LAST QUIZ. neuro

A pt reports increased fatigue and stiffness of the extremities. These symptoms have occurred in the past, but resolved and no medical attention was sought. Which questions does the nurse ask to assess whether the symptoms may be associated with multiple sclerosis? (all)

"do you have a persistent sensitivity to cold?" "Do you ever have slurred speech or trouble swallowing?" "Has anyone in your family been diagnosed with multiple sclerosis?"

A client with myasthenia gravis asks the nurse why the disease has occurred. What pathology underlies the nurse's reply?

A decreased number of functioning acetylcholine receptor sites

A client with GB has been hospitalized for 3 days. Which assessment finding indicates a need for more frequent monitoring?

Ascending weakness

A client with myasthenia gravis experiences dysphagia. What is the priority risk associated with dysphagia that must be considered when planning nursing care?

Aspiration

A client with myasthenia gravis asks the nurse what is going to happen to me and to my family? What info about what the client can anticipate should be incorporated into the nurse's response?

Chronic illness with exacerbations and remissions

An ambulatory female client with relapsing-remitting multiple sclerosis is to receive every other day injections of interferon beta-1a (avonex). What adverse effects should the nurse explain may occur when taking this medication? (all)

Depression, constipation, flulike symptoms, increased heart rate

form of myasthenia; often seen with small cell carcinoma of the lung

Eaton-lambert syndrome

Which statement by a client with multiple sclerosis indicates to the nurse that the client needs further teaching?

I will take a hot bath to help relax my muscles

What does the nurse understand that clients with myasthenia gravis, GBS, and amyotrophic later sclerosis ALS share in common?

Increased risk for respiratory complications

To what does the nurse attribute the increased risk of respiratory complications in clients with myasthenia gravis?

Ineffective coughing

The pt is a woman in her early 30s who has recently been diagnosed with multiple sclerosis. The nurse has taught the pts husband about the course of the illness and what problems might occur in the future. Which statement by the husband indicates the need for additional teaching?

Later on she could have intermittent short term memory loss

What nursing intervention is anticipated for a client with GBS?

Maintaining ventilator settings to support respiration

The nurse explains to the family of a client suspected of having myasthenia gravis that edrophonium (enlon) is used to establish the diagnosis. An increase in which factor will confirm the diagnosis?

Muscle strength~

The nursing assistant reports to you, the RN, that a client with myasthenia gravis has an elevated temperature (102.2) and increased heart rate (120) a rise in blood pressure (158/94), and was incontinent of urine and stool. What is your best first action at this time?

Notify the physician immediately

A nurse enters the room of a client with myasthenia gravis and identifies that the client is experiencing increased dysphagia. What should the nurse do first?

Raise the head of the bed

A client with MS tells the nursing assistant after physical therapy that she is too tired to take a bath. What is the priority nursing diagnosis at this time?

Self-care deficit related to fatigure and neuromuscular weakness

A nurse is caring for a client in the home who has the diagnosis of amyotrophic later sclerosis. Which position should the nurse recommend that the client assume after eating?

Semi-fowler

An LPN under your supervision is providing nursing care for a client with GBS. What observation should you instruct to LPN to report immediately?

Shallow respirations and decreased breath sounds

A recently hospitalized client with multiple sclerosis is concerned about generalized weakness and fluctuating physical status. What is the priority nursing intervention for this client?

Space activities throughout the day

A home care nurse is counseling a client with amyotrophic later sclerosis. What info should the nurse include in the discussion?

Space activities throughout the day, anticipate the use of alternate ways to communicate

Which client should be assigned to the traveling nurse, new to neurologic nursing care, who has been on the neuro unit for 1 week?

a 68 year old with chronic amyotrophic lateral sclerosis

The LPN whom you are supervising comes to you and says, "I gave the client with myasthenia gravis 90 mg of neostigmine (prostigmin) instead of the ordered 45mg!" In which order should perform the following actions?

assess the clients heart rate, notify physician of the incorrect medication dose, ask the LPN to explain how the error occurred, complete a medication error report

muscles of facial expression, chewing, and speech are affected

bulbar involvement

Overmedication with cholinesterase inhibitors

cholinergic crisis

A pt with multiple sclerosis is prescribed oral prednisone 60 mg daily for 7 days following a course of IV methylprednisolone (solumedrol). Which lab abnormality is a side effect of the medication?

decrease in serum potassium

destruction of myelin between the nodes of ranvier

demyelination

A client is admitted to the hospital with a dx of myasthenia gravis. For which common early clinical finding should the nurse assess the client?

diplopia

double vision

diplopia

Which clinical findings does the nurse anticipate a client with an exacerbation of multiple sclerosis to experience? (all)

double vision, scanning speech

difficulty chewing or swallowing

dysphagia

muscle twitching

fasciculations

extreme sensitivity to touch

hyperesthesia

undermedication with cholinesterase inhibitors

myasthenic crisis

unpleasant sensations such as burning, stinging, and prickly feeling

paresthesias

method to remove antibodies from the plasma to decrease symptoms

plasmapheresis

drooping eyelids

ptosis

Weakness in all four extremities

quadriparesis

A client with myasthenia gravis continues to become weaker despite treatment with neostigmine (prostigmin). What reason should the nurse identify for the health care provider's prescription for edrophonium? (enlon)

rule out cholinergic crisis

A hospitalized client is receiving pyridostigmine (mestinon) for control of myasthenia gravis. In the middles of the night, the nurse finds the client weak and barely able to move. Which additional clinical findings support the conclusion that these responses are related to pyridostigmine? (all)

respiratory depression, decreased blood pressure, high pitched gurgling bowel sounds

A client with multiple sclerosis is in remission. Which diversional activity should the nurse encourage that best meets the clients needs while in remission?

swimming

A client with myasthenia gravis has been receiving neostigmine (prostigmin) and asks about its action. What information about its action should the nurse consider when formulating a response?

Blocks the action of cholinesterase

A nurse is caring for a client with the dx of GBS. The nurse identifies that the client is having difficulty expectorating respiratory secretions. What should be the nurse's first intervention?

Suction the client's oropharynx