The nurse is caring for a client who was recently diagnosed with ALS (Amyotrophic lateral sclerosis). Which of the following signs and symptoms is MOST important for the nurse to assess for?

Inability to void

Unable to eat without thickening meals

Loss of function in the lower extremity

Difficulty breathing

Answer and Explanation

The Correct Answer is D

A) Inability to void:
While urinary retention or difficulties with voiding can occur in ALS patients due to weakened muscles affecting the bladder, it is not the most immediate or life-threatening symptom that requires urgent attention. ALS primarily affects motor neurons and the voluntary muscles, and while autonomic dysfunction can lead to bladder or bowel issues, these are typically not the first concern in the acute phase of ALS unless they are severe.

B) Unable to eat without thickening meals:
Dysphagia (difficulty swallowing) is a common symptom in ALS, especially as the disease progresses and affects the muscles of the throat. While this symptom is important to address, it is manageable with interventions like speech therapy, modified diets, and thickened liquids

C) Loss of function in the lower extremity:
Loss of function in the lower extremities is a hallmark symptom of ALS as the disease progresses, but it is not an acute or life-threatening situation on its own. ALS leads to gradual muscle weakness and atrophy, particularly affecting voluntary motor functions.

D) Difficulty breathing:
As ALS progresses, respiratory muscles, including the diaphragm and intercostal muscles, weaken, which can lead to respiratory failure. The inability to breathe adequately can be life-threatening and may require interventions like mechanical ventilation, non-invasive positive pressure ventilation (BiPAP), or even a tracheostomy.

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Correct Answer is D

Explanation

A. "Are you having any headaches?" : While headaches can be a side effect of medications, this question does not directly assess the effectiveness of baclofen. Baclofen is primarily used to reduce muscle spasms and improve muscle tone.

B. "How has your appetite been?": Changes in appetite can be related to many factors, including medication side effects, but this question does not address the primary purpose of baclofen, which is to manage muscle spasms.

C. "Does your urine look clear or cloudy?": The appearance of urine is not directly related to the effectiveness of baclofen. This question might be more relevant to assessing other conditions or medications that affect the urinary system.

D. "Are you having trouble with spasms?": Baclofen (Lioresal) is prescribed to manage and reduce muscle spasms in conditions like multiple sclerosis. Asking the client about their experience with muscle spasms directly assesses the effectiveness of the medication in managing their symptoms.

A. Spironolactone B. Furosemide C. Hydrochlorothiazide D. Metolazone

Correct Answer is A

Explanation

A) Spironolactone:
Spironolactone is a potassium-sparing diuretic commonly used in the treatment of heart failure. Unlike other diuretics, spironolactone works by antagonizing aldosterone, a hormone that promotes sodium and water retention and potassium excretion. By blocking aldosterone's action, spironolactone prevents the kidneys from excreting potassium, thus increasing potassium levels in the blood (hyperkalemia). Additionally, spironolactone can lead to hyponatremia (low sodium levels), as it also causes the kidneys to retain sodium and water, diluting sodium levels in the blood.

B) Furosemide:
Furosemide, a loop diuretic, is typically used in heart failure to remove excess fluid. It works by inhibiting the reabsorption of sodium, chloride, and potassium in the loop of Henle, which increases urine output. While furosemide can cause hypokalemia (low potassium levels) due to the increased excretion of potassium, it does not typically cause hyperkalemia.

C) Hydrochlorothiazide:
Hydrochlorothiazide is a thiazide diuretic, which works by inhibiting sodium and chloride reabsorption in the distal convoluted tubule of the kidney, leading to increased urine production. Thiazide diuretics can cause hypokalemia (low potassium levels) and hyponatremia (low sodium levels) due to the enhanced excretion of both electrolytes.

D) Metolazone:
Metolazone is also a thiazide-like diuretic that works similarly to hydrochlorothiazide. It can cause hypokalemia and hyponatremia, but like hydrochlorothiazide, it does not typically cause hyperkalemia. Metolazone is more potent than hydrochlorothiazide but still does not carry the risk of hyperkalemia like spironolactone does.

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The nurse is caring for a client who was recently diagnosed with ALS (Amyotrophic lateral sclerosis). Which of the following signs and symptoms is MOST important for the nurse to assess for?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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