Chapter 50

Time your medication so that its action peaks during the time you need the most energy

A mother of three young children who has a 3-year history of myasthenia gravis has had to stop helping in the childrens classrooms in the morning because of fatigue. What should the nurse say to help the patient best cope with the problem?

It may be an autoimmune reaction to a virus

A patient diagnosed with Guillain-Barr syndrome (GBS) asks how the disease developed since the patient rarely has an illness. What nursing response is the most accurate?

Manifestations can last up to 2 weeks

A patient in the plateau stage of Guillain-Barre syndrome is frustrated because there has not been any improvement in manifestations for 5 days. What should the nurse explain to the patient?

MG

A patient is scheduled for a thymectomy. For which peripheral nervous system disorder should the nurse plan care for this patient?

It makes more neurotransmitters available so that your muscles can contract

A patient who is prescribed neostigmine (Prostigmin) for newly diagnosed myasthenia gravis (MG) asks how the medication works. What should the nurse respond to the patient?

Taste and chewing are affected

A patient with Bell's palsy has lost 10 pounds since being diagnosed. Why should the nurse plan interventions to address the risk for nutrition problems?

Inability to close the affect eye

A patient with Bell's palsy is experiencing symptoms. Which symptom should the nurse address first?

Suction

A patient with amyotrophic lateral sclerosis has difficulty swallowing and copious pulmonary secretions. What equipment should the nurse ensure is at the bedside at all times?

Report shortness SOB or other respiratory problems, Do not drive until effects known, and try to prevent constipation

A patient with multiple sclerosis has been prescribed baclofen (Lioresal) to relax muscles. What should be included in the nurses teaching about this drug? (Select all that apply.)

Observe for grimacing or agitation

A patient with multiple sclerosis is unable to verbally communicate needs. Which approach should the nurse use to assess this patient for pain?

Provide soft foods at body temp at mealtimes

A patient with trigeminal neuralgia is admitted to the hospital for diagnostic testing and possible surgery. What intervention would be the most appropriate for this patient?

Nerve Biopsy, Electroencephalogram, Nerve conduction velocity, and Analysis of CSF

After frequent examinations a patient is diagnosed with amyotrophic lateral sclerosis (ALS). Which test results should the nurse review as confirmation of this diagnosis? (Select all that apply.)

I have to take my Prostigmin exactly as prescribed without skipping a dose

The nurse is assisting with discharging a patient with myasthenia gravis after hospitalization for severe respiratory distress. Which patient statement indicates that the nurses discharge teaching has been effective?

Ptosis is temporarily improved

The nurse is assisting with the administration of a Tensilon test. What response to the test causes the nurse to suspect that the patient has myasthenia gravis?

Demyelination and destruction of nerve fibers

The nurse is caring for a patient experiencing an acute exacerbation of multiple sclerosis (MS). Which pathophysiological change should the nurse recognize as causing the manifestations of MS?

Ptosis and Weakness

The nurse is caring for a patient who is being tested for possible myasthenia gravis (MG). Which early symptoms of myasthenia gravis should the nurse document in the medical record? (Select all that apply.)

Progressive Weakness and decreased coordination of extremities

The nurse is caring for a patient with amyotrophic lateral sclerosis (ALS). Which assessment findings should the nurse anticipate? (Select all that apply.)

UTI

The nurse is caring for a patient with an exacerbation of multiple sclerosis (MS). What should the nurse include when teaching the patient about risk factors for exacerbation?

Pyridostigmine

The nurse is caring for a patient with an exacerbation of multiple sclerosis. Which medication should the nurse anticipate administering to this patient?

Engage in moderate exercise and Ensure adequate amount of rest each day

The nurse is caring for a patient with post-polio syndrome. What should the nurse explain to the patient in preparation for discharge? (Select all that apply.)

Drooling, Facial droop, and Loss of taste over anterior part of tongue

The nurse is explaining the difference between Bell's palsy and trigeminal neuralgia to a nursing assistant. What should the nurse include as characteristics of Bell's palsy? (Select all that apply.)

Use lukewarm water and cotton balls

The nurse is helping a patient with trigeminal neuralgia with bathing. Which action should the nurse take when washing the patients face?

CBC, Platelets, and Clotting studies

The nurse is preparing a patient with myasthenia gravis to undergo plasmapheresis. Which laboratory tests should the nurse verify and place on the medical record before the procedure?

ABGs

The nurse is providing care to a patient with Guillain-Barr syndrome. Which laboratory result should the nurse evaluate first?

Check for pupil response twice daily

The nurse is providing eye care to a patient with Bell's palsy. Which nursing action is most appropriate to help protect the affected eye?

Pain related to inflammation of cranial nerve V

The nurse is reviewing nursing diagnoses identified for a patient with trigeminal neuralgia. Which nursing diagnosis should the nurse identify as a priority for this patient?

Diarrhea, Salivation, Vomiting, Abdominal Cramping, and Increased bronchial secretions

The nurse is teaching a patient with myasthenia gravis how to recognize a cholinergic crisis. What manifestations should the nurse include in this teaching? (Select all that apply.)

Elevate HOB, Evaluate gag reflex q shift, Monitor oxygen sats twice a shift, and Encourage deep breathing and coughing q 2 hours

The nursing diagnosis Ineffective Airway Clearance has been identified for a patient with multiple sclerosis. Which interventions should the nurse include in this patients plan of care? (Select all that apply.)