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MS
pn 141 test 3 book burke: pg 949
| Question | Answer |
|---|---|
| what is it | a chronic, degenerative disease that damages the myelin sheath surrounding the axons of the CNS |
| what is it marked by | periods of exacerbation and periods of remission |
| what happens in the end | the persion is chronically disabled and may become wheelchair bound |
| who does it affect | fm, caucasions, ages 20-40, family hx, living in cild damp northern parts of the US |
| cause | unknown |
| what can trigger the autoimmune response | viral infections, emotional strees, fatigue, pregnancy and acute URIs |
| what is myelin sheaths | it makes up what is known as white matter in the CNs |
| myelin sheaths: what does MS do to this; what is the process called | destroys the myelin sheath of the spinal cord, brain, and optic nerve and replaces it with plaque; demyelination |
| myelin sheaths: where in the body is it affected | CNS (brain, spinal cord and optic nerve) |
| myelin sheaths: what happens to nerve conduction when the myelin is destroyed | the nerve impulse conduction is slowed |
| why do manis vary | according to teh area of the nervous system affected |
| what happens to exacterbations as the disease progresses | they last longer and occur more often |
| when do the manis remain permanent | when the nerve cells are finally destroyed |
| s/s: what is a common s/s but often ignored | fatigue |
| s/s: when does pt usually seek medical care | is sought when the client develops diplopia, weakness, and tingling, and numbness in the extremities |
| s/s: what happens after a hot shower or exersice | motor s/s worsen |
| complications: as the disease progresses what what happens | prone to UTIs, pressure unclers, joint contractures, injuries fron falls, PNA, depression |
| complications: what does death often result from | PNA and debilitated condition |
| what is the goal of tx | keep the pt functioning for as long as possible |
| s/s: what are they in the respiratory system | resp infection |
| s/s: what are they in the urinary system | hesitency, frequency, retention, recurring uti, incontinence |
| s/s: what are they in the GI system | difficulty chewing, dysphagia, bowel incontenence, constipation, |
| s/s: what are they in the MS system | fatigue, ataxia, intention tremors, spasticity, dysarthria with slurred speech, feeling of heavyness in limbs |
| what is ataxia | shaky, irregular, uncorrdinated movements |
| s/s: what are they in the neurologic system | emotional lability, forgetfullness, apathay, scanning speech, impaired judgement, irritability |
| s/s: what are they in the sensory system | blurred vision, diplopia, nystagmus, vertigo, numness, tingling, decreased temp perception, pain with spasms |
| s/s: what are they in the reproductive system | impotence, loss of genital sensation |
| why is early Dx difficult | manis are vague and mild |
| how is dx made | based on H&P, and s/s |
| diagnostic tests: why is a CSF analysis ordered | it may reveal increased T lymphocytes, protein and immunoglobulin G which indicates increased immune system |
| diagnostic tests: why is a MRIordered | it may reveal the plaque lesions in the white matter |
| diagnostic tests: why is a EEgordered | it may show slowed brain activity during acute stages of ms |
| meds: what is given to decrease inflammation and increase periods of remission | steroids |
| what type of stance is taught to help with balance | a wide base |
| how is spasticity managed | with stretching, gait training, and use of braces |
| what three surgical procedures help with uncontrolled spascicity | neurotomy, rhizotomy, cordotomy |
| surgery: what is a neurotomy | cutting a nerve |
| surgery: what is a rhizotomy, | CUTTING A nerve root |
| surgery: what is a cordotomy | cutting of lateral pathway in the spinal cord |
| plasmapheresis: what is it | plasma exchagne, a prcedure that removes plasma from whole blood |
| plasmapheresis: what is its purpose | is to remove t lymphoctyes that cause inflammation |
| plasmapheresis: how does it help MS | it decreases inflammation and can cause remission |
| can the CNS regrow myelin sheaths | no |
| where weather wise it is worse | warm weather |
| what is the #1 classic way to Dx | with an MRI (shows plague formation in myelin sheath) |
| meds: what are the the only ones used | immunoregulators (interferon Beta 1B and 1A) betaseron and avonex and immunosuppressant copaxone |
| meds: what is the class of glatiramer copaxone | immunosuppressant |
| meds: what is the route of the ones used to tx | im or sq |
| meds: what is the steroid given daily ; why | prednisone (deltasone) |
| meds: why are muscle relaxants given | bc the spasms are painful |
| meds: muscle relaxants- names for them | baclofen (lioresal), dantrolene (dantrium), diazepam (valium), cyclobenzaprine (flexeril) |
| meds: muscle relaxants- action | not clearly understoon, sedative action, |
| meds: muscle relaxants- what is the most common side effects | drowsiness |
| meds: carbamazepine (tegretol)- what is it used for in MS | neuropathic pain |
| meds: carbamazepine (tegretol)-adverse reactions | dizzeness, n, drowsiness, unsteady gait |
| meds: what are the ones usd for neuropathic pain | tegrtol, and gabapentin (neurotin) |
| meds: gabapentin (neurotin)- use | neuropathic pain |
| meds: gabapentin (neurotin)- class | miscell preparations |
| meds: what is the one used for fatigue; what is the class of it; what else is it used for | amantadine (symmetrel), daponergics, malaria and parkinsons |
| meds: what is used for urinary frequancy | propantheline (probanthine) |
| meds: what is used for urinary retention | bethanecol (urecholine) |
| UTI teaching | look at color, clearidy, odar, they will not be able to feel the urgancy |
Created by:
jmkettel
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