Question

Discussion

1.What is multiple sclerosis?

2.What is the best treatment for multiple sclerosis?

3.What are the stages of MS?

4.The nurse is assessing a 48-year-old client diagnosed with multiple sclerosis. Which clinical manifestation warrants immediate intervention?

1. The client has scanning speech and diplopia.
2. The client has dysarthria and scotomas.
3. The client has muscle weakness and spasticity.
4. The client has a congested cough and dysphagia.

5. The 30-year-old female client is admitted with complaints of numbness, tingling, a crawling sensation affecting the extremities, and double vision which has occurred two(2) times in the month. Which question is most important for the nurse to ask the client?

1. "Have you experienced any difficulty with your menstrual cycle?"
2. "Have you noticed a rash across the bridge of your nose?"
3. "Do you get tired easily and sometimes have problems swallowing?"
4. "Are you taking birth control pills to prevent conception?"

6. The home health nurse is caring for the client newly diagnosed with multiple sclerosis. Which client issue is of most importance?

1. The client refuses to have a gastrostomy feeding.
2. The client wants to discuss if she should tell her fiancé.
3. The client tells the nurse life is not worth living anymore
.4. The client needs the flu and pneumonia vaccines.

7. The male client diagnosed with multiple sclerosis states he has been investigating alternative therapies to treat his disease. Which intervention is most appropriate by the nurse?

1. Encourage the therapy if it is not contraindicated by the medical regimen.
2. Tell the client that only the health-care provider should discuss this with him.
3. Ask how his significant other feels about this deviation from the medical regimen.
4. Suggest the client research an investigational therapy instead.

8. The client diagnosed with an acute exacerbation of multiple sclerosis is placed on high-dose intravenous injections of corticosteroid medication. Which nursing intervention should be implemented?

1. Discuss discontinuing the proton pump inhibitor with the HCP.
2. Hold the medication until after all cultures have been obtained.
3. Monitor the client's serum blood glucose levels frequently
4. Provide supplemental dietary sodium with the client's meals.

9.The nurse is admitting a client diagnosed with multiple sclerosis. Which clinical manifestation should the nurse assess? Select all that apply.

1. Muscle flaccidity.
2. Lethargy.
3. Dysmetria.
4. Fatigue.
5. Dysphagia.

10. The 45-year-old client is diagnosed with primary progressive multiple sclerosis and the nurse writes the nursing diagnosis "anticipatory grieving related to progressive loss." Which intervention should be implemented?

1. Consult the physical therapist for assistive devices for mobility.

2. Determine if the client has legal power of attorney.

3. Ask if the client would like to talk to the hospital chaplain.

4. Discuss the client's wishes regarding end-of-life care.

Answer 1

1) Multiple sclerosis (MS) is a degenarative disorder in the central nervous system (CNS) .It is specially chronic & progressive in nature.In this type of disorder the nerve fibres of the brain & spinal cord become demyelinated. This type of disorder is more common between the age of 20 - 50. But it can occour in any age group.

2) Multiple sclerosis is not completely cureable..so,in this case it is concerned for the symptomatic relief or the medical treatment for the disease .The medications are-

• Immunomodulators ( Teriflunomide )
• Monoclonal antibody therapy ( Daclizumab )
• Anticholinergics ( Oxybutynin )
• Skeletal Muscle relaxants ( baclofen ) etc.

3) Stages Of Multiple sclerosis -

• Relapsing remitting
• Primary progressive
• Secondary progressive
• Progressive relapsing

4) Immediate intervention is needed for-

The client has a congested cough & dysphagia

5) The most important question to be asked by the nurse is-

"Do you get tired easily and sometimes have problems swallowing?"

6) The most important client issue is-

The client needs the flu and pneumonia vaccines.

[ Because MS is a infectious disease . So, the client has the more chance to develop any infection ]

7) The most appropriate intervention by the nurse is-

Encourage the therapy if it is not contraindicated by the medical regimen.

8) The nursing intervention which should be implimented is-

Provide supplemental dietary sodium with the client's meals.

[ Because- Sodium retention is a complication for long term steroid medication ]

9) The clinical menifestation which nurse should assess are-

Lethargy & Dysphagia

10) The following intervention should be implimented-

Discuss the client's wishes regarding end-of-life care.