MULTIPLE SCLEROSIS (LIPPINCOTT) QUESTIONS AND ANSWERS

MULTIPLE SCLEROSIS (LIPPINCOTT)
QUESTIONS AND ANSWERS
Thesdnursesdshouldsdconductsdasdfocusedsdassessmentsdwithsdthesdclientsdwithsdmultiplesd
sclerosissdforsdrisksdofsdwhichsdofsdthesdfollowing?sdSelectsdallsdthatsdapply.
1.sdDehydration.
2.sdFalls.
3.sdSeizures.
4.sdSkinsdbreaksddown.sd
5.sdFatigue.sd-sdanswer--
2,sd4,sd5.sdThesdclientsdwithsdmultiplesdsclerosissdissdatsdrisksdforsdfallssdduesdtosdmuscle
weakness,sdskinsdbreakdownsdduesdtosdbowelsdandsdbladdersdincontinence,sdandsdfatigue
.sdThesdclientsdissdnotsdatsdrisksdforsddehydration;sdseizuressdaresdnotsdassociatedsdwithsdmy
elinsddestruction.

Thesdnursesdissdteachingsdasdclientsdwithsdbladdersddysfunctionsdfromsdmultiplesdsclerosissd
(MS)sdaboutsdbladdersdtrainingsdatsdhome.sdWhichsdinstructionssdshouldsdthesdnursesdinclu
desdinsdthesdteachingsdplan?sdSelectsdallsdthatsdapply.
1.sdRestrictsdfluidssdtosd1,000sdmL/24sdhours.
2.sdDrinksd400sdtosd500mLsdwithsdeachsdmeal.
3.sdDrinksdfluidssdmidmorning,sdmidafternoon,sdandsdlatesdafternoon.sd4.sdAttemptsdtosdvoi
dsdatsdleastsdeverysd2sdhours.
5.sdUsesdintermittentsdcatheterizationsdassdneeded.sd-sdanswer--
2,sd3,sd4,sd5.sdMaintainingsdurinarysdfunctionsdinsdasdclientsdwithsdneurogenicsdbladdersddysf
unctionsdfromsdMSsdissdansdimportantsdgoal.sdThesdclientsdshouldsdideallysddrinksd400sdtosd5
00sdmLsdwithsdeachsdmeal;sd200sdmLsdmidmorning,sdmidafternoon,sdandsdlatesdafternoon;s
dandsdattemptsdtosdvoidsdatsdleastsdeverysd2sdhourssdtosdpreventsdinfectionsdandsdstonesdfor

mation.sdThesdclientsdmaysdneedsdtosdcatheterizesdherselfsdtosddrainsdresidualsdurinesdinsdth
esdbladder.sdRestrictingsdfluidssdduringsdthesddaysdwillsdnotsdproducesdsufficientsdurine.sdHo
wever,sdinsdbladdersdtrainingsdforsdnighttimesdcontinence,sdthesdclientsdmaysdrestrictsdfluids
sdforsd1sdtosd2sdhourssdbeforesdgoingsdtosdbed.sdThesdclientsdshouldsddrinksdatsdleastsd2,000sd

mLsdeverysd24sdhours.

Whichsdofsdthesdfollowingsdissdnotsdasdtypicalsdclinicalsdmanifestationsdofsdmultiplesdsclerosi
ssd(MS)?
1.sdDoublesdvision.
2.sdSuddensdburstssdofsdenergy.
3.sdWeaknesssdinsdthesdextremities.sd
4.sdMusclesdtremors.sd-sdanswer--
2.sdWithsdMS,sdhyperexcitabilitysdandsdeuphoriasdmaysdoccur,sdbutsdbecausesdofsdmusclesd
weakness,sdsuddensdburstssdofsdenergysdaresdunlikely.sdVisualsddisturbances,sdweakness

, insdthesdextremities,sdandsdlosssdofsdmusclesdtonesdandsdtremorssdaresdcommonsdsympto
sd

mssdofsdMS.

Asdclientsdwithsdmultiplesdsclerosissd(MS)sdissdreceivingsdbaclofensd(Lioresal).sdThesdnurses
ddeterminessdthatsdthesddrugsdissdeffectivesdwhensditsdachievessdwhichsdofsdthesdfollowing?

1.sdInducessdsleep.
2.sdStimulatessdthesdclient'ssdappetite.
3.sdRelievessdmuscularsdspasticity.
4.sdReducessdthesdurinesdbacterialsdcount.sd-sdanswer--
3.sdBaclofensdissdasdcentrallysdactingsdskeletalsdmusclesdrelaxantsdthatsdhelpssdrelievesdthes
dmusclesdspasmssdcommonsdinsdMS.sdDrowsinesssdissdansdadversesdeffect,sdandsddrivingsd

shouldsdbesdavoidedsdifsdthesdmedicationsdproducessdasdsedativesdeffect.sdBaclofensddoess
dnotsdstimulatesdthesdappetitesdorsdreducesdbacteriasdinsdthesdurine.



Asdclientsdhassdhadsdmultiplesdsclerosissd(MS)sdforsd15sdyearssdandsdhassdreceivedsdvariou
ssddrugsdtherapies.sdWhatsdissdthesdprimarysdreasonsdwhysdthesdnursesdhassdfoundsditsddiffic
ultsdtosdevaluatesdthesdeffectivenesssdofsdthesddrugssdthatsdthesdclientsdhassdused?

1.Thesdclientsdexhibitssdintolerancesdtosdmanysddrugs.
2.Thesdclientsdexperiencessdspontaneoussdremissionssdfromsdtimesdtosdtime.
3.Thesdclientsdrequiressdmultiplesddrugssdsimultaneously.
4.Thesdclientsdenduressdlongsdperiodssdofsdexacerbationsdbeforesdthesdillnesssdrespondssdt
osdasdparticularsddrug.sd-sdanswer--
2.sdEvaluatingsddrugsdeffectivenesssdissddifficultsdbecausesdasdhighsdpercentagesdofsdclient
ssdwithsdMSsdexhibitsdunpredictablesdepisodessdofsdremission,sdexacerbation,sdandsdstead
ysdprogresssdwithoutsdapparentsdcause.sdClientssdwithsdMSsddosdnotsdnecessarilysdhavesdin
creasedsdintolerancesdtosddrugs,sdnorsddosdtheysdenduresdlongsdperiodssdofsdexacerbations
dbeforesdthesdillnesssdrespondssdtosdasdparticularsddrug.sdMultiplesddrugsdusesdissdnotsdwhats

dmakessdevaluationsdofsddrugsdeffectivenesssddifficult.



Whensdthesdnursesdtalkssdwithsdasdclientsdwithsdmultiplesdsclerosissdwhosdhassdslurredsdspe
ech,sdwhichsdnursingsdinterventionsdissdcontraindicated?
1.sdEncouragingsdthesdclientsdtosdspeaksdslowly.
2.sdEncouragingsdthesdclientsdtosdspeaksddistinctly.
3.sdAskingsdthesdclientsdtosdrepeatsdindistinguishablesdwords.sd
4.sdAskingsdthesdclientsdtosdspeaksdloudersdwhensdtired.sd-sdanswer--
4.sdAskingsdasdclientsdtosdspeaksdloudersdevensdwhensdtiredsdmaysdaggravatesdthesdproble
m.sdAskingsdthesdclientsdtosdspeaksdslowlysdandsddistinctlysdandsdtosdrepeatsdhard-to-
understandsdwordssdhelpssdthesdclientsdtosdcommunicatesdeffectively.

Thesdrightsdhandsdofsdasdclientsdwithsdmultiplesdsclerosissdtremblessdseverelysdwheneversds
hesdattemptssdasdvoluntarysdaction.sdShesdspillssdhersdcoffeesdtwicesdatsdlunchsdandsdcanno
tsdgetsdhersddresssdfastenedsdsecurely.sdWhichsdissdthesdbestsdlegalsddocumentationsdinsdn
urses'sdnotessdofsdthesdchartsdforsdthissdclientsdassessment?
1."Hassdansdintentionsdtremorsdofsdthesdrightsdhand."
2."Right-handsdtremorsdworsenssdwithsdpurposefulsdacts."
3."Needssdassistancesdwithsddressingsdandsdeatingsdduesdtosdseveresdtremblingsdandsdclu
msiness."
4."Slightsdshakingsdofsdrightsdhandsdincreasessdtosdseveresdtremorsdwhensdclientsdtriessdto