UNIT 2- MULTIPLE SCELORIS

Question 1

What is MS?

Answer 1

A chronic progressive degenerative disorder of the CNS, characterized by segmental demyelination of nerve fibers of brain and spinal cord

Question 2

What causes MS?

Answer 2

Unknown cause

Question 3

What are possible factors contributing to the cause of MS?

Answer 3

1. Infection
2. Smoking
3. Physical injury
4. emotional stress
5. Excessive fatigue
6. PREGNANCY
7. Poor state of health
8. Genetic factors.

Question 4

How is MS different from other types of progressive degenerative disorders?

Answer 4

MS has periods of remission and exacerbation

Question 5

When is MS typically considered most progressive?

Answer 5

When diagnosed at the age of 50 or older

Question 6

True or false: Researches suspect that exposure to some environmental agents before puberty my predispose a person to develop MS later in life?

Answer 6

True

Question 7

What is the typical progression like of MS?

Answer 7

Often insidious and gradual, vague symptoms occur intermittently over months to year. Typically its so vague that many pts don’t even think to see a doctor for it.

Question 8

True or false: Symptoms may vary according to areas of CNS involved and plague formation?

Answer 8

True

Question 9

What are visual clinical manifestations of MS?

Answer 9

Blurred/double vision, blind in 1 eye (may be one of the first symptoms a pt might experience)

Question 10

What are some clinical manifestations of motor function in a patient that has MS?

Answer 10

1. Weakness or paralysis of limbs and trunk (later stages)
2. Spasticity of muscle (esp. bladder)
3. Scanning of speech

Question 11

What are some sensory clinical manifestations of MS?

Answer 11

1. Facial numbness
2. Numbness and tingling
3. Pain
4. Tremor (intentional)
5. Decreased hearing, vertigo, tinnitus

Question 12

What are the common manifestations we should address in a patient that has MS

Answer 12

1.visual
2. Motor
3. Sensory
4. Cerebellar
5. Bowel, bladder, sexual
6. Cognitive and emotional

Question 13

What are some bowel/bladder clinical manifestations of MS?

Answer 13

1. Constipation
2. Variable urinary problems
3. Spastic bladder
4. Flaccid bladder

Question 14

What are some sexual dysfunction clinical manifestations of MS?

Answer 14

1. Erectile dysfunction
2. Decreased libido
3. Painful intercourse

Question 15

What are some cognitive manifestations of MS?

Answer 15

1. Short-term memory attention
2. Information processing
3. attention, planning
4. Visual perception, word finding

Question 16

What is the definitive test for MS?

Answer 16

There isn’t one

Question 17

How is MS diagnosed?

Answer 17

1. Based primary on history, clinical manifestations and results of diagnostic test

Question 18

What exams can we run in effort to diagnose a patient with MS?

Answer 18

1. MRI (looking for plaques on brain and spinal cord)
2. CSF analysis
3. Evoked potential studies (electrical activity associated with nerve conduction along sensory pathways)
4. Neuropsychological testing
5. Sexual history

Question 19

What criteria does a patient have to meet to get an official diagnosis of MS?

Answer 19

1. Evidence of at least 2 inflammatory (brain/spinal cord) demyelinating lesions in at least 2 different locations within the CNS
2. Damage or attack occurring at different times (usually >1 month apart)
3. All other possible dx must have been ruled out.

Question 20

Can MS be cured?

Answer 20

No it is a chronic progressive degenertive disorder

Question 21

What is the goal of treatment for MS?

Answer 21

1. Delay progression of disease, manage chronic symptoms and treat acute exacerbations

Question 22

True or false: Late intervention is most effective in the treatment of MS?

Answer 22

False- early intervention is most effective.

Question 23

Multiple drugs are used to manage what MS symptoms? (couldn’t think of a good way to word this)

Answer 23

1. Bladder dysfunction: detrusor hyperreflexia, flaccid bladder
2. Bowel dysfunction: constipation, & fecal incontinence
3. Depression
4. Fatigue
5. Spasticity– Baclofen is used
6. Neuropathic pain- gabapentin
7. improved walking- medications help but dosent fully tx
8. Vertigo and dizziness

Question 24

What other interventions may be required in the treatment of spasticity?

Answer 24

1. Surgery
2. Dorsal Column electrical stimulation
3. intrathecal baclofen pump

Question 25

What are some nursing intervention for MS?

Answer 25

1. Promote physical mobility- Gait training 2. Prevent injury-falls 3. Enhance bowel and bladder control- bladder retraining (2hrs) 4.Enhance communication- they speak slow 5. Improve sensory and cognitive function- dont overwork or rush may make symptoms worse 6. Teach about meds 7. Educate family 8. Psychological 9. Social symptoms 10. counseling