1
Q
Pathophysiology
A
-progressive demyelination of the CENTRAL NERVOUS SYSTEM
- can vary and have different patterns
- consists of relapses and remitting
2
Q
S/S
A
- fatigue
- weakness
- numbness
- difficulty in coordination
- loss of balance
- pain
- visual disturbances
3
Q
Risk Factors
A
- 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
4
Q
Interferon B-1a and Interferon B-1b
A
- subQ or IM
- s/e: flu-like s/s, leukopenia, HA, depression, skin necrosis, liver issues
5
Q
Glatiramer acetate
A
- subQ
- reduces rate of relapse in relapsing-remitting type
- s/e: flushing, unpleasant s/e but they go away
6
Q
Teriflunomide, Fingolimod, Dimethyl furmarate
A
oral, disease modifying
7
Q
IV methyl prednisone followed by oral prednisone
A
- treats acute exacerbations + shortens duration of relapse
- oral to taper
- s/e: mood swings, weight gain, electrolyte imbalances
8
Q
Tx for Muscle Spasms
A
- baclofen
- benzodiazepines (diazepam, etc.)
- tizanidine
- dantrolene
9
Q
Tx for Fatigue
A
- amantadine
- pemoline
- dalfampridine
10
Q
Tx for Ataxia
A
- BB (propanol, etc.)
- gabapentin
- benzodiazepines (clonazepam, etc.)
11
Q
Medications for Bowel and Bladder Control
A
- anticholinergics
- alpha-adrenergic blockers
- antispasmodics
12
Q
Nursing Diagnosis
A
- 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
13
Q
Patient Education
A
- promoting physical mobility (gait training and rehab)
- preventing falls (assistive devices)
- managing fatigue (sleep hygiene)
- strengthening coping mechanisms (family support)
14
Q
Progressive-Relapsing Type
A
- Rare
- steady decline since onset with superimposed attacks
15
Q
Secondary-Progressive Type
A
initial relapsing-remitting MS that suddenly begins to have decline w/o periods of remission
16
Q
Primary-Progressive Type
A
steady increase in disability w/o attacks
17
Q
Relapsing-Remitting Type
A
- most common
- unpredictable attacks which may or may not leave permanent deficits followed by periods of remission
NURS 240 Exam 3
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