Chapter 50. Nursing Care of Patients With Peripheral Nervous System Disorders

A patient reports to the nurse an inability to rest or sleep due to a constant urge to move the legs. What should the nurse recommend 2. Take a cool bath at bedtime. 3. Perform exercises before bedtime. 4. Minimize night-time sleep to 6 hours only.

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A patient with GBS has stopped having a progression of the symptoms. The family asks the nurse how much longer it will be before the patient begins to improve. How should the nurse reply? 1. It will take a week or two before there is improvement 2. Improvement will begin in about a month. 3. There may or may not be improvement; it varies. 4. There will be further deterioration before improvement begins.

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The nurse is collecting information from a patient in the HCP's office who is exhibiting symptoms associated with Bell palsy. Which supporting data increases the risk for this condition? 1. The patient is in the third trimester of pregnancy. 2. The patient has a history of a stroke. 3. The patient has a history of polio. 4. The patient has a history of alcohol abuse.

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The nurse reviews information with a patient and family members about the patient's recent diagnosis of amyotrophic lateral sclerosis (ALS). What recommendations should the nurse make? 1. Exploration of support groups 2. Consideration of surgical options 3. Importance of following medication regime 4. Exploration of hospice services

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20. The nurse is teaching a patient with MG how to recognize a cholinergic crisis. Which manifestations does the nurse include in this teaching? (Select all that apply.) 1. Diarrhea 2. Salivation 3. Vomiting 4. Difficulty speaking 5. Increased bronchial secretions

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1. The nurse is caring for a patient experiencing an acute exacerbation of multiple sclerosis (MS). Which pathophysiological change leads to the symptoms of MS? 1. Myelin buildup in the central nervous system 2. Demyelination and destruction of nerve fibers 3. Gamma aminobutyric acid (GABA) deficiency 4. Reduced acetylcholine receptors with impaired nerve impulse transmission

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A mother of two young children has a 1-year history of MS and recently stopped helping in the children's classrooms because of fatigue and weakness. What advice should the nurse give to help the patient best cope with the problem? 1. You need to realize that you may not be able to do the things you used to do. 2. You may plan to be there for shorter visits so you can rest. 3. Get plenty of sleep the night before you help give you the stamina you need. 4. Take your medication after you finish helping and you may have a better energy level. ANS: 2

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The nurse is caring for patients with a variety of neuromuscular disorders. Which findings are most concerning? 1. Evidence of severe muscle wasting 2. Indications of the development of respiratory distress 3. Interruption of skin integrity over bony prominences 4. Difficulty maintaining weight due to difficulty swallowing

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The nurse is collection admission information for a patient who has a history of having a thymectomy. Which condition should the nurse inquire about? 1. MS 2. MG 3. GBS 4. ALS

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The nurse is preparing a patient with MG to undergo plasmapheresis. Which laboratory tests should the nurse verify and place on the medical record before the procedure? 1. Urine analysis, urine protein, blood urea nitrogen (BUN), and creatinine 2. Complete blood count (CBC), platelets, and clotting studies 3. Creatinine phosphokinase, blood type, and electrolytes 4. Electrolytes, BUN, creatinine, and albumin

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The nurse is providing care for a patient being treated for trigeminal neuropathy. The nurse is concerned about the patient's nutritional status because of an inability to eat without experiencing severe pain. Which patient behavior indicates the nurse's interventions are successful? 1. The patient can sip cool or warm beverages through a straw. 2. The patient can eat multiple small, soft, lukewarm meals daily. 3. The patient's weight remains 10 pounds below the target weight. 4. The patient's pain is managed with postprandial pain medication.

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The nurse is speaking with the family of a patient diagnosed with Guillain-Barr syndrome (GBS). They ask what could cause something like this. How should the nurse reply? 1. No one knows an exact cause. 2. It may be an autoimmune reaction to a virus. 3. It most often occurs as a result of a bacterial infection. 4. It is usually hereditary. Does anyone in your family have it?

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11. The nurse is providing care for a patient after surgery for treatment of trigeminal neuralgia. Which action should the nurse take when providing care? 1. Protect the patient's face from any movement of air. 2. Place eye patches bilaterally while the patient sleeps. 3. Check the eye on the surgery side for corneal sensation. 4. Provide a soft diet with food served at room temperature.

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A patient who is prescribed neostigmine for newly diagnosed MG asks how the medication works. Which response should the nurse provide to the patient? 1. It is a muscle relaxant to prevent the cramping in your muscles. 2. It provides potassium to your muscles so they will contract better. 3. It makes more neurotransmitters available so your muscles can contract. 4. It reduces the inflammation in your nerves so they transmit signals better.

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A patient with trigeminal neuralgia is admitted to the hospital for diagnostic testing and possible surgery. What should the nurse plan with care? 1. Provide tissues for the patient to deal with drooling. 2. Provide frequent mouth care with a firm toothbrush. 3. Provide liquid foods at body temperature at mealtimes. 4. Provide a fan in the room to keep the room well ventilated.

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The nurse is assisting with the care of a patient diagnosed with post-polio syndrome. Which symptom(s) support(s) this diagnosis? 1. Paralysis of one or both legs 2. Confusion and hallucinations 3. Muscle weakness and atrophy 4. Shooting pains to the extremities

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The nurse is collecting up-to-date data from a patient who was diagnosed with MS 15 years ago. The patient has a good understanding of the disease and manages to maintain a relatively high level of functioning. Which statement by the patient is most concerning? 1. I am very careful to avoid sick people and crowds in the winter. 2. I have been attending a special yoga class for people with MS. 3. Ilove to work in my flower beds during the summer months. 4. I find that I do much better if I let other people run errands for me.

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A patient with MS has been prescribed baclofen to relax muscles. Which information is included in the nurse's teaching about this drug? (Select all that apply.) 1. Avoid crowds while on this medication. 2. Take a calcium supplement while on this medication. 3. Report any shortness of breath or other respiratory problems. 4. Avoid driving or operating machinery until the effects of the drug are known. 5. Prevent constipation by increasing fluids and fiber-rich foods; use suppositories when necessary.

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The nurse is caring for a patient who is diagnosed with MG. What is the nurse's priority of care? 1. Ascertain if the patient's needs are being met by an adequate support system 2. Ask what amount of activity causes fatigue and muscle weakness to occur. 3. Determine baseline muscle strength through the use of appropriate techniques. 4. Monitor the patient's respiratory function and the ability to swallow effectively.

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The nurse is visiting the home of a patient who is being treated for Bell palsy. Which statement by the patient indicates that care instructions require clarification? 1. I find that I can eat better with a facial sling in place. 2. Gentle massage of the affected muscles reduces discomfort. 3. I follow the physical therapy exercises exactly as prescribed. 4. Alternating heat and cold therapy is helping the swelling.

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