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Care at Home of the Patient With Advanced Multiple Sclerosis: Part 2

Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional: May 2010 - Volume 28 - Issue 5 - p 275–277
doi: 10.1097/01.NHH.0000374866.52651.4b
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Care at Home of the Patient with Advanced Multiple Sclerosis – Part II


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To present registered professional nurses with comprehensive information on symptom management for patients who have advanced multiple sclerosis.

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After reading this article and taking this test, you should be able to:

  1. Summarize the research, resources, and goals of care presented here as they relate to multiple sclerosis.
  2. Outline the clinical manifestations of multiple sclerosis.
  3. Plan the appropriate interventions for patients who have advanced multiple sclerosis.

1. A primary goal for interdisciplinary care services for patients who have advanced multiple sclerosis (MS) is

a. reversing the disease process.

b. preparing for end-of-life care.

c. making appropriate referrals.

d. averting crises and complications.

2. Patients who have advanced MS are at risk for loss of bone density due to

a. pain.

b. impaired mobility.

c. elimination dysfunction.

d. respiratory compromise.

3. Clinicians should suspect a urinary tract infection in patients with MS who cannot speak when they notice a

a. decrease in irritability.

b. sudden increase in mobility.

c. sudden worsening of other symptoms.

d. ongoing cognitive deficits.

4. For many years, it was believed that MS did not cause

a. immobility.

b. incontinence.

c. pain.

d. depression.

5. Of all MS patients, what percentage will have a major depressive episode at some point in the course of the disease?

a. about 10%

b. at least 25%

c. at least 50%

d. about 75%

6. According to Moulin, what percentage of patients with MS has significant pain?

a. 55%

b. 65%

c. 75%

d. 85%

7. In patients with MS, neurogenic pain is typically experienced as

a. throbbing.

b. aching.

c. burning.

d. tearing.

8. In patients with MS, nociceptive pain is often a result of

a. infection.

b. immobility.

c. fatigue.

d. spasticity.

9. According to Feinstein, depression in patients with MS has been associated with

a. immune system changes.

b. renal disorders.

c. cognitive disorders.

d. musculoskeletal dysfunction.

10. An example of a common symptom of depression that overlaps with symptoms of MS is

a. paresthesias.

b. disturbed sleep.

c. blurred vision.

d. heat sensitivity.

11. How many patients with a definite diagnosis of MS have thoughts of suicide over the course of their lives?

a. about one tenth

b. just under one quarter

c. nearly one third

d. more than one half

12. Of the following, which cognitive function is most often affected in patients with MS?

a. judgment

b. planning

c. decision making

d. information processing

13. Which of the following types of therapists is especially helpful for assisting patients who have MS with time management?

a. respiratory

b. occupational

c. physical

d. speech/language

14. Which of the following types of therapists is essential for evaluating dysphagia in patients who have MS?

a. respiratory

b. occupational

c. physical

d. speech/language

15. For patients with MS, life expectancy is

a. close to normal.

b. about 5 years less than normal.

c. about 10 years less than normal.

d. about 15 years less than normal.

16. According to this article, all of these statements are accurateexcept

a. Anxiety may be less common than depression in patients who have MS.

b. Self and patient abuse are both signs of caregiver burden.

c. Untreated depression can mimic cognitive impairment in patients who have MS.

d. Psychotherapy and/or antidepressants are indicated to treat depression in patients who have MS.



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