Multiple Sclerosis- Nursing 2023 with 100% correct questions and answers

MS; WHAT is it? Autoimmune disease that affects the MS (Myelin Sheaths) of CNS. Leads to INFL and scarring of nerves= decrease in nerve transmission= more sensory/nerve problems Autoimmune the immune system's attack on the body sensory and motor problems due to WHAT? Nerve cells in CNS/PNS affected Who is affected more? Women, 20-40's What is so damning about the SS? They appear then reappear all over again. Exact cause unknown. Currently no cure. How is it Managed? lifestyle changes and medications can improve SS How is MS diagnosed? -Assessing pt ss -MRI to assess for lesions in brain and spinal cord -Lumbar puncture to assess spinal fluid for oligoclonal bands= more inflammation. -Evoked potential studies= you get to shock your pt. General path Myelin sheaths are attacked by the bodies own immune system. Ergo, the messages are not getting to where they need to. Example- normal person can lift a coffee cup up. In a person with MS- the nerves sending that message to your brain are misfiring the message, and its disorganized= tremors, shaky, clumsy movements. SS- SENSATION Involuntary tremors, spasms, clumsiness= can be a risk for unintentional injury-- safety concerns--fall risk prevention. Numbness and tingling in face and extremities. Lhermittes sign= electric shock sensation down spine Dizzy/ stiff muscles affecting coordination horrible proprioception SS- VISION Nystagmus- involuntary eye movement. Diplopia- double vision Blurry vision Color changes Blindness in one eye Seeing dark spots NI* Get up slowly, scan room before moving, clear your walkway. Pace yourself. SS- Emotional- cognitive Drained/weak fatigue depressed trouble articulating speech (dysarthria) dysphagia- difficulty swallowing mood swings trouble thinking, focusing and problem solving SS ELIMINATION Nerves of bladder are also affected Cannot hold urine- spastic bladder- incontinence= leads to nocturia Flaccid bladder- hesitancy, leads to retaining urine--at risk for UTI/Renal stones. NI- bladder scan and then In and out catheter as a last resort. Why? give the pt a chance to void on their own. NURSING INTERVENTIONS FOR MS SAFETY- vision, coordination, decreased proprioception. prevent SS from worsening. Watch the heat avoid infection relaxation techniques maintain regular exercise use assistive devices as needed clutter free environment consult speech pathologist PT/OT Support groups Bladder and bowel- make accessibility to bathroom easy. may need to learn self catheterizing care. 1-2 Liters of fluid, increase fiber intake. stool softeners. MEDS for MS BETA INTERFERON; decrease number of relapses of SS by INFL and the immune system response. *RISK OF INF BC WBC Drug names-Avonex, Rebig, Betaferon MEDS FOR MS CORTICOSTEROIDS- For relapse SS prednisone *SE- hyperglycemia, sodium and water retention, lowers immune system so avoid large crowds and practice hand hygiene. Can alter K levels. Mood swings and Moon face. MEDS FOR MS OXYBUTYNIN- ANTICHOLINERGIC Helps with overactive bladder...relaxes bladder to prevent contractions. Bethanechol- cholinergic- helps with completely emptying bladder by contracting fully Fatigue Amantadine- antiviral but has CNS effects. helps improve fatigue in MS pt Modafinil- CNS stimulant SPASMS sudden, involuntary muscle contractions that are usually painful. Take Baclofen- skeletal muscle relaxant. diazepam works too. TREMORS Continuous quivering or shaking. BETA BLOCKER-OLOL Smile because you're awesome.