Pathophysiology & Disease Process
What body system does multiple sclerosis primarily affect?
The central nervous system (CNS) — demyelination disrupts nerve impulse transmission in the brain and spinal cord.
What is Lhermitte’s sign?
An electric shock sensation down the spine when flexing the neck, due to demyelinated spinal nerves.
What is the purpose of disease-modifying therapies (DMTs) in MS?
To reduce relapse frequency, slow progression, and limit lesion formation.
What general exercise recommendation is best for patients with MS?
Light, regular exercise like swimming or stretching to maintain strength and prevent fatigue.
Why is stress management important for MS patients?
Stress and infection can trigger relapses; teach relaxation and coping strategies.
What causes the neurological symptoms seen in MS?
Immune-mediated destruction of the myelin sheath, leading to slowed or blocked nerve conduction.
What visual changes are common in MS?
Blurred vision, diplopia, nystagmus, or partial vision loss from optic nerve lesions.
Name one common disease-modifying drug used for MS.
Interferon-beta (Avonex, Rebif, Betaseron) or Glatiramer acetate (Copaxone).
How can nurses help prevent urinary tract infections in MS patients?
Encourage adequate hydration (1–2 L/day), timed voiding, and clean intermittent catheterization if needed.
Why should patients stop smoking if diagnosed with MS?
Smoking accelerates disease progression and increases disability risk.
What are two hallmark diagnostic findings of MS?
MRI showing demyelinated plaques in white matter and oligoclonal bands in CSF on lumbar puncture.
Which symptoms reflect MS involvement of the motor system?
Weakness, spasticity, tremors, poor coordination, and gait imbalance.
What side effect is common with interferon therapy, and how can it be reduced?
Flu-like symptoms; give acetaminophen or ibuprofen and administer at bedtime.
What interventions reduce fatigue and conserve energy?
Cluster care, rest periods, and prioritizing activities during times of highest energy.
What should the nurse teach about temperature sensitivity?
Avoid heat exposure; use cooling garments or fans during warm weather.
What is Uhthoff’s sign, and how should the nurse respond?
Temporary worsening of MS symptoms with heat; keep the environment cool and avoid hot baths or direct heat.
What urinary problems can MS cause?
Urinary retention, urgency, frequency, or incontinence from disrupted nerve signals to the bladder.
Which medications help manage MS-related muscle spasticity?
Baclofen or diazepam — central-acting muscle relaxants that reduce spasms.
What bowel management teaching should the nurse provide?
High-fiber diet, stool softeners, and adequate fluids to prevent constipation from immobility and medications.
What community resources can support MS patients?
National Multiple Sclerosis Society, counseling, and physical therapy programs.
Why do MS symptoms vary among patients and over time?
Lesions form in different CNS areas and flare-ups alternate with periods of remission and relapse.
Which sensory symptoms often appear in MS?
Numbness, tingling, burning pain, or loss of proprioception in affected limbs.
What is the role of corticosteroids (e.g., methylprednisolone) in MS management?
Used during acute exacerbations to decrease inflammation and speed recovery.
What safety measures should nurses implement for a patient with MS who has ataxia or weakness?
Clutter-free environment, assistive devices, nonslip shoes, and fall-prevention education.
What long-term goals reflect effective management of MS?
Reduced relapses, maintained independence, safety, and optimized quality of life.