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Chapter 34: Problem 514

Which actions might the nurse discuss with a client with multiple sclerosis who has recently had a number of exacerbations of the disease? (Select all that apply.) A. Joining a support group B. Avoiding the use of hot tubs. C. Preventing pregnancy D. Limiting fluid intake to \(1250 \mathrm{ml}\) per day E. Requesting a job transfer to a less stressful situation The answers are \(A, B\), and \(E\). Support groups help support emotional coping mechanisms. The MS client is encouraged to avoid heat and cold situations as they have been implicated in exacerbations. A job transfer may allow the client to

Short Answer

Expert verified
A, B, E.

Step by step solution

01

Analyze Exacerbation Factors

Identify factors that might cause or worsen exacerbations in multiple sclerosis. For this exercise, consider physical, emotional, and environmental factors.
02

Evaluate the Actions

Determine the relevance of each action in preventing exacerbations. Specifically, focus on whether each action can either reduce stress, provide emotional support, or manage physical symptoms associated with multiple sclerosis.
03

Discuss Support Groups

Joining a support group (Option A) helps provide emotional support and shared experiences, which can be beneficial for coping with the disease.
04

Assess Heat Management

Avoiding the use of hot tubs (Option B) is critical as excessive heat can lead to worsening symptoms in patients with multiple sclerosis.
05

Stress Reduction Through Job Environment

Requesting a job transfer to a less stressful situation (Option E) can help manage emotional and physical stress, which can contribute to disease exacerbations.
06

Eliminate Non-Relevant Options

Examine and eliminate actions that are not directly related to symptom management or exacerbation prevention. Preventing pregnancy (Option C) and limiting fluid intake (Option D) do not directly influence exacerbations for multiple sclerosis and can be disregarded in this context.
07

Conclusion

Based on the analysis, the most relevant actions to discuss with a client are joining a support group, avoiding hot tubs, and requesting a job transfer to reduce stress.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Exacerbation Factors
Understanding what triggers or worsens exacerbations in multiple sclerosis (MS) is crucial for effective management. Exacerbations can be influenced by several factors:

  • **Physical Factors:** Overexertion or physical trauma can worsen symptoms.
  • **Environmental Factors:** Exposure to extreme temperatures, especially heat, can be harmful.
  • **Emotional Factors:** High levels of stress and emotional turmoil can lead to exacerbations.
By identifying and controlling these factors, patients can better manage their condition and potentially reduce the frequency and severity of exacerbations.
Emotional Support
For individuals with multiple sclerosis, emotional support is essential. Joining a support group, for instance, can provide immense benefits:

  • **Shared Experiences:** Patients can share their journey with others facing the same challenges, offering mutual support and understanding.
  • **Emotional Coping:** Emotional difficulties can be managed better with community support, reducing feelings of isolation.
  • **Resource Sharing:** Information about treatment options, lifestyle changes, and coping mechanisms can be shared within the group.
Emotional well-being is linked to physical health, making emotional support a vital part of MS management.
Stress Reduction
Managing stress is crucial for MS patients, as stress can exacerbate symptoms. Some effective ways to reduce stress include:

  • **Mindfulness and Meditation:** Practices like meditation and mindfulness can help in calming the mind and reducing stress levels.
  • **Exercise:** Gentle exercises such as yoga or tai chi can be beneficial.
  • **Work Environment:** Requesting a job transfer to a less stressful situation is a practical step. A supportive work environment can have a positive impact on stress levels and thus on symptom management.
Stress management techniques are essential for maintaining a balanced lifestyle and minimizing MS flare-ups.
Heat Management
Heat sensitivity is common in MS, and managing heat exposure is critical:

  • **Avoid Hot Tubs:** High temperatures can worsen symptoms, so it's advisable to avoid hot tubs and saunas.
  • **Stay Cool:** Use cooling vests, fans, and air conditioning during hot weather.
  • **Modify Activities:** Plan activities during cooler parts of the day and take frequent breaks to cool down.
By being proactive about heat management, patients can prevent unnecessary exacerbations and manage their symptoms more effectively.
Symptom Management
Effective symptom management involves addressing both the physical and emotional aspects of MS:

  • **Medications:** Follow prescribed treatments to manage symptoms like muscle spasms, fatigue, and pain.
  • **Lifestyle Modifications:** Adapt daily activities to accommodate physical limitations and conserve energy.
  • **Therapies:** Physical and occupational therapies can help improve mobility and daily function.
  • **Nutrition:** Maintaining a balanced diet can support overall health and well-being.
Comprehensive symptom management ensures a better quality of life for MS patients by addressing all facets of the disease.

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Most popular questions from this chapter

A home health nurse sees many elderly clients and is concerned about their nutritional status. The nurse recognizes that the following factors contribute to the risk of malnutrition in older adults: A. Gastrointestinal changes including diminished saliva, decreased gastric acid and digestive enzyme secretions B. Chronic illness C. Poor dentition D. Inadequate financial resources E. Decline in functional ability F. Moving to an Assisted Living Facility

The nurse is comparing laboratory results on admission with laboratory results following treatment of a client with DIC. Which change in laboratory values from admission indicates a positive response to therapy? A. Decrease in platelet count B. Increase in fibrinogen level C. D-dimer assay increase D. Decreased bleeding time

A 35-year old man is brought to the emergency department by EMS personnel after he was found sitting in the car in an enclosed garage with the motor running. He is unresponsive and hypotensive, and his skin is bright red. Which intervention would have the greatest priority?A. Administration of oxygen B. Placing the client in a prone position. C. Administration of Narcan D. Initiating CPR.

Six hours after birth, an infant is found to have an axil- lary temperature of 97F. The child is placed in an overbed warmer. When the nurse tells the mother that the infant will not be able to leave the nursery at the next feeding, the mother asks why this low tempera- ture is a concern. The nurse explains that low body temperature in the newborn can cause which effects? (Select all that apply.)

Which parameters would the nurse assess as part of a complete neurological assessment? (Mark all that apply.) ___ A. Deep tendon reflexes ___ B. Shape of the head ___ C. Cranial nerves ___ D. Sensory perception ___ E. Coordination ___ F. Skin ___ G. Heart
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