Etiology and Pathophys.
A chronic, progressive, degenerative disorder of the CNS characterized by disseminated demyelinaitoin of nerve fibers of the brain and spinal cord.
Multiple Sclerosis (MS)
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Describe the manifestations of MS.
vaque, insidiuos, gradual, intermittent occuring over months to years.
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Is there a definitive diagnostic test for MS?
No there is not.
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These medicaitons modify the disease progression and prevent relapses.
Immunomodulator drugs ie. Interforon B 1a-1b.
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The nurse should assist the patient is identify what that cause exacerbations or worsening of the disease?
Triggers.
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The climate were MS is more prevalent.
Temperate climate (between 45 and 65 degrees)
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What is one of the sensory disturbances that a client can experience?
blurred vision, red-green color dstortion, or even blindness in one eye.
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This study will show the brin and spinal cord with plaques, inflammation, atrophy, and tissue breakdown and destruction.
MRI.
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With this medication the injection site needs to be rotated, and the client is to be assessed for depression, the client needs to wear sunscreen and protective clothing when in the sun.
Interferon B 1a-1b.
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As the client is progressing through diagnostic tests and is dealing with the anxiety related to this disease. How can the nurse be toward the client?
To reassure that the testing needs to be completed and to remain supportive to the client as they go through the greiving process.
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The cause of MS.
Unkown.
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What is the transient sensory symptom described as shock radiating down the spine into the limbs with flexion of the neck?
Lhermitte's sign.
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This study shows an increase in immunoglobulin G and the presence of oligoclonal banding.
Cerebrospinal fluid (CSF)
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Antineoplastic medications have serious effects like cardiotoxicity, leukemia, and infertility.
Mitoxantrone.
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What must be encouraged for the client in order to maintain health?
Balance between excercise and rest.
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What are precipitating factors that may cause MS?
infection, smoking, physical injury, emotionalstress, excessive fatigue, pregnancy, and a poor state of health.
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What other sensory disturbance is an occasional finding?
Hearing loss.
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This test shows a slowing due to decreased nerve conduction.
Evoked potential testing.
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This medications are to teat exacerbations of MS and are effective at reducing inflammation.
Corticosteroids.
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(The client may have difficutly sleeping and have an increase with blood glucose levels.)
What type of food can the client increase in their diet to decrease constipation?
fiber.
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As ongoing inflammation occurs, it eventually damages the axons. What is left behind found throughout the white matter?
sclerotic placques.
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What other area of the body can be affected causing a change in daily routine?
Bowel and bladder issues.
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Since there is not a definitive test, what other evidence that the client may have?
*two inflammatory demyelinating leadions in at least two different locations withing the CNS
*damage or an attack occurring at different times
*rule out of all other diagnosis
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These medications can treat the spaciticity of muscles.
Muslce relaxants such as diazepam, baclofen, dantrolen, and tizanidine.
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They may also cause sleepiness and dizziness, so enourage the client not to drive or operate machinery and to keep the medication secure.
As the client and caregiver make several emotional and lifestyle adjustments due the unpredictability of the disease who can the nurse refer the client to?
Support groups and the the National Multiple Sclerosis Society.
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