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17 Cards in this Set
- Front
- Back
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Multiple Sclerosis: -What is it? -cause -age effected |
-Chronic, progressive, degenerative disease of the CNS characterized by demyelination of the neurons. Consists of periods of remission and exacerbation. -Cause is unknown but thought to be the result of an autoimmune response or viral infection. -Usually occurs between ages of20-40 years, more women than men. |
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Multiple Sclerosis: What can cause flare ups? |
pregnancy,fatigue, stress, infection, and trauma. |
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Multiple Sclerosis: Pathophysiology |
-Abnormal immune response→inflammation→demyelination. -Demyelination--destruction of the myelin(fatty & protein material that surrounds certain nerve fibers in the brain and spinal cord). -Impaired transmission of nerve impulses. -Plaques appear & worsen transmission of impulses. -Axons degenerate → permanent& irreversible damage. |
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Multiple Sclerosis: -Areas most affected? |
Optic nerve, cerebrum,brain stem, cerebellum, and spinal cord.
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Multiple Sclerosis: Clinical Presentation |
-Fatigue & weakness—most common and most disabling -Emotional changes (depression,irritability, apathy, euphoria) -Dysphagia -Tremors & spasticity of the lower extremities -Impaired sensations (numbness,paresthesia, pain, temperature sensation) -Loss of coordination (ataxia) and balance -Visual disturbances Bowel & bladder disturbances -Abnormal reflexes -Memory changes & confusion |
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Multiple Sclerosis: Gerontological concerns |
-Additional chronic health problems/medications that could interact with MS medications. -Kidney/Liver age related changes that alter MS medication effectiveness. -High cost of MS meds and fixed income =poor adherence. -Concerns regarding functional loss,dependence, & family burden |
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Multiple Sclerosis: Assessment and Diagnostics |
-Thorough health history -Lumbar puncture- ↑ gamma globulin (IgG)level -EEG- abnormal -MRI– Multiple plaques will be seen -Bladder dysfunction -Neuropsychological testing to assess cognitive impairment |
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Multiple Sclerosis: Medical management |
Pharmacologic Therapy-- No cure, symptom management is the goal -Disease modifying medications—reduce frequency &duration of relapses, & number/size of plaques -Immunosuppressant medications—reduce the frequency of relapses -Other medications that manage symptoms of the disease. |
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Multiple Sclerosis:Pharmacology Prednisone -What is it -What does it do |
-steroid -reduce inflammation in acute exacerbations. |
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Multiple Sclerosis:Pharmacology Baclofen -What is it -What does it do |
-anti-spasmodic -treat muscle spasticity. |
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Multiple Sclerosis:Pharmacology Gabapentin -What is it -What does it do |
-anti-epileptic -control dysesthesias (neuropathic pain from MS lesions) and pain caused by spasticity. |
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Multiple Sclerosis:Pharmacology Carbamazepine(Tegratol) -What is it -What does it do |
-anticonvulsent -paresthesia (a burning or prickling sensation) |
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Multiple Sclerosis:Pharmacology Interferonbeta (Betaseron) -What is it -What does it do |
- immunomodulator -used to prevent/treat relapses. |
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Multiple Sclerosis:Pharmacology Imuran& Sandimmune -What is it -What does it do |
- immunosuppressive agents -reduce frequency of relapses. |
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Multiple Sclerosis: Nursing Interventions |
-encourage independence -Safety is HUGE with MS!!! As disease progresses, it becomes even more important. Falls and Aspiration are two of biggest risks in that they can have snowball effect in these patients!! -Instruct client in safety measures(swallowing, ambulation, sensory loss, etc.) -Plan for disease progression. Providecommunity resources and services. -Consider appropriate referrals and assessneeds for assistive devices (OT, PT, ST) -Medication education including purpose,side effects, etc. -Provide energy conservation measuresduring exacerbation. -Monitor for complications (UTI, pressureulcers, upper respiratory infections, & contractures). -Bladder/bowel training is applicable. -Nutrition education—avoid obesity |
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Multiple Sclerosis: A nurse is beginning a physical assessment of a client who was recently diagnosed with multiple sclerosis (MS). Which of the following findings should the nurse expect? Select all that apply. A.Areas of paresthesia B.Involuntary eye movements C.Alopecia D.Increased salivation E.Ataxia |
A,B,E |
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Multiple Sclerosis: A client with MS is receiving baclofen.The nurse determines that the drug is effective when it achieves which of the following? 1.Induces sleep. 2.Stimulated the client’s appetite. 3.Relieves the muscle spasticity. 4.Reduces the urine bacterial count. |
3 |
