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NURS 3512 - Class 7-12 > Week 7 - MS > Flashcards

Week 7 - MS Flashcards

1
Q

what is multiple sclerosis

A
  • chronic, progressive, degenerative autoimmune disorder of the CNS
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2
Q

what is MS characterized by

A
  • demylination of the nerve fibres of the brain, spinal cord, and optic nerve
  • chronic inflammation, demyelination, and scarring in CNS
    = electrical transmission not fully transmitted from A to B
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3
Q

what are causes/risk factors for MS of MS (6)

A
  • unknown
  • may be linked to vit D deficiency
  • genetic factors
  • poor access to sunlight, cold climates
  • infectious (viral) factors
  • immunological
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4
Q

describe the onset of MS

A
  • insidious
  • begins w vague symptoms that occur intermittently over months or years
  • involves remissions & exacerbations
  • S&S vary over time as the disease process has a spotty distribution in the CNS
  • eventually leads to progressive deterioration d/t progressive scarring
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5
Q

what do the S&S of MS depend on

A
  • varies according to the areas of the CNS involved
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6
Q

what are common symptoms of MS (6)

A
  • motor
  • sensory
  • cerebellar
    • emotional problems
  • severe fatigue
  • pain
  • urinary problems –> retention, freq, urgency, incont.
  • constipation
  • sexual dysfunction
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7
Q

what motor symptoms are often involved w MS (4)

A
  • weakness or paralysis of limbs, trunk, or the head
  • diplopia (double vision)
  • scanning speech
  • spasticity of the muscles
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8
Q

what sensory symptoms are involved in MS (8)

A
  • numbness
  • tingling
  • patchy blindness (scotomas)
  • blurred vision
  • vertigo
  • tinnitus
  • decreased hearing
  • neuropathic pain
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9
Q

what cerebellar symptoms are involved in MS (4)

A
  • nystagmus
  • ataxia
  • dysarthria
  • dysphagia
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10
Q

what emotional problems are associated w MS (4)

A
  • fatigue
  • depression
  • anger
  • euphoria
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11
Q

what is used to diagnose MS (4)

A
  • history
  • S&S
  • MRI (for lesions)
  • evoked response testing
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12
Q

what is evoked response testing

A
  • tests that measure the electrical activity in parts of the brain caused by light, sound, and touch
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13
Q

what are the goals of care for a pt with MS (7)

A
  • functioning
  • independence in daily living
  • manage fatigue
  • mental health
  • help adjust
  • reduce factors that lead to exacerbations
  • treat the disease process and provide symptomatic relief
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14
Q

what are some triggers for exacerbations (7)

A
  • infection (esp. upper resp & UTIs)
  • trauma
  • emotional stress
  • excessive fatigue
  • state of poor health
  • pregnancy/child birth
  • changes in climate
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15
Q

what is included in collaborative care for MS (3)

A
  • meds
  • nutritional therapy
  • alternate therapies
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16
Q

what is the goal of drug therapy for a pt with MS (2)

A
  • decrease the progression of the disease process

- control symptoms

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17
Q

what classes of meds are used for treatment of MS (6)

A
  • corticosteroids
  • immunomodulators
  • immunosuppressants
  • anticholinergics
  • antispasmodic
  • fatigue meds
18
Q

what are 2 examples of corticosteroids for MS

A
  • methylprednisolone

- prednisone

19
Q

why/when are corticosteroids used for MS (2)

A
  • reduce edema & inflammation

- treat acute exac

20
Q

what are 2 examples of immunomodulators used for MS

A

interferons

  • betaseron
  • avonex
21
Q

what are 3 types of immunosuppressants used for MS

A
  • methotrexate
  • imuran
  • mitoxantrone
22
Q

what should be noted w immunomodulators and immunosuppressants

A
  • can have more serious s/e

- consider risk vs benefit

23
Q

what is an example of an antispasmodic used for MS

A
  • baclofen
24
Q

what are antispasmodics used for in MS

A
  • muscle spascitity
25
Q

what is a type of anticholinergic used for MS

A
  • ditropan
26
Q

why are anticholinergics used for MS

A
  • bladder symptoms
  • decrease bladder spasms & increase tone
  • more bladder control, can be fully emptied
  • decreases risk of UTIs
27
Q

what med is used to fight fatigue w MS

A
  • ritalin
28
Q

what nutritional measures can be used for mngmt of MS

A
  • no standard prescribed diet
  • nutritious well balanced diet essential
  • high protein, supplemental vitamins (ex. D), good fibre (prevent constipation) is advocated
  • adapt based on pts ability to swallow*
29
Q

what are the benefits of exercise in a pt w MS (4)

A
  • improves daily functioing
  • decreases spascitity
  • increases coordination
  • retrains unaffected muscles to substitute for impaired ones
30
Q

what should be noted w exercise for a pt with MS

A
  • no excessive exercise in summer d/t the extreme heat = weak
  • light to mod, interval training instead
31
Q

what is a specifically beneficial type of exercise for pts with MS

A
  • water exercise
32
Q

what is the most common reasons for hospitalization for a pt with MS (2)

A
  • diagnostic workup

- treatment of acute exac

33
Q

describe care for a pt with MS during an acute exac (2)

A
  • pt may be immobile
    = prevent major complications of immobility
  • treat the symptoms or complications (pain, spasms, etc.)
34
Q

describe pt teaching for a pt with MS (6)

A
  • triggers & how to minimize or avoid them
  • good balance of exercise & rest
  • nutritious & well balanced diet
  • avoid hazards of immobility
  • med education
  • consult w HCP before taking nonprescription meds
35
Q

bladder control is a major problem for pts with MS. what can be used to decrease bladder spascitity and improve bladder control (2)

A
  • anticholinergics

- self catheterization (straight cath)

36
Q

bowel problems is an issue associated w MS. what can be done to help the pt achieve regularity in bowel habits

A
  • increase in dietary fibre
37
Q

a nursing diagnosis r/t MS is impaired physical activity d/t muscle spasms & weakness/paralysis. what nursing interventions can be done for this (5)

A
  • use assistive devices
  • ROM exercise 2x/day
  • encourage and assist w ambulation
  • turn q2h
  • perform stretching exercises
38
Q

a nursing diagnosis r/t MS is impaired urinary elimination. what nursing interventions can be done for this (6)

A
  • anticholinergic meds
  • intermittent cath
  • reflex stimulation to help empty bladder
  • maintain fluid intake of 3000mL/day to dilute urine and reduce risk of UTI
  • teach pt S&S of UTI
  • initiate bladder training
39
Q

a nursing diagnosis r/t MS is sexual dysfunction. what nursing interventions can be done for this (2)

A
  • initiate sexual counselling

- suggest alternative methods of achieving sexual gratification

40
Q

a nursing diagnosis r/t MS is interrupted family processes. what nursing intervention can be done for this (4)

A
  • facilitate open communication
  • promote problem solving
  • refer for family or financial counselling
  • educate family regarding fluctuating nature of disease

NURS 3512 - Class 7-12 (49 decks)

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