N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide Multiple sclerosis has three different manifestations: • Benign multiple sclerosis: The mildest form of the disease where patients usually do not need treatment. These patients usually live a long and normal life, but do experience relapses of symptoms on occasion after stress. • Relapsing-remitting multiple sclerosis: In the early stages of this disease, the patient experiences several relapses with full symptoms. They then experience complete recovery. During the relapse, the myelin sheath experiences damage and deterioration. This causes the disease to become progressively worse with each relapse. • Chronic progressive multiple sclerosis: These patients experience no remission, but instead a chronic progression of deterioration in the myelin sheath. This manifestation is the most severe and patients can decline very quickly or slowly over the course of time. Signs and symptoms of multiple sclerosis: • Partial blind spots • Dizziness (vertigo) • Spastic weakness • Fatigue • Vision loss/blurred vision/floaters • Uhthoff’s sign: heat worsens symptoms • Lhermitte’s phenomenon: electric shock sensations • Pneumonia • Incontinence of both bowel and bladder • Urinary tract infections • Pressure ulcers/skin breakdown • Contractures • Sexual dysfunction • Cognitive decline • Depression • Numbness • Ataxia tremors • Poor coordination • Loss of reflexes Nursing assessment for multiple sclerosis: • Full neurological and head to toe general assessment: o Check vision for blind spots, floaters, and vision loss/blurriness o Check cognition, memory, verbal communication, and emotional status o Check extremities for numbness, weakness, spasticity, contractures, and motorcontrol o Skin assessment for pressure ulcers and skinbreakdown o Check gait, Lhermitte’s phenomenon, reflexes, and tremor • Inquire about personal and family history of disease, prior infections, and medications • Check on patient’s resources for support with ADLs, medications, and physician appointments ©2017 Achieve Test Prep Page 92 of 204