1010- Test 3 Multiple Sclerosis

Front 1

____ is a chronic degenerative disease of the CNS primarily affecting the white matter. It damages the myelin that surrounds nerves.

Back 1

Multiple sclerosis

Front 2

Multiple Sclerosis may be related to previous ____ or possibly _____.

Back 2

viral disease
genetics

Front 3

____ is the loss of myelin sheath material essential in nerve impulse transmission.

Back 3

Demyelination

Front 4

MS is an ____ reactive disease.

Back 4

autoimmune

Front 5

The manifestations of MS include:

Back 5

-FATIGUE
-spastic weakness of limbs, bowel, bladder
-numbness
-ataxia
-diplopia, blindness, optic neuritis
-intention tremors

Front 6

There are 4 different types of MS

Back 6

-relapsing-remitting
-primary progressive
-secondary progressive
-progressive-relapsing

Front 7

During ____ MS the S/Sx come and go. There are periods of exacerbation and remission but S/Sx return to baseline each time.

Back 7

Relapsing-remitting

Front 8

During _____ MS the person will experience a slow but continuous worsening of their disease from the onset with no distinct relapses or remissions.

Back 8

Primary-progressive

Front 9

During ____ MS there is an initial period of relapsing-remitting followed by steadily worsening with or without occasional flare ups, remissions and plateaus.

Back 9

Secondary-progressive

Front 10

During _____ MS people continue to get worse with intermittent flares that are much worse.

Back 10

Progressive-Relapsing

Front 11

The diagnostic procedure for determining MS is ____.

Back 11

MRI

Front 12

A CSF analysis for MS would reveal

Back 12

T- lymphocytes, IGG and WBCs

Front 13

5 means of diagnosis for MS are:

Back 13

-History and physical exam
-CSF analysis
-MRI
-CT Scan
-EEG

Front 14

When a person dies with MS it is often related to _____.

Back 14

infections

Front 15

The treatment of MS aims to shorten ____ and relieve _____ deficits.

Back 15

exacerbations
neurologic

Front 16

Effectiveness of drugs used to treat MS are monitored thru _____.

Back 16

ongoing evaluation

Front 17

Ongoing evaluation of MS drugs includes 3 types of exams

Back 17

Neuro
Sensory function
Motor function

Front 18

4 types of drugs used to treat MS are:

Back 18

-immunomodulators
-adrenocorticosteroids
-muscle relaxants/antispasmodics
-immunosuppressants

Front 19

_____ are MS drugs that produce a decrease in MS lesions therefore the sooner you begin the meds the better.

Back 19

Immunomodulators

Front 20

4 types of immunomodulator medications for MS are:

Back 20

-Interferons
-Glatimer Acetate
-Natazumab
-Fingolimod

Front 21

The first oral immunomodulator for MS is ______.

Back 21

Fingolimod

Front 22

Immunomodulators are all _____.

Back 22

injectable

Front 23

Fingolimod is an oral immunomodulator but many people don't take it because it causes...

Back 23

decreases WBCs and increased risk for infection.

Front 24

Complications forImmunomodulators include:

Back 24

-redness and pain at injection site
-flu-like symptoms
-increase in liver function
-contraindicated for pregnancy

Front 25

Nsg implications for patients on immunomodulators include:

Back 25

-assess liver function tests and CBC differentials q6mos
-teach abt flu-like symptoms and injection site redness
-teach client to rotate injections
-report pregnancy or breastfeeding

Front 26

___, ____, and ____ are adrenocorticosteroids that are used to treat MS.

Back 26

Prednisone, ACTH, and Medrol

Front 27

______ suppress the immune system. They are given to sustain a remission and to treat exacerbations.

Back 27

Adrenocorticosteroids

Front 28

Adrenocorticosteroids are often given during ______.

Back 28

initial diagnosis

Front 29

Nsg implications for adrenocorticosteroids include:

Back 29

-assess and record baseline data (VS, wt, mental status, motor and sensory function)
-report cushingnoid effects
-give orals with meals
-taper when Dc
-monitor BG, osteoporosis, and cataract formation

Front 30

___, ____, ____ and ____ are antispasmodics or muscle relaxants that may be given to treat MS.

Back 30

Baclofen (Loresal)
Dantrolene (Dantrium)
Diazepam (Valium)
Flexeril

Front 31

Baclofen, Diazepam and Flexeril act by ______.

Back 31

suppressing CNS reflexes

Front 32

Dantrolene acts directly on the _____.

Back 32

skeletal muscle

Front 33

Sudden withdrawal of ____ may cause seizures and paranoid ideations.

Back 33

Baclofen

Front 34

____ may cause hepatotoxicity.

Back 34

Dantrolene

Front 35

Nsg implications for patients on antispasmodics are:

Back 35

-evaluate baseline muscle strength, spasticity, and ROM
-falls precautions
-monitor LFTs
-wean off Baclofen

Front 36

____, ____ and ____ are immunosuppressants used to treat MS.

Back 36

Imuran, Cytoxan, Neoral

Front 37

Immunosuppressants control the immune system by _____.

Back 37

suppressing.

Front 38

Complications of immunosuppressants include:

Back 38

-may cause bone marrow suppressions and increase cancer risk
-Imuran may produce hepatitis
-Cytoxan can lead to hemorrhagic cystitis, sterility and stomatitis

Front 39

Nsg implications for Immunosuppressants include:

Back 39

-watch for bleeding, anemia, infection, report jaundice immediately
-drink 2L fluid daily
-monitor hepatic, renal, hematologic effects
-avoid exposure to infection

Front 40

An alternative therapy that may be helpful for patients with MS is _____.

Back 40

cannabis

Front 41

____ and ____ work with MS patients most often to help with mobility.

Back 41

PT and OT

Front 42

Heat is a problem with MS patients, therefore some people wear _____.

Back 42

ice vests

Front 43

_____ is used with MS patients to control weight.

Back 43

Diet therapy

Front 44

Patients with Multiple Sclerosis may experience:

Back 44

-Tinnitus
-decreased hearing
-nystagmus
-diplopia
-blurred vision
-dysarthria, dysphagia
-urinary retention
-spastic bladder
-constipation
-weakness to paralysis
-muscle spasticity
-ataxia
-vertigo

Front 45

MS is more common in women between ____ and ____ years old.

Back 45

20-40