1750: MS EXAM III

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xiongav
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301702
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1750: MS EXAM III
Updated:
2015-05-16 17:24:34
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MS
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MS
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  1. What happens in MS (pathophys)?
    T cells attack Myelin which interrupts the impulse and deteriorates the myelin.
  2. What are the 4 types of MS?
    1: Relapse & Remitting: peaks & comes back (relapse) and goes away (remits).

    2: Primary progressive MS; continual progression of sx w/ temporary minor improvements.

    3: Secondary progressive: includes RR and then PP.

    • 4: Progressive-relapsing: progression
    • from onset but with clear acute relapses w/ or w/o recovery.
  3. Clinical Prognostic Factors:

    What are signs of a GOOD VS BAD prognosis?
    • Good prognosis:
    • Optic neuritis
    • Isolated sensory symptoms
    • Long interval to second relapse
    • No disability after 5 years
    • Normal MRI

    • Poor prognosis:
    • CIS: clinically isolated syndrome
    • Motor systems affected
    • High relapse rate in first 2-15 years
    • Substantial disability after 5 years
    • Abnormal MRI with large lesion load
  4. What are some examples of diagnostic tests?
    • Evoked potentials:
    • recordings of the NS's electrical response to the stimulation of specific sensory pathways (e.g., visual, auditory, general sensory).

    Damage to myelin results in a slowing of response time
  5. What are some nursing dx RT MS?
    • Activity intolerance
    • Depression
    • Impaired physical mobility
    • Urinary/Bowel elimination
  6. What is an EARLY sign of MS?
    Visual: diplopia, nystagmus, optic neuritis
  7. Explain the cycle of MS sx related & interdependent.
    Increased fatigue --> decreased exercise --> increases spasticity constipation (inv. muscle stiffness) --> increase bladder problems --> decrease sleep --> decreased cognitive function.
  8. What is the #1 sign of MS?

    Because of this symptom, when should duties/chores activities be done?
    *Fatigue; not alleviated w/ rest or sleep.

    In the morning with rest periods in between; when Pt has highest energy.
  9. What are some interventions for Fatigue?
    Conserve energy & cooling techniques

    Improve mobility & exercise

    Prescription meds
  10. What is "spasticity" described as and what is it?

    What are some interventions?
    Described as a "charley horse".

    • Muscle stiffness
    • Painful spasms
    • Sudden contractions/movements

    • Interventions:
    • PT & exercise
    • Orthopedic aids & OT
    • Prescribed meds
  11. How do you manage spasticity?

    (pharmacologic)
    • Pharmacologic:
    • Antispasmodics
    • –Baclofen (Lioresal) 
    • Seizure drugs
    • Gabapentin (Neurontin)
    • Pregabalin (Lyrica)
    • Benzodiazepines
    • Clonazepam (Klonopin)
    • Diazepam (Valium)
  12. Pts w/ MS usually also present w/ Bowel sx.

    What are some interventions?
    •Kegel exercises

    •Incontinence pads

    •Bladder control medications

    •Catheters

    •Fluid intake—2 liters/day
  13. What is the MOST COMMON mood Sx of MS?

    What are some interventions?
    Depression.

    Psychotherapy & counseling

    Physical activities

    Prescription meds

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