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Post-polio syndrome: unraveling the mystery

doi: 10.1097/01.NURSE.0000394081.30377.cf
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INSTRUCTIONS Post-polio syndrome: Unraveling the mystery

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Post-polio syndrome: Unraveling the mystery

GENERAL PURPOSE: To provide nurses with an overview of PPS. LEARNING OBJECTIVES: After reading the preceding article and taking this test, you should be able to: 1. Describe the pathophysiology of PPS. 2. Identify signs and symptoms of PPS. 3. Describe nursing interventions for PPS.

1. Signs and symptoms of PPS include

a. papilledema.

b. chest pain.

c. fatigue.

d. unilateral lower extremity edema.

2. Which of the following is the best description of poliomyelitis?

a. progressive weakness and myalgia 20 to 40 years after virus exposure

b. an infectious viral disease that causes flulike symptoms

c. the gradual onset of weakness and muscle fatigue that persists for a year

d. the degeneration of the spinal cord's reinnervation

3. Patients with PPS are now being seen in the acute care setting because

a. most polio patients survived.

b. the oral polio vaccine caused 21,000 cases of paralytic polio in the 1960s.

c. PPS is a highly infectious viral disease spread by nasal secretions.

d. the polio vaccine hasn't been widely used for 10 years.

4. Your patient with PPS may be N.P.O. because

a. surgical intervention is the best treatment for PPS.

b. nausea and vomiting are common symptoms of PPS.

c. cerebral angiography is part of the diagnostic workup.

d. dysphagia is a common symptom of PPS.

5. PPS is thought to be caused by

a. the normal aging process.

b. degeneration of reinnervated nerve cells.

c. induction of alloimmunity.

d. reactivation of poliovirus in muscle fibers.

6. Signs and symptoms of PPS

a. are often mistaken for multiple sclerosis.

b. progress rapidly without remission.

c. are limited to the muscles originally affected by the illness.

d. rarely persist beyond a year.

7. A patient with PPS is most likely to have respiratory complications if he or she

a. was asymptomatic upon exposure to the polio virus.

b. had difficulty breathing during the acute illness.

c. had only pyrexia in the acute illness.

d. had only lower extremity muscle weakness during the acute illness.

8. Which intervention is best for the patient with PPS?

a. administering opioids every 4 hours to prevent pain

b. vigorous physical therapy throughout the day

c. allowing frequent visitors to prevent emotional distress

d. grouping activities to allow uninterrupted rest periods

9. Which treatment would beleasthelpful in alleviating joint stress?

a. vigorous physical therapy multiple times a day

b. acetaminophen before physical therapy

c. weight loss for the obese

d. use of assistive devices

10. Why are psychologic interventions important for the patient with PPS?

a. to alleviate emotional distress from misdiagnosis and body image issues

b. to help the patient cope with paralytic polio that usually develops from PPS

c. to treat depression, which is a known trigger for PPS

d. to help the patient cope with the highly contagious nature of PPS

11. Which intervention is best for the patient with dysphagia?

a. administering prophylactic antibiotics

b. limiting oral intake to clear liquids

c. obtaining an evaluation by a speech therapist

d. elevating the head of the bed 30 degrees for meals

12. Sleep apnea in PPS

a. is usually related to paralytic polio experienced during the acute illness.

b. can be treated with continuous positive airway pressure ventilation.

c. can be alleviated by using sedatives at bedtime.

d. isn't common enough to be of concern.

13. What is key for a diagnosis of PPS?

a. a history of oral polio vaccine administration

b. depression that persists for at least 1 year

c. 15 years of neurologic stability after the acute onset of polio

d. an abrupt onset of weakness that resolves in 4 weeks

14. What can help establish a diagnosis of PPS?

a. progressive functional decline

b. contagious, flulike symptoms

c. absence of respiratory symptoms or complications

d. gradual onset of new weakness 20 years after the acute illness

15. Many cases of PPS are undiagnosed because

a. it's frequently fatal before it can be diagnosed.

b. it's misinterpreted as normal aging.

c. PPS patients are unlikely to present in acute care.

d. presenting symptoms differ widely between patients.

16. Nursing interventions for patients with PPS

a. can mitigate signs and symptoms that can't be cured.

b. are less helpful than physical therapy.

c. include transmission-based precautions.

d. involve educating the patient that PPS is part of the normal aging process.

17. Myalgia in PPS is often described as

a. deep, aching pain.

b. sharp, intermittent pain.

c. continuous burning pain.

d. severe, knifelike pain.

18. Which diagnosis isleastlikely to be mistaken for PPS?

a. osteoarthritis

b. depression

c. venous thromboembolism

d. multiple sclerosis

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