MS Mysteries
In multiple sclerosis, the immune system damages this protective covering of nerve fibers in the central nervous system.
What is myelin?
An injury to the cervical spinal cord may result in paralysis affecting both arms and both legs. What is this condition called?
What is tetraplegia (quadriplegia)?
Sudden facial drooping, arm weakness, and difficulty speaking are classic warning signs of what neurological emergency?
What is stroke?
A brain tumor can cause headaches, nausea, and altered neurological functioning by increasing this pressure inside the skull.
What is intracranial pressure (ICP)?
This neurological assessment tool evaluates eye opening, verbal response, and motor response following a brain injury.
What is the Glasgow Coma Scale (GCS)?
Low back pain that radiates down the buttock and leg along the sciatic nerve is commonly called this.
What is sciatica?
A patient with MS reports significant fatigue by late afternoon. What strategy should the nurse recommend to help conserve energy?
What is scheduling activities during peak energy periods and incorporating planned rest breaks?
A patient with a chronic T4 spinal cord injury develops sudden severe hypertension, facial flushing, and a pounding headache. What emergency should the nurse suspect?
What is autonomic dysreflexia?
When assessing a patient for possible stroke, what essential time must the nurse determine and communicate?
What is the last-known-well time?
A patient with a brain tumor reports headaches that are becoming more severe and are accompanied by vomiting. What complication should the nurse consider?
What is increased intracranial pressure?
A patient who sustained a concussion asks about warning signs after discharge. Name one symptom that requires immediate emergency evaluation.
What is a worsening headache, repeated vomiting, new weakness, seizure, unequal pupils, or increasing difficulty awakening?
A patient has uncomplicated mechanical low back pain without neurological red flags. What general activity recommendation should the nurse reinforce?
What is continuing gentle activity as tolerated and avoiding prolonged bed rest?
A patient with MS reports increased blurred vision and leg weakness after spending an hour in a hot tub. Symptoms begin improving after cooling. What explains this change?
What is Uhthoff phenomenon (heat-related temporary worsening of MS symptoms)?
A patient with a recent T5 spinal cord injury has BP 82/46, heart rate 48, and warm, dry skin. There is no obvious bleeding. Which type of shock is most concerning?
What is neurogenic shock?
A patient arrives with slurred speech, confusion, and unilateral weakness. Which immediate bedside test helps detect a potentially reversible stroke mimic?
What is a point-of-care blood glucose measurement?
A patient with a brain tumor is increasingly confused and now responds only when their name is spoken loudly. Compared with baseline, which assessment change is most concerning?
What is the decreased level of consciousness?
Following a fall, a patient opens their eyes to speech, is confused when speaking, and follows commands. What is the patient's GCS score?
What is 13? Eye opening 3 + verbal response 4 + motor response 6.
A patient reports new neck pain and tingling in both hands after a motor vehicle collision. What immediate safety precaution is indicated?
What is maintaining cervical spine motion restriction and initiating urgent spinal injury assessment?
A patient with MS reports increased weakness and difficulty walking. Temperature is 101.8°F and the patient reports burning with urination. What should the nurse prioritize?
What is assessing for infection, promptly reporting findings, and implementing fall precautions?
A patient with a chronic T4 injury develops BP 206/108 and a severe headache while lying in bed. What immediate positioning action should the nurse take?
What is sitting the patient upright?
At 0915, a hospitalized patient suddenly develops facial asymmetry and right arm weakness. The patient was normal at 0900. What should the LPN do first?
What is immediately activating the facility stroke response and communicating the neurological findings and last-known-well time?
A patient with a brain tumor becomes difficult to arouse and develops a newly dilated, poorly reactive pupil. What should the LPN do immediately?
What is activating an emergency response, assessing airway and breathing, and immediately reporting the neurological deterioration?
A patient admitted after head trauma had a GCS of 15 one hour ago. The patient now has a GCS of 12 and is increasingly drowsy. What is the priority nursing action?
What is initiating immediate neurological reassessment and emergency escalation?
A patient with severe low back pain develops new difficulty urinating and decreased sensation in the groin and perineum. Which emergency should the nurse suspect?
What is cauda equina syndrome?
A patient with MS develops new unilateral leg weakness lasting 48 hours, without fever or evidence of infection. Which complication should the nurse suspect, and what is the appropriate response?
What is a possible MS relapse requiring prompt notification and neurological evaluation?
A patient with a T4 injury has suspected autonomic dysreflexia. After sitting upright, the nurse finds kinked urinary drainage tubing and BP remains 192/100. What actions should follow?
What are relieving the kink immediately, checking drainage, frequently reassessing BP, and escalating urgently under the facility protocol?
A patient with suspected acute ischemic stroke takes apixaban and last used it this morning. Which information must be communicated before the stroke team decides on reperfusion treatment?
What is the anticoagulant name, most recent dose and administration time, and relevant bleeding history?
A patient with suspected elevated ICP develops BP 184/62, HR 42, and irregular respirations. What neurological warning pattern is present, and why is it dangerous?
What is Cushing triad, a late sign of critically elevated ICP and possible brain herniation?
A patient with TBI becomes less responsive and develops unequal pupils. BP is 178/58, HR 46, and respirations are irregular. What complication is most concerning, and what immediate response is needed?
What is critically increased ICP with possible brain herniation, requiring emergency response activation and immediate ABC assessment?
A patient being treated for low back pain reports new bilateral leg weakness, urinary retention, and numbness between the legs. What is the priority nursing response, and why?
What is immediate emergency escalation for suspected cauda equina syndrome because delayed treatment may cause permanent neurological and bladder dysfunction?