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NCM 116 Lecture > Midterms_Multiple Sclerosis > Flashcards

Midterms_Multiple Sclerosis Flashcards

1
Q

a chronic, progressive, non-
contagious, degenerative disease of the CNS
characterized by demyelination of the neurons.

A

Multiple Sclerosis

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2
Q

.This is described as the ________ of the
brain, spinal cord, and optic nerve’s white matter
and usually occurs as small patches

A

demyelination

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3
Q

what age does MS usual happen?

A

20 and 40

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4
Q

Causes disruption of electrical messages from
the brain to the peripheral nervous system.
_____________ findings are abnormal

A

Electroencephalogram

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5
Q

A lumbar puncture indicates ______

A

increased gamma
globulin, but the serum globulin level is
normal.

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6
Q

Other possible factors:
(may help destroy axons and myelin sheath)

A

A. trauma
B. Anorexia
C. toxins
D. Nutritional deficiencies
E. Vascular lesions -
F. Anorexia nervosa

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7
Q

More prevalent in the _____

A

Northern latitudes and
among Caucasians

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8
Q

defined as damage to the
myelin, the protein, and lipid-rich substance that
serves as a cover to the neural fibers of the
brain spinal cord.

A

Demyelination

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9
Q

Due to demyelination, there is a disruption in the
_______the affected nerve fibers are scarred because of the inflammatory reactions.-

A

nerve transmissions,

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10
Q

This is described as the demylination of the
________,_______, _________
and usually occurs as small patches

A

brain, spinal cord, and optic nerve’s white matter

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11
Q

Results in disordered transmission of nerve impulses Inflammatory changes lead to the scarring of the affected nerve fibers.

A

Demyelination

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12
Q

Signs and Symptoms of MS
(BUV DMS IV)

A

Body weakness and fatigue
● Unusual reflexes, either hyperactive or absent
● Visual disorders may be nystagmus ( impaired
double vision)
● Dysarthria and dysphagia
● Motor disturbances (incoordination and tremor)
● Sensory dysfunctions (paresthesias, impaired
sense of position and vibration, reduced deep
sensation)•
● Impaired urinary functions (frequency,
incontinence,hesitancy, retention, urgency) •
● Behavioral patterns ( depression, emotional
lability,disturbed cognition)

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13
Q

Diagnostic test for MS

A

Cerebrospinal fluid (CSF) analysis

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14
Q

Cerebrospinal fluid (CSF) analysis reveals…

A

elevated protein level,increased white blood cells.

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15
Q

Electrophoresis of CSF shows

A

increased myelin basic protein and IgG bands.

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16
Q

Supporting Diagnostic Tests Include

A

electroencephalography, evoked potential studies, computed tomography (CT) scan, and magnetic resonance imaging(MRI)

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17
Q

helpful in visualization of the lesions on the white matter of the central nervous system

A

.Magnetic Resonance Imaging

18
Q

Nursing Diagnosis (ISAAS)

A
  1. Impaired physical mobility related to fatigue and weakness.
  2. Sensory-perceptual alteration
  3. Altered urinary elimination
  4. Altered family processes
  5. Sexual dysfunction
19
Q

Medical Management
1. ACUTE CASES

A

Corticosteroids or adrenocorticotropic hormone

Immunosuppressive agents

Beta-interferon (Betason)

20
Q

Meds

is necessary to minimize inflammation and reduce the extent of exacerbation or relapse.

A

Corticosteroids or adrenocorticotropic hormone

21
Q

Meds

provides stabilization throughout the course of the condition

A

Immunosuppressive agents

22
Q

Meds

for relieving quick-advancing symptoms for some patients

A

Beta-interferon (Betason)

23
Q

Meds Chronic Cases

A

Antispasmodic agents

Amantadine (Symmetrel)

Antidepressant drugs and counseling

  1. Anticholinergics
24
Q

Meds

Antispasmodic agents such as ________ , ___________, __________ Muscle Spasms are managed by physical therapy, neural block surgery.

A

Baclofen(Lioresal),Dantrolene (Dantrium) and Diazepam(Valium).

25
Q

Meds for reducing fatigue

A

Amantadine (Symmetrel)

26
Q

Meds for bladder control;
intermittent catheterization to facilitate drainage

A

Anticholinergics

27
Q

Other medical managements:

A

Stool softeners,

Carbamazepine (Tegratol)

Phenytoin (Dilantin)

28
Q

Meds like suppositories and bulk laxatives for bowel movement

A

Stool softeners

29
Q

Meds for dystonia

A

Carbamazepine (Tegratol)

30
Q

Meds for for pain syndromes

A

Phenytoin (Dilantin) and perphenazine with
amitriptyline (Triavil

31
Q

physicians generally prescribe _________ to reduce tissue edema during acute exacerbation.

A

steroid therapy

32
Q

______________for weakness are prescribed.

A

Muscle stretching for spastic muscles and selective strengthening exercises

33
Q

COMPLICATIONS

A

Respiratory disorders
● Respiratory, bladder and blood infections
● Complications resulting from immobility
● Speech, voice and language disorders -
dysarthria

34
Q

NURSING MANAGEMENTS

A

A. STIMULATING MOTOR FUNCTION
B. REDUCING FATIGUE
C. ENHANCE SENSORY FUNCTION
D. MAINTAINING URINARY ELIMINATION

35
Q

STIMULATING MOTOR FUNCTION

A

Instruct to perform everyday exercises that are both helpful to strengthen and stretch the muscles.
● Teach how to perform stretch-hold-relax activities to reduce muscle spasms and contractures.
● Before muscle stretching, apply ice packs to minimize spasm.
● Advise to take frequent rest periods and avoid muscle fatigability as much as possible.

Encourage them to do activities and ambulate as tolerated.
● Instruct on the proper use of assistive devices such as braces,canes and walkers.

36
Q

B. REDUCING FATIGUE

A

Inform about fatigue and how it is an integral symptom of multiple sclerosis.
● Make a plan of activities for each day. Make Sure There Are Enough rest periods in between activities.
● Encourage us to use techniques that conserveenergysuchassitting while doing some activities and pushing or pulling objects instead of lifting them up.

37
Q

ENHANCE SENSORY FUNCTION

A

Recommend to make use of an eye patchif experiencing double vision.
● Orient to the surroundings; keep personal belongings and furniture on fixed arrangement.
● Advise making use of other senses to compensate for reduced sensation.
● Provide a clutter-free and safe environment.

38
Q

D. MAINTAINING URINARY ELIMINATION

A

Ensure adequate hydration to prevent urinary tract infection and stones.
● Use a catheter to expel retained urine.
● Set up on a bladder training program to lessen
incontinence episodes.

39
Q

DOCUMENTATION GUIDELINES

A
  1. Pain meds accurate instructions
  2. Instructions about adequate bladder and bowel elimination.
  3. notify the primary caregiver any exacerbation or sudden worsening of the condition.
  4. be sure that she or he has access to a telephone support network
  5. stress, fatigue, and being overheated stimulate
  6. contact community agencies such as the MS Society for use of sachin-home equipment as beds and
    wheelchairs and home maintenance support.
  7. home care agency for home supervision
40
Q

DISCHARGE AND HOME HEALTHCARE GUIDELINES

A

Be sure the patient understands any pain medication prescribed, including dosage, route, action, and side effects.
● Be sure the patient understands the need for adequate bladder and bowel elimination.
● Instruct the patient to notify the primary caregiver any exacerbation or sudden worsening of the condition.

If the patient has difficulty speaking or communicating,be sure that she or he has access to a telephone support network or some other means of calling for assistance when she or he is at home alone for any length of time.
● Be sure the patient understands that stress, fatigue, and being overheated stimulate exacerbations. Teachthepatienthow to avoid
situations that produce these reactions.
● Be sure the patient knows how to contact community agencies such as the MS Society for use of sachin-home equipment as beds and
wheelchairs and home maintenance support.
● Determine whether a home care agency is needed to provide home supervision and
ongoing physical therapy support.

NCM 116 Lecture (11 decks)

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