Medical Surgical Multiple Sclerosis MS #5

Question

A client with multiple sclerosis is being discharged from the hospital following treatment for a fall. Which discharge teaching is appropriate for the client? Select all that apply.

Answers

  1. Use a cane to conserve energy
    • Rationale:

      This answer is correct because use of a cane should be encouraged to help conserve energy of the client with MS. Weakness is profound with MS and the client should balance rest with exercise to promote overall movement and strength. Also, the cane can provide stability when walking.

  2. Drink 6 to 8 glasses of water daily
    • Rationale:

      This answer is correct because drinking 6 to 8 glasses of water helps promote good urinary tract health. Due to the risk of neurogenic bladder and difficulty emptying their bladder, the client has a risk for UTIs and urine should be kept as clear as possible. Furthermore, the overall health is promoted with good hydration.

  3. Minimize stretching to prevent stiffness
    • Rationale:

      This answer is not correct because stretching is encouraged since this will reduce (not cause) stiffness. Muscular weakness and fatigue is associated with MS so keeping stretched will promote optimal mobility.

  4. Avoid aerobic exercise to conserve energy
    • Rationale:

      This answer is not correct because aerobic exercise should be encouraged, not avoided. This type of exercise helps improve strength, promote muscle tone, coordination, and balance. Swimming is a great exercise as long as the client is not alone. This is in case the client becomes too weak and needs assistance.

  5. Report vision changes including diplopia
    • Rationale:

      This answer is correct because clients with MS should report any signs of vision changes including diplopia (double vision). Optic neuritis is a vision problem that occurs in the MS client. It involves inflammation of the optic nerve of one eye. Symptoms can include eye pain, vision loss, headache, and double vision.

Overview

Discharge teaching appropriate for a client with multiple sclerosis (MS) includes encouragement to use a cane to conserve energy, stretching to prevent stiffness, drinking 6 to 8 glasses of water daily, encouraging aerobic exercise to improve strength, and reporting vision changes including diplopia.

Explanation

Learning Outcomes

Multiple sclerosis is disease of the central nervous system that affects the brain and spinal cord by damaging the myelin sheath. It is also known as encephalomyelitis disseminata. It is autoimmune in nature. The myelin sheath surrounds and protects the nerve cells. Damage to the myelin sheath results in faulty communication between these nerves and the brain. Tremors, weakness in extremities, visual disturbances, and loss of muscular tone may occur with MS. Diplopia can occur when the nerves that control your eye movement become damaged. Discharge teaching appropriate for a client with multiple sclerosis (MS) includes encouragement to use a cane to conserve energy and for safety, aerobic exercise to improve strength, and stretching to prevent stiffness. The client should also drink 6 to 8 glasses of water daily for hydration and to promote good urinary tract health. Since MS can affect the eyes, the client should report vision changes including diplopia.

Test Taking Tip

Understanding the pathophysiology of MS and the needs associated with the neuromuscular effects of the disease is very helpful to answer this question correctly.

Video Rationale