The nurse is preparing discharge teaching for a client who is recently diagnosed with Multiple sclerosis. Which of the following is the most important to include in the patient teaching?

Limit fluid intake

Utilize assistive devices as needed

Schedule eye examinations every other year

Double up on any missed scheduled medications

Answer and Explanation

The Correct Answer is B

A) Limit fluid intake:
There is no evidence to suggest that limiting fluid intake is necessary or beneficial for clients with multiple sclerosis (MS). In fact, staying well-hydrated is often encouraged, especially for individuals with bladder dysfunction or those at risk for urinary retention or constipation, which are common symptoms of MS. Restricting fluid intake could exacerbate these issues and is not a priority in MS management.

B) Utilize assistive devices as needed:
The most important aspect of teaching for a client recently diagnosed with multiple sclerosis is to encourage the use of assistive devices as needed. MS often causes mobility issues, weakness, and coordination difficulties due to damage to the nervous system. Using devices like canes, walkers, or wheelchairs can significantly improve independence and safety, helping the client maintain mobility and prevent falls

C) Schedule eye examinations every other year:
Eye problems, such as optic neuritis or diplopia (double vision), are common in MS, but the frequency of eye exams depends on the individual’s symptoms. Regular eye exams are important, but every other year is generally not frequent enough. Most MS patients are advised to have annual eye exams or as recommended by their ophthalmologist, especially if they experience any changes in vision.

D) Double up on any missed scheduled medications:
Doubling up on missed medications is not recommended, as it can lead to overdose or increase the risk of side effects. It is important to follow the prescribed medication regimen and use strategies to help the client remember their medications, such as setting reminders or using a medication organizer.

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Correct Answer is A

Explanation

A) Peaked T waves:
Peaked T waves are a classic sign of hyperkalemia on an EKG. As potassium levels rise, the T waves become taller, more pointed, and narrow, indicating changes in the heart's electrical conduction. This is one of the earliest and most characteristic EKG changes seen with hyperkalemia. Hyperkalemia can result from conditions such as kidney dysfunction, use of potassium-sparing diuretics, or other electrolyte imbalances.

B) Inverted P waves:
Inverted P waves typically suggest issues such as atrial ischemia or ectopic atrial rhythms but are not a hallmark sign of hyperkalemia. They may also appear with other conditions, like atrial fibrillation or atrial flutter. However, inverted P waves are not typically linked to elevated potassium levels.

C) Widened QRS:
A widened QRS complex can occur in several conditions, including hyperkalemia, but it is generally seen in more severe cases. As potassium levels rise further, the QRS complex may widen due to delayed conduction through the ventricles. Although a widened QRS can indicate hyperkalemia, it is a later sign, and it typically occurs after more specific changes like peaked T waves.

D) Prominent U wave:
Prominent U waves are more often associated with hypokalemia (low potassium levels) rather than hyperkalemia. U waves are typically seen after the T wave on the EKG and can be more prominent in conditions of low potassium.

A. Obtain blood specimen for a BMP test. B. Prepare for synchronize cardioversion C. Start CPR D. Prepare for defibrillation

Correct Answer is B

Explanation

A) Obtain blood specimen for a BMP test:
Although obtaining laboratory tests like a BMP (Basic Metabolic Panel) can be important in evaluating the client’s electrolyte balance and kidney function, it is not the priority intervention in this acute situation. The client is exhibiting a potentially dangerous rhythm and the immediate intervention to stabilize the rhythm is necessary before ordering lab tests.

B) Prepare for synchronized cardioversion:
The priority intervention for a client exhibiting this cardiac rhythm with accompanying signs of hemodynamic instability (low blood pressure, tachycardia, respiratory distress) is synchronized cardioversion. This is especially the case if the rhythm is atrial fibrillation, atrial flutter, or supraventricular tachycardia (SVT), which can be life-threatening if not treated promptly. Synchronized cardioversion is indicated when the patient is symptomatic and hemodynamically unstable.

C) Start CPR:
While starting CPR is critical for a patient who is unresponsive and in a pulseless rhythm (such as ventricular fibrillation or asystole), this client is still responsive with a pulse of 130 bpm. Although the client is in a high-risk rhythm with signs of hemodynamic instability, CPR is not indicated at this moment because the client is not in cardiac arrest.

D) Prepare for defibrillation:
Defibrillation is indicated for life-threatening arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia. In this case, the client has a pulse, indicating that defibrillation is not appropriate.

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The nurse is preparing discharge teaching for a client who is recently diagnosed with Multiple sclerosis. Which of the following is the most important to include in the patient teaching?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Correct Answer is B

Explanation

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