Multiple Sclerosis

Question 1

Pathophysiology

Answer 1

-progressive demyelination of the CENTRAL NERVOUS SYSTEM
- can vary and have different patterns
- consists of relapses and remitting

Question 2

S/S

Answer 2

• fatigue
• weakness
• numbness
• difficulty in coordination
• loss of balance
• pain
• visual disturbances

Question 3

Risk Factors

Answer 3

• women ages 20-40
• greater prevalence in: Europe, New Zealand, Australia, Norther US, Canada
• may have genetic predisposition or onset after viral infection
• environmental risks: obesity, lack of vitamin d exposure, increased salt intake during teenage years

Question 4

Interferon B-1a and Interferon B-1b

Answer 4

• subQ or IM
• s/e: flu-like s/s, leukopenia, HA, depression, skin necrosis, liver issues

Question 5

Glatiramer acetate

Answer 5

• subQ
• reduces rate of relapse in relapsing-remitting type
• s/e: flushing, unpleasant s/e but they go away

Question 6

Teriflunomide, Fingolimod, Dimethyl furmarate

Answer 6

oral, disease modifying

Question 7

IV methyl prednisone followed by oral prednisone

Answer 7

• treats acute exacerbations + shortens duration of relapse
• oral to taper
• s/e: mood swings, weight gain, electrolyte imbalances

Question 8

Tx for Muscle Spasms

Answer 8

• baclofen
• benzodiazepines (diazepam, etc.)
• tizanidine
• dantrolene

Question 9

Tx for Fatigue

Answer 9

• amantadine
• pemoline
• dalfampridine

Question 10

Tx for Ataxia

Answer 10

• BB (propanol, etc.)
• gabapentin
• benzodiazepines (clonazepam, etc.)

Question 11

Medications for Bowel and Bladder Control

Answer 11

• anticholinergics
• alpha-adrenergic blockers
• antispasmodics

Question 12

Nursing Diagnosis

Answer 12

• IMPAIRED MOBILITY associated w/ weakness, muscle paresis, spasticity, increased weight
• RISK FOR FALLS associated w/ sensory and visual impairment, lower extremity weakness
• FATIGUE associated w/ insufficient energy
• DIFFICULTY COPING associated w/ uncertainty of course of MS

Question 13

Patient Education

Answer 13

• promoting physical mobility (gait training and rehab)
• preventing falls (assistive devices)
• managing fatigue (sleep hygiene)
• strengthening coping mechanisms (family support)

Question 14

Progressive-Relapsing Type

Answer 14

• Rare
• steady decline since onset with superimposed attacks

Question 15

Secondary-Progressive Type

Answer 15

initial relapsing-remitting MS that suddenly begins to have decline w/o periods of remission

Question 16

Primary-Progressive Type

Answer 16

steady increase in disability w/o attacks

Question 17

Relapsing-Remitting Type

Answer 17

• most common
• unpredictable attacks which may or may not leave permanent deficits followed by periods of remission