Multiple Sclerosis Questions and Answers Graded A

Multiple Sclerosis Questions and Answers Graded A what is MS? Multiple Sclerosis Immune mediated, progressive demyelinating disease of the CNS -Damage to myelin -Damage to axon Patho -Sensitized T & B lymphocytes cross BBB Start inflammatory process CAUSE??? what are clinical manifestation for MS? 1. Fatigue/Weakness 2. Ataxia and vertigo 3. Tremors/spasiticity of LE 4. Parasthesias 5. Blurred vision/diplopia 6. Nystagmus 7. Dysphasia 8. Bowel/Bladder disturbances 9. Abnormal reflexes 10. Emotional changes (Depression) what are nursing diagnoses for MS? Impaired Physical Mobility Sexual Dysfunction Impaired Elimination Pattern Interrupted Family Processes what are Nursing Interventions for MS? 1-6 1. Protect from injury/safety measures 2. Eye patch for diplopia 3. Monitor for complications 4. Regular elimination 5. Encourage independence 6. Regular exercise/rest program what are Nursing Interventions for MS? 7-12 7. Need for assistive devices 8. PT/OT 9. Avoid fatigue, stress, infection, overheating, chilling 10. Food/Fluid 11. National MS groups 12. Administration of medications what does Medications do to MS? Complex Treatment Treatment based on phase, sign and symptom, patient tolerance... Drugs used to decrease inflammation in CNS and sign and symptom just the treat the sign and symptom only what are those medications for MS? 1. Glucocorditcoids • IV methylprednisolone 2. Muscle Relaxants • Diazepam (Valium), Baclofen (Lioresal), Carisoprodol (Soma)... 3. Immunomodulators • Interferons: SE = flu like symptoms - IFN-B1b (Betaseron) - IFN-B1a (Rebif) • Non-interferon - Glatiramer acetate (Capaxone) Description for multiple sclerosis Demyelinating disease resulting in the destruction of CNS myelin and consequent disruption in the transmission of nerve impulses what about the onset for multiple sclerosis? Onset is insidious, with 50% of clients still ambulatory 25 years after diagnosis. how do nurse diagnosis for multiple sclerosis? Diagnosis determined by a combination of data: 1. Presenting symptoms 2. Increased white matter density seen on CT scan 3. Presence of plaques seen on MRI 4. CSF electrophoresis shows presence of oligoclonal (IgG) bands. multiple sclerosis is more common is men or women? in woman is the progression for multiple sclerosis in orderly? nope what is the progression for multiple sclerosis? Symptoms involving motor function usually begin in the upper extremities with weakness progressing to spastic paralysis. Bowel and bladder dysfunction occurs in 90% of cases. what are nursing assessment for history for multiple sclerosis? A. Nursing history of client to include: 1. History of symptoms 2. Progression of illness 3. Types of treatment received and the responses 4. Additional health problems 5. Current medications 6. Client's and family's perception of illness 7. Community resources used by the client what are nursing physical assessment for multiple sclerosis? 1-4 1. Optic neuritis - loss of vision or blind spots 2. Visual or swallowing difficulties 3. Gait disturbances; intention tremors 4. Unusual fatigue, weakness, and clumsiness what are nursing physical assessment for multiple sclerosis? 5-8 5. Numbness, particularly on one side of face 6. Impaired bladder and bowel control 7. Speech disturbances 8. Scotomas - white spots in visual field, diplopia what are the nursing plans and interventions for multiple sclerosis? 1-4 1. Allow hospitalized client to keep own routine. 2. Orient client to environment, and teach strategies to maximize vision. 3. Encourage self-care and frequent rest periods. 4. With exercise programs, encourage client to work up to the point just short of fatigue what are the nursing plans and interventions for multiple sclerosis? 5-6 5. Teach client that for muscle spasticity, stretch-hold-relax exercises are helpful, as are riding a stationary bicycle and swimming; take precautions against falls. 6. Initially, work with client on a voiding schedule. what are the nursing plans and interventions for multiple sclerosis? 7-8 7. Teach client that as incontinence worsens, the female may need to learn clean self-catheterization; the male may need a condom catheter. 8. Encourage adequate fluid intake, high-fiber foods, and a bowel regimen for constipation problems. what are the nursing plans and interventions for multiple sclerosis? 9-11 9. Encourage the client and the family to verbalize their concerns about ongoing care issues. 10. Encourage client to maintain contact with a support group. 11. Refer client for home health care services. what are the nursing plans and interventions for multiple sclerosis? 12-13 12. Encourage client to contact the local MS society for emotional support and direct services. 13. Administer steroid therapy and chemotherapeutic drugs in acute exacerbations to shorten length of attack. what are the nursing plans and interventions for multiple sclerosis? 14 14. Remember that biologic response modifiers such as interferon-beta products have shown recent success for MS relapses. Drug therapy for MS clients ACTH, cortisone, cyclophosphamide (Cytoxan), and other immunosuppressive drugs. Nursing implications for administration of these drugs? should focus on the prevention of -----infection.----