Parkinson's/MS review
The nurse is caring for a patient who is hospitalized with an exacerbation of MS. To ensure the patients safety, what nursing action should be performed? A)Ensure that suction apparatus is set up at the bedside. B)Pad the patients bed rails. C)Maintain bed rest whenever possible. D)Provide several small meals each day.
A)Ensure that suction apparatus is set up at the bedside.
A patient with MS has been admitted to the hospital following an acute exacerbation. When planning the patients care, the nurse addresses the need to enhance the patients bladder control. What aspect of nursing care is most likely to meet this goal? A)Establish a timed voiding schedule. B)Avoid foods that change the pH of urine. C)Perform intermittent catheterization q6h. D)Administer anticholinergic drugs as ordered.
A)Establish a timed voiding schedule.
An older adult has encouraged her husband to visit their primary care provider, stating that she is concerned that he may have Parkinsons disease. Which of the wifes descriptions of her husbands health and function is most suggestive of Parkinsons disease? A)Lately he seems to move far more slowly than he ever has in the past. B)He often complains that his joints are terribly stiff when he wakes up in the morning. C)Hes forgotten the names of some people that weve known for years. D)Hes losing weight even though he has a ravenous appetite.
A)Lately he seems to move far more slowly than he ever has in the past.
The nurse is caring for a 77-year-old woman with MS. She states that she is very concerned about the progress of her disease and what the future holds. The nurse should know that elderly patients with MS are known to be particularly concerned about what variables? Select all that apply. A)Possible nursing home placement B)Pain associated with physical therapy C)Increasing disability D)Becoming a burden on the family E)Loss of appetite
A)Possible nursing home placement C)Increasing disability D)Becoming a burden on the family
The nurse caring for a patient diagnosed with Parkinsons disease has prepared a plan of care that would include what goal? A)Promoting effective communication B)Controlling diarrhea C)Preventing cognitive decline D)Managing choreiform movements
A)Promoting effective communication
What medications help with the fatigue associated with MS?
Amantadine Modafinil
Complications of Parkinson's
Aspiration Depression Fall risk Personality changes Sleep disturbances (sleep during the day, awake at night)
What medications help prevent relapses of MS?
Avonex, rebif, betaferon
What medications help with muscle spasms?
Baclofen Diazepam
What is the PD triad?
Bradykinesia, tremors, rigidity
A 33-year-old patient presents at the clinic with complaints of weakness, incoordination, dizziness, and loss of balance. The patient is hospitalized and diagnosed with MS. What sign or symptom, revealed during the initial assessment, is typical of MS? A)Diplopia, history of increased fatigue, and decreased or absent deep tendon reflexes B)Flexor spasm, clonus, and negative Babinskis reflex C)Blurred vision, intention tremor, and urinary hesitancy D)Hyperactive abdominal reflexes and history of unsteady gait and episodic paresthesia in both legs
C)Blurred vision, intention tremor, and urinary hesitancy
A patient with Parkinsons disease is undergoing a swallowing assessment because she has recently developed adventitious lung sounds. The patients nutritional needs should be met by what method? A)Total parenteral nutrition (TPN) B)Provision of a low-residue diet C)Semisolid food with thick liquids D)Minced foods and a fluid restriction
C)Semisolid food with thick liquids
How do anti-depressants help patients with PD?
Help reduce tremors
What are diagnostics for MS?
History - signs and symptoms MRI
What are the first symptoms of MS?
MS attacks motor and visual function first
What is a common complication of parkinson's disease related to bradykinesia?
Orthostatic hypotension
What medications will a doctor prescribe for tremors?
Propanolol - beta blocker Isoniazid - antibiotic
What are some causes of parkinson's?
Repeated head trauma Atherosclerosis Viral infections Anti-pyschotics
What form of exercise is good for people with MS?
Resistance exercise
3 triggers of MS
Temperature (heat) Euphoria Infection
Are tremors a diagnostic for parkinson's?
Tremor's are not a diagnostic because they could be caused by medications
When do you see tremors in a patient with parkinson's?
at rest
What medications help with the bladder?
oxybutyin - overactive bethanechol - empties
Progressive-relapsing MS
progressive with relapses most common
What are signs of parkinson's?
Drooling Bradykinesia Pill rolling tremors Short steps Drooping eyelids Impaired postural reflexes
What two medications are used together to combat acetylcholine?
Levodopa and cogentinn
What sign is often scene in patients with ms?
Lhermittes Electrical sensation
The nurse is working with a patient who is newly diagnosed with MS. What basic information should the nurse provide to the patient? A)MS is a progressive demyelinating disease of the nervous system. B)MS usually occurs more frequently in men. C)MS typically has an acute onset. D)MS is sometimes caused by a bacterial infection.
A)MS is a progressive demyelinating disease of the nervous system.
What needs to be present for a diagnosis of parkinson's disease?
At least two of the four characteristic signs of PD
A patient diagnosed with MS has been admitted to the medical unit for treatment of an MS exacerbation. Included in the admission orders is baclofen (Lioresal). What should the nurse identify as an expected outcome of this treatment? A)Reduction in the appearance of new lesions on the MRI B)Decreased muscle spasms in the lower extremities C)Increased muscle strength in the upper extremities D)Decreased severity and duration of exacerbations
B)Decreased muscle spasms in the lower extremities
The clinic nurse caring for a patient with Parkinsons disease notes that the patient has been taking levodopa and carbidopa (Sinemet) for 7 years. For what common side effect of Sinemet would the nurse assesses this patient? A)Pruritus B)Dyskinesia C)Lactose intolerance D)Diarrhea
B)Dyskinesia
A patient with MS has developed dysphagia as a result of cranial nerve dysfunction. What nursing action should the nurse consequently perform? A)Arrange for the patient to receive a low residue diet. B)Position the patient upright during feeding. C)Suction the patient following each meal. D)Withhold liquids until the patient has finished eating.
B)Position the patient upright during feeding.
The nurse is caring for a patient with multiple sclerosis (MS). The patient tells the nurse the hardest thing to deal with is the fatigue. When teaching the patient how to reduce fatigue, what action should the nurse suggest? A)Taking a hot bath at least once daily B)Resting in an air-conditioned room whenever possible C)Increasing the dose of muscle relaxants D)Avoiding naps during the day
B)Resting in an air-conditioned room whenever possible
The nurse is caring for a patient diagnosed with Parkinsons disease. The patient is having increasing problems with rising from the sitting to the standing position. What should the nurse suggest to the patient to use that will aid in getting from the sitting to the standing position as well as aid in improving bowel elimination? A)Use of a bedpan B)Use of a raised toilet seat C)Sitting quietly on the toilet every 2 hours D)Following the outlined bowel program
B)Use of a raised toilet seat
A patient with Parkinsons disease is experiencing episodes of constipation that are becoming increasingly frequent and severe. The patient states that he has been achieving relief for the past few weeks by using OTC laxatives. How should the nurse respond? A)Its important to drink plenty of fluids while youre taking laxatives. B)Make sure that you supplement your laxatives with a nutritious diet. C)Lets explore other options, because laxatives can have side effects and create dependency. D)You should ideally be using herbal remedies rather than medications to promote bowel function.
C)Lets explore other options, because laxatives can have side effects and create dependency.
A patient who was diagnosed with Parkinsons disease several months ago recently began treatment with levodopa-carbidopa. The patient and his family are excited that he has experienced significant symptom relief. The nurse should be aware of what implication of the patients medication regimen? A)The patient is in a honeymoon period when adverse effects of levodopa-carbidopa are not yet evident. B)Benefits of levodopa-carbidopa do not peak until 6 to 9 months after the initiation of treatment. C)The patients temporary improvement in status is likely unrelated to levodopa-carbidopa. D)Benefits of levodopa-carbidopa often diminish after 1 or 2 years of treatment.
D)Benefits of levodopa-carbidopa often diminish after 1 or 2 years of treatment.
A middle-aged woman has sought care from her primary care provider and undergone diagnostic testing that has resulted in a diagnosis of MS. What sign or symptom is most likely to have prompted the woman to seek care? A)Cognitive declines B)Personality changes C)Contractures D)Difficulty in coordination
D)Difficulty in coordination
The nurse is creating a plan of care for a patient who has a recent diagnosis of MS. Which of the following should the nurse include in the patients care plan? A)Encourage patient to void every hour. B)Order a low-residue diet. C)Provide total assistance with all ADLs. D)Instruct the patient on daily muscle stretching.
D)Instruct the patient on daily muscle stretching.
A patient has just been diagnosed with Parkinsons disease and the nurse is planning the patients subsequent care for the home setting. What nursing diagnosis should the nurse address when educating the patients family? A)Risk for infection B)Impaired spontaneous ventilation C)Unilateral neglect D)Risk for injury
D)Risk for injury
Main S+S of MS
Fatigued Trouble swallowing (aspiration risk) Spasms Clumsy - decrease in coordination Numbness Dizzy Nystagmus Optic neuritis Urinary/bowel overactive
What should be avoided when a patient is on levodopa for parkinson's?
high protein diet
Primary Progressive MS
steady increase in disability without attacks no period of remission
