demyelination of nerve fibers of brain and spinal cord
What causes MS?
Unknown cause
What are possible factors contributing to the cause of MS?
- Infection
- Smoking
- Physical injury
- emotional stress
- Excessive fatigue
- PREGNANCY
- Poor state of health
- Genetic factors.
How is MS different from other types of progressive degenerative disorders?
MS has periods of remission and exacerbation
When is MS typically considered most progressive?
When diagnosed at the age of 50 or older
True or false: Researches suspect that exposure to some environmental agents before puberty my predispose a person to develop MS later in life?
True
What is the typical progression like of MS?
Often insidious and gradual, vague symptoms occur intermittently over months to year. Typically its so vague that many pts don’t even think to see a doctor for it.
True or false: Symptoms may vary according to areas of CNS involved and plague formation?
True
What are visual clinical manifestations of MS?
Blurred/double vision, blind in 1 eye (may be one of the first symptoms a pt might experience)
What are some clinical manifestations of motor function in a patient that has MS?
- Weakness or paralysis of limbs and trunk (later stages)
- Spasticity of muscle (esp. bladder)
- Scanning of speech
What are some sensory clinical manifestations of MS?
- Facial numbness
- Numbness and tingling
- Pain
- Tremor (intentional)
- Decreased hearing, vertigo, tinnitus
What are the common manifestations we should address in a patient that has MS
1.visual
2. Motor
3. Sensory
4. Cerebellar
5. Bowel, bladder, sexual
6. Cognitive and emotional
What are some bowel/bladder clinical manifestations of MS?
- Constipation
- Variable urinary problems
- Spastic bladder
- Flaccid bladder
What are some sexual dysfunction clinical manifestations of MS?
- Erectile dysfunction
- Decreased libido
- Painful intercourse
What are some cognitive manifestations of MS?
- Short-term memory attention
- Information processing
- attention, planning
- Visual perception, word finding
What is the definitive test for MS?
There isn’t one
How is MS diagnosed?
- Based primary on history, clinical manifestations and results of diagnostic test
What exams can we run in effort to diagnose a patient with MS?
- MRI (looking for plaques on brain and spinal cord)
- CSF analysis
- Evoked potential studies (electrical activity associated with nerve conduction along sensory pathways)
- Neuropsychological testing
- Sexual history
What criteria does a patient have to meet to get an official diagnosis of MS?
- Evidence of at least 2 inflammatory (brain/spinal cord) demyelinating lesions in at least 2 different locations within the CNS
- Damage or attack occurring at different times (usually >1 month apart)
- All other possible dx must have been ruled out.
Can MS be cured?
No it is a chronic progressive degenertive disorder
What is the goal of treatment for MS?
- Delay progression of disease, manage chronic symptoms and treat acute exacerbations
True or false: Late intervention is most effective in the treatment of MS?
False- early intervention is most effective.
Multiple drugs are used to manage what MS symptoms? (couldn’t think of a good way to word this)
- Bladder dysfunction: detrusor hyperreflexia, flaccid bladder
- Bowel dysfunction: constipation, & fecal incontinence
- Depression
- Fatigue
- Spasticity– Baclofen is used
- Neuropathic pain- gabapentin
- improved walking- medications help but dosent fully tx
- Vertigo and dizziness
What other interventions may be required in the treatment of spasticity?
- Surgery
- Dorsal Column electrical stimulation
- intrathecal baclofen pump
What are some nursing intervention for MS?
- Promote physical mobility- Gait training
- Prevent injury-falls
- Enhance bowel and bladder control- bladder retraining (2hrs)
4.Enhance communication- they speak slow - Improve sensory and cognitive function- dont overwork or rush may make symptoms worse
- Teach about meds
- Educate family
- Psychological
- Social symptoms
- counseling