A client presents to the emergency department with complaints of numbness and weakness which began in the feet and has progressed symmetrically in an ascending pattern through the bilateral lower extremities. The nurse understands that this pattern most closely fits which neurological disorder?

Multiple sclerosis

Guillain Barre Syndrome

Myasthenia gravis

Parkinson's disease

Answer and Explanation

The Correct Answer is B

A.   MS is a chronic autoimmune disorder affecting the central nervous system (CNS), specifically the brain and spinal cord. It typically presents with a wide range of neurological symptoms such as blurred vision, sensory disturbances, weakness, and difficulties with coordination and balance. However, MS does not typically present with a sudden onset of ascending numbness and weakness starting in the feet and moving upwards.
B.   GBS is an acute autoimmune disorder where the immune system attacks the peripheral nervous system. It often starts with numbness, tingling, and weakness in the feet and legs, which then

progresses symmetrically upwards to involve the upper limbs and potentially affect respiratory muscles. This ascending pattern of weakness is characteristic of GBS, making it the most likely diagnosis in this scenario.
C.   Myasthenia gravis is a chronic autoimmune disorder affecting neuromuscular junctions, leading to muscle weakness and fatigue, especially with repetitive use. It typically presents with fluctuating muscle weakness that worsens with activity and improves with rest. The pattern of ascending numbness and weakness seen in the scenario does not align with the typical presentation of myasthenia gravis.
D.   Parkinson's disease is a progressive neurological disorder primarily affecting movement. It presents with symptoms such as tremors, bradykinesia (slowness of movement), rigidity, and postural instability. It does not typically cause numbness or a symmetrical ascending pattern of weakness as described in the scenario.

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Correct Answer is C

Explanation

A. During chemotherapy, many patients experience nausea, vomiting, and changes in taste or appetite. Spicy and highly-seasoned foods can exacerbate gastrointestinal symptoms and may not be well tolerated. It's generally recommended to encourage bland, easy-to-digest foods to help maintain adequate nutrition and reduce discomfort.
B. Loperamide is not used to prevent nausea; rather, it is an antidiarrheal medication used to treat diarrhea, which can be a side effect of chemotherapy. Nausea prevention is typically managed with antiemetic medications such as ondansetron, metoclopramide, or others prescribed based on the patient's specific needs and chemotherapy regimen.
C. Pain management is an essential aspect of caring for oncology patients, including those receiving chemotherapy. Cancer and its treatment can cause pain directly or indirectly (such as from procedures or complications). Regular and thorough pain assessments allow for timely intervention and improvement in the client's comfort and quality of life.
D. Chemotherapy medications are typically administered through central venous access devices (e.g., central lines, PICC lines) rather than through peripheral veins. This is because chemotherapy drugs can be vesicants (causing tissue damage if they leak out of the vein) or irritants to smaller peripheral veins.
Using a larger gauge peripheral line (e.g., 18 gauge) is not standard practice for administering chemotherapy due to the potential risks and complications associated with peripheral administration.

A. Physical abuse B. Psychologic abuse C. Neglect D. Financial abuse

Correct Answer is C

Explanation

A. Involves the use of physical force that may result in bodily injury, pain, or impairment. This option does not fit the scenario described because it does not involve direct physical harm.
B. Involves behaviors such as intimidation, threats, humiliation, and isolation that cause mental or emotional distress. While similar to neglect in some aspects, neglect specifically refers to the failure to provide essential care rather than actively causing psychological harm.
C. Neglect refers to the failure of a caregiver or responsible person to provide the necessary care, assistance, or supervision that is essential to maintain the health and well-being of an elderly person.
D. Involves unauthorized or improper use of an elderly person's financial resources. This option does not apply to the scenario described as it involves financial exploitation rather than the physical or emotional neglect of the resident.

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A client presents to the emergency department with complaints of numbness and weakness which began in the feet and has progressed symmetrically in an ascending pattern through the bilateral lower extremities. The nurse understands that this pattern most closely fits which neurological disorder?

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