Adult Health ATI Chapter 10- Multiple Sclerosis
A,B,E
a nurse is beginning a physical assessment of a client who has a new diagnosis of multiple sclerosis. which of the following findings should the nurse expect? select all that apply a. areas of paresthesia b. involuntary eye movements c. alopecia d. increased salivation e. ataxia
B
a nurse is caring for a client who has multiple sclerosis. which of the following findings should the nurse expect? a. fluctuations in BP b. loss of cognitive function c. ineffective cough d. drooping eye lids
D
a nurse is teaching a client who has MS a new prescription for baclofen. which of the following statements should the nurse include in the teaching? a. this medication will help you with your tremors b. this medication will help you with your bladder infection c. this medication can cause your skin to bruise easily d. this medication can cause you to experience dizziness
-dantrolene, tizanidine, baclofen, diazepam -used to treat muscle spasticity -observe for increased weakness, monitor for liver damage with tizanidine or dantrolene -report increased weakness and jaundice to the provider, avoid stopping baclofen abruptly
antispasmodics used for MS what are they used for? what do nurses need to monitor and education the patient on?
propatheline
what anticholinergic is used for MS for bladder dysfunction?
carbamazepine
what anticonvulsant is used for MS for paresthesia?
-prednisone, dexamethasone, methylprednisolone -reduce inflammation in acute exacerbations and are administered in large doses over a 3-5 day period followed by an oral taper with prednisone -increased risk of infection, hypervolemia, hypernatremia, hypokalemia, hyperglycemia, GI bleeding, personality changes
corticosteroids used for MS what are they used for? what do nurses need to monitor?
-fatigue -pain or paresthesia -diplopia, changes in peripheral vision, decreased visual acuity, scotomas (patches of blindness), periods of total blindness -Uhtoff's sign -tinnitus, vertigo, decreased hearing acuity -dysphagia -dysarthria (slurred and nasal speech) -muscle spasticity -ataxia or muscle weakness -nystagmus -bowel dysfunction -bladder dysfunction -cognitive changes (memory loss, impaired judgment) -sexual dysfunction
what are some expected findings in patients with MS?
oral alternative for those who have experienced injection reactions
what are teriflunomode, fingolimod, and dimethyl fumarate used for?
optic nerve, cerebrum, brainstem, cerebellum, spinal cord
what are the most common areas affected by MS?
propranolol and clonazepam
what beta blocker and benzodiazepine are used for MS for ataxia?
a genetic, immune-mediated attack or infection that destroys myelin. as a result, demyelination interrupts the flow of nerve impulses
what causes MS?
MRI reveals plaques of the brain and spine, which is most diagnostic
what diagnostic procedure can be done to help diagnose MS?
reduce the frequency and duration of relapses
what do disease-modifying therapies do?
cerebrospinal fluid analysis reveals elevated protein level and a slight increase in WBCs
what lab test can be done to help diagnose MS?
amatadnie, pemoline, dalfampridine, baclofen, tizanidine
what meds are administered to combat fatigue that can interfere with ADL's?
-monitor visual acuity, speech patterns, swallowing, activity tolerance, skin integrity, cognitive changes -encourage fluid intake, assist with bladder elimination, create schedule -use communication board -use eye patches for diplopia, teach scanning techniques -exercise and stretch involved muscles -promote energy conservation -safety
what nursing care should be done for patients with MS?
docusate sodium
what stool softener is used for MS?
