A nurse is teaching a client who has multiple sclerosis about factors that can worsen their manifestations. Which of the following factors should the nurse include in the teaching?

Choice A Reason:

Hypoxemia due to dead space is not appropriate. Dead space refers to areas of the lung where ventilation occurs but no perfusion takes place. In ARDS, hypoxemia typically occurs due to ventilation-perfusion (V/Q) mismatch and shunting rather than dead space.

Choice B Reason:

Impaired carbon dioxide elimination due to shunting is not appropriate. Shunting occurs when blood bypasses ventilated alveoli, leading to inadequate gas exchange. In ARDS, shunting contributes to hypoxemia, but it doesn't directly impair carbon dioxide elimination.

Choice C Reason:

Decreased pulmonary arterial pressure due to ventilation-perfusion (V/Q) mismatch is incorrect. V/Q mismatch occurs when ventilation and perfusion are mismatched in different areas of the lung. This leads to areas of low ventilation (dead space) and areas of low perfusion (shunting). V/Q mismatch contributes to hypoxemia in ARDS but does not typically lead to decreased pulmonary arterial pressure.

Choice D Reason:

Decreased pulmonary compliance due to stiffness is correct. This is a characteristic feature of ARDS. The inflammation and damage to the alveoli cause them to become stiff, reducing pulmonary compliance and impairing lung expansion during ventilation.

Choice A Reason:

Photosensitivity is incorrect. Photosensitivity, or sensitivity to light, is not a common symptom of multiple sclerosis. While individuals with MS may experience visual disturbances, such as blurred vision or optic neuritis, sensitivity to light is not typically reported as a primary symptom.

Choice B Reason:

Memory issues is correct. Memory issues, including problems with short-term memory, concentration, and cognitive processing speed, are common neurological symptoms in individuals with multiple sclerosis. Cognitive impairment can affect various aspects of memory and cognitive function.

Choice C Reason:

Lhermitte's sign is correct. Lhermitte's sign is a classic neurological sign characterized by an electric shock-like sensation that radiates down the spine or into the limbs upon flexing the neck. It is a common symptom in multiple sclerosis, often associated with cervical spinal cord lesions.

Choice D Reason:

Seizures is incorrect. Seizures are not a typical symptom of multiple sclerosis. While individuals with MS may experience various neurological symptoms, seizures are not a common manifestation of the disease.

Choice E Reason:

Central vision loss is correct. Visual disturbances, including central vision loss, blurred vision, double vision, or optic neuritis, are common symptoms of multiple sclerosis. Optic neuritis, inflammation of the optic nerve, is a frequent manifestation of MS that can lead to temporary or permanent central vision loss.