A recently hospitalized client with multiple sclerosis voices a concern about generalized weakness

1,4,5

Involuntary, rhythmic movements of the eyes (nystagmus) and other visual disturbances, such as diplopia and blurred vision, are common initial symptoms of optic nerve lesions. Some common initial signs of multiple sclerosis are scanning speech, intention tremors, and nystagmus. These adaptations are associated with disseminated demyelination of nerve fibers of the brain and spinal cord. Although this is a neuromuscular disorder, headaches are not a common symptom. Pressure ulcers may occur late, not early, in the progression of the illness because of immobility, and these pressure ulcers may become infected.

3

The response, "Some clients report feeling a tingling or burning sensation , but not unbearable pain," is a truthful answer that provides hope for the client. Although neuropathic pain may sometimes occur, it does not occur in all clients. These clients more typically have diminished sensitivity to pain and paresthesias (e.g., tingling, burning, crawling sensations). The response, "Tell me about your fears regarding pain," avoids the client's question and may increase anxiety. Analgesics are not commonly prescribed unless pain results from some other condition. The response, "Let's make a list of the things you need to ask your healthcare provider," avoids the client's question and abdicates the nurse's responsibility.

3

Difficulty swallowing (dysphagia) is a manifestation of both neurologic disorders. With Parkinson disease there is a progressive loss of spontaneity of movement, including swallowing, related to degeneration of the dopamine-producing neurons in the substantia nigra of the midbrain. With myasthenia gravis there is a decreased number of acetylcholine (Ach) receptor sites at the neuromuscular junction, which interferes with muscle contraction, impairing muscles involved in chewing, swallowing, speaking, and breathing. A cogwheel gait is associated with Parkinson disease, not myasthenia gravis. Impaired cognition is associated with Parkinson disease, not myasthenia gravis. Nonintention tremors are associated with Parkinson disease, not myasthenia gravis. The nonintention tremors associated with Parkinson disease result from the loss of the inhibitory influence of dopamine in the basal ganglia, which interferes with the feedback circuit within the cerebral cortex.

What nursing intervention is anticipated for a client with Guillain

Which procedure would be considered as a treatment option for a client newly diagnosed with Guillain

Which procedure would the nurse expect as a treatment option for a client newly diagnosed with Guillain Barre?