Multiple Sclerosis

Question 1

Multiple Sclerosis - Pathophysiology

Answer 1

• Chronic disease characterized by demyelination & axonal nerve damage
  > immune mediated
  > women greater than men; 25-35yrs old

Question 2

Multiple Sclerosis - Risk Factors

Answer 2

• Viruses: Epstein-Barr virus
• Genetic predisposition

Question 3

Multiple Sclerosis - Types

Answer 3

• Relapsing-remitting (85%)
• Primary Progressive
• Secondary Progressive
• Progressive-relapsing

Question 4

Multiple Sclerosis - CMs

Answer 4

• Depends on location of lesions; mild to severe
• Fatigue/weakness
• Spasticity lower extrems
• Bowel, bladder, sexual dysfunc
• Pain, paresthesia’s
• Visual disturbances (dbl vision)
• Emotional lability

Question 5

Multiple Sclerosis - Diagnosis

Answer 5

• MRI
  > presence of mult plaques CNS
• Lumbar Puncture: CSF sample

Question 6

Multiple Sclerosis - Medical Interventions

Answer 6

• No cure; delay progression
• Symptom management
• Med therapy
  > Acute: methylprednisolone IV, followed by oral prednisone taper
  > Reduce relapses: interferons

Question 7

Multiple Sclerosis - Nursing Diagnosis

Answer 7

• Impaired home maintenance management
• Ineffective coping
• Impaired physical mobility
• Risk for injury RT sensory & visual impairment

Question 8

Multiple Sclerosis - Nursing Interventions

Answer 8

• Promoting physical mobility
• Preventing injury
• Enhancing bladder & bowel control
• Enhancing communication & managing swallowing difficulties

Question 9

Multiple Sclerosis - Pt Education

Answer 9

• Meds
  > purpose, dose, route, schedule, side effects, precautions
• When to contact HCP
• Envir’t mods & adaptive techniques
• Manage symptoms
• Optimal nutritional intake; consider weight reduction
• Manage bowel & bladder func
  > self cath, neurogenic bladder
• Minimize immobility/spasticity
• Identify sources of support
• Prevent comps: pressure ulcers, pneum, depression