A client with a diagnosis of multiple sclerosis is scheduled to receive plasmapheresis treatments. A nurse explains to the client's spouse that the purpose of plasmapheresis is to:
infuse lipoproteins to restore the myelin sheath.
remove excess fluid from the blood stream.
restore protein levels in the blood.
remove circulating antibodies from the blood stream.
The Correct Answer is D
A) Infuse lipoproteins to restore the myelin sheath:
Multiple sclerosis (MS) is an autoimmune disease where the immune system attacks the myelin sheath around nerve fibers. Plasmapheresis does not work by infusing lipoproteins to restore the myelin sheath. The treatment's primary goal is to remove harmful substances from the blood that may be contributing to the autoimmune attack, particularly antibodies that target the nervous system, not by restoring the myelin itself.
B) Remove excess fluid from the bloodstream:
Plasmapheresis is a process used to remove certain substances from the plasma, including antibodies and immune complexes that might be exacerbating an autoimmune condition like MS. If the goal were to remove excess fluid, the treatment would be more akin to dialysis or a fluid management procedure, but this is not the case with plasmapheresis.
C) Restore protein levels in the blood:
While plasmapheresis can sometimes lead to a temporary decrease in protein levels due to the removal of plasma, this is not its primary purpose. The primary goal of plasmapheresis in the context of multiple sclerosis is to remove circulating antibodies and other immune-related substances.
D) Remove circulating antibodies from the bloodstream:
Plasmapheresis works by removing circulating antibodies from the bloodstream. In multiple sclerosis, the immune system mistakenly targets the myelin sheath, and plasmapheresis helps to remove the antibodies responsible for this autoimmune response. This can provide temporary relief of symptoms during acute flare-ups of MS by reducing the immune system's attack on the nervous system.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Assess for dislodgement and use forceps to retrieve the dislodged pellets and place in the lead container:
The priority action when a patient is receiving brachytherapy for uterine cancer is to assess for potential dislodgement of the radioactive implant. If the radiation source has been displaced, it must be handled carefully to prevent radiation exposure to the nurse, other patients, and staff. The nurse should use forceps to carefully retrieve the dislodged pellets and place them in a lead container to prevent contamination.
B) Assess the patient's knowledge of the treatment plan and her willingness to participate:
While it is important to assess the patient's understanding of the treatment plan and her willingness to participate, this is not the immediate priority in this situation. The nurse’s first priority is to address the potential risk of radiation exposure due to the dislodgement of the implant.
C) Assess the UAP's knowledge and explain the rationale for strict bed rest:
Although it is important for the nurse to ensure that all team members, including UAPs, understand the rationale for strict bed rest during brachytherapy, this action is not the most immediate priority in this scenario. The potential dislodgement of the radiation implant requires urgent assessment and intervention.
D) Notify the physician about the potential dislodgment of the radiation implant:
Notifying the physician about the dislodgement is an important step, but it is not the first action the nurse should take. The immediate priority is to assess and secure the radiation implant using appropriate protocols. Once the dislodged pellets have been safely contained in the lead container, the nurse should then notify the physician for further guidance on the next steps in treatment or care.
Correct Answer is A
Explanation
A) It is pain that can be relieved with rest:
Stable angina is typically predictable and occurs during physical exertion or emotional stress when the heart’s oxygen demand exceeds its supply. The pain associated with stable angina usually resolves with rest or after the cessation of the activity that triggered it. Additionally, nitroglycerin can help alleviate the discomfort by dilating blood vessels and improving blood flow to the heart muscle.
B) It is normal pain that will go away on its own:
Although stable angina pain may resolve on its own when the precipitating factor (e.g., exercise or stress) is removed, it is not considered "normal" pain. The pain is a symptom of underlying coronary artery disease (CAD), indicating that the heart muscle is not getting enough oxygen. It’s important for the client to manage angina carefully, as it may progress to more serious forms, such as unstable angina or myocardial infarction (heart attack), if not addressed appropriately.
C) It is pain that is not relieved by taking nitroglycerin:
Nitroglycerin is commonly effective in relieving stable angina by relaxing the coronary arteries and improving blood flow to the heart. If a client’s angina is not relieved by nitroglycerin, it may indicate that the angina is no longer stable (i.e., it has become unstable angina) or that a more serious cardiovascular event is occurring, such as a heart attack.
D) It is pain that requires a cardiac catheterization:
Cardiac catheterization is a diagnostic and interventional procedure typically used when a patient has unstable angina or a history of myocardial infarction or when other treatments have failed. However, stable angina usually does not require immediate catheterization unless the pain is refractory or there is evidence of significant coronary artery blockage. The most common management for stable angina is lifestyle modifications, medications (e.g., nitroglycerin, beta-blockers, calcium channel blockers), and addressing risk factors for coronary artery disease.
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