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Multiple Sclerosis (M.S.) Pathophysiology, Treatment, Nursing Care RN & LPN NCLEX

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Ms multiple sclerosis is an autoimmune disease where the body attacks the myelin sheaths those sheets of fatty tissue around the nerve cells which help the body move so the memory trick for ms just think ms myelin sheath destruction so we get ms muscle spasms and stiffness now myelin sheath i call muscle sheets since they are the protective coverings around the

Nerve cells in the central nervous system the brain and spinal cord which helps the body move by sending electrical impulses from the brain to the rest of the body now in terms of diagnostics we do an mri or ct scan to see plaque on the brain and spinal cord and so think multiple scars with plaque in multiple sclerosis we see a lot of scars we can also do a

Lumbar spinal puncture also called the spinal tap where we see high levels of antibodies meaning the body’s own immune system is attacking itself now hesse mentions three to four millimeters of sclerotic brain plaque on an mri the key term there is brain plaques is indicative of ms diagnosis and elevated gamma globulin in cerebral spinal fluid from that lumbar

Puncture so fancy words for antibodies are present now specific causes are unknown but it’s linked to genetics like females as well as environmental factors like infection as well as vitamin d deficiency in terms of signs and symptoms clients with ms can look perfectly fine on the outside but inside they can have burning sensations numbness and tingling now

During bad flare-ups we can see the key sign so write this down muscle spasicity remember ms is muscle spasms that’s the number one key sign check out our brand new app and get access to our new pharmacology and med surg mastery courses plus 11 other courses like fundamentals pediatrics maternity mental health and more complete with over 300 follow along

Cheat sheets and a massive quiz bank loaded with detailed rationales to test your knowledge join for free click the link in our description below now kaplan also states that ataxia or uncoordination and even balance impairment as well as urinary retention and hyperreflexia of the extremities as well as decreased concentration and fatigue and paralysis and

Even i envision problems like double vision blurry or even dark spots again try not to memorize all these symptoms but rather just think of the patho here so just think ms you have myelin sheath destruction leading to ms those muscle spasms and muscle weakness all over the body speaking of this weakness for patient education we need to educate the clients to

Balance exercise with rest so write that down fatigue is a common symptom of ms so do not increase the duration of workouts we must balance exercise with rest basically don’t overdo it with crazy hardcore workouts a commonly chosen wrong answer was to build strength by building duration of daily exercise and no that is incorrect remember stress is a trigger

For ms and typical for all autoimmune diseases so avoid the four s’s that trigger flare-ups again this is typical for all autoimmune diseases where anything that can irritate the body can usually cause an immune response so the first s is for stress this includes exercise surgery and even injury but really the big one here is don’t overdo the workouts so no

Marathons and no intense hardcore workouts here now the second s is to avoid sickness or sepsis we need to educate the clients to stay healthy and free from infection the third s is smoking so we use smoking sensation typical for all nclex questions and then the last one here is the one to note sun and extreme heat are big no-no’s so no hot tub no bath and no

Sauna that’s extremely hot out of all these triggers this is the one to know so write this one down here avoid extreme temperatures no yard work outside when it’s too hot no hot showers or baths or even those hot tubs and definitely no saunas or even heating blankets remember cool is best here so mellow out and stay cool with ms now hesse had two tricky

Questions about this so question one which action requires immediate intervention for a patient with ms and the correct answer was preparing to place a client with ms into a bathtub with hot water the key term there is hot water so we must immediately intervene because this can cause a flare-up now question two which instructions regarding techniques to

Avoid fatigue with multiple sclerosis and the correct answer is rest in an air-conditioned surroundings remember you got a mallowell and stay cool with ms now for patient teaching like all neurodiseases we want to promote independence for all neuro patients so we teach number one self-care adls the key term here is never do all the adls for the client so

Don’t let the nclex trick you tricky nclex questions ask if the nurse should help the client complete all their daily activities or if the nurse should give the patient tools to have the client help themselves seems pretty tricky right but the correct answer is always to enable the patient with those tools to help themselves so this promotes independence now

Number two along that same line of thinking is gait training so think of the same thing here we want to preserve independence as long as possible so write this down we teach first gate training then we offer a cane and then a walker and then very last a wheelchair so once again common nclex questions ask about a client with ms having trouble walking the

Wrong option is to speak with the hcp about getting a wheelchair first no we always want to maintain mobility and independence as long as possible so we promote gate training first and then a cane and then very lastly a wheelchair if it’s needed now for pharmacology again think of the patho here first try not to memorize all the drugs here so for ms we have

Myelin sheath destruction right the body’s attacking itself so we give ivig that sort of acts like bait the body attacks this substance instead of the nerves and we also give interferon which interferes with the body attacking itself and steroids ending in zone like prednisone these decrease the swelling so just think zone ending steroids help to decrease

Total body inflammation and swelling and we can also give muscle relaxants like baclofen for those ms muscle spasms so just think baclofen like you have a bad back so you take baclofen for those muscle spasms now last but not least the big one to know here is the immunosuppressant cyclosporin which i call cyclosparin since it spares the body from attacking

Itself and in this case it spares the body from destroying those ms myelin sheaths so let’s play a segment from our pharmacology master course so the key point here is the adverse effects like all immunosuppressants bone marrow suppression like low wbcs and low platelets so we get a big risk for infection as well as bleeding so before giving these medications we

Always check wbcs and platelets so we report the key numbers for leukopenia to the hcp so low wbcs below 4 000 and we monitor bleeding as well as not giving to pregnant patients so we teach to use contraception these are the three typical for all immunosuppressants now a common side effect for cyclosporine is that gingival hyperplasia basically meaning that

Overgrowth of gum tissue around the teeth now no you do not need to report this since this is an expected effect now for patient teaching no grapefruit juice like always the big nclex tip we always avoid grapefruit juice on 99 of the drugs on the nclex and we avoid crowds to avoid infection and again we use birth control because it’s not baby safe now the

Ati mentioned we have to notify the provider for any signs of infection from that low immune system and the hesse says teaching for cyclosporine and as a thioprin we avoid crowds no live vaccines like herpes zoster as well as shingles and we use a soft bristle toothbrush since gum bleeding is a common side effect and then lastly we always use contraception

Because it’s not baby safe now the last point is kaplan mentioned patient statement that requires further teaching so when the patient says i will mix cyclosporine with grapefruit juice no we never do that and then secondly cyclosporine teaching for organ transplant we take the medication for life since it’s a lifelong drug and the hcp will evaluate blood

Work regularly and then lastly you take the medication at the same time every single day these three were the biggest key findings on all the various quiz banks all right that wraps it up for ms thanks so much for watching don’t forget to take your quiz and download the study guides and please share with your classmates and even instructors alright i’ll see

You guys in the next videos thanks for watching for our full video and new quiz bank click right up here to access your free trial and please consider subscribing to our youtube channel last but not least a big thanks to our team of experts helping us make these great videos alright guys see you next time

Transcribed from video
Multiple Sclerosis (M.S.) Pathophysiology, Treatment, Nursing Care RN & LPN NCLEX By Simple NursingliveBroadcastDetails{isLiveNowfalsestartTimestamp2021-03-16T170015+0000endTimestamp2021-03-16T171307+0000}