Neurological Disorders Q 46

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The nurse is assessing a 37-year-old client diagnosed with multiple sclerosis. Which of the following symptoms would the nurse expect to find?

  

     A. Vision changes

     B. Absent deep tendon reflexes

     C. Tremors at rest

     D. Flaccid muscles

    

    

Correct Answer: A. Vision changes

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Vision changes, such as diplopia, nystagmus, and blurred vision, are symptoms of multiple sclerosis. Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system (CNS) characterized by inflammation, demyelination, gliosis, and neuronal loss. Neurological symptoms vary and can include vision impairment, numbness and tingling, focal weakness, bladder and bowel incontinence, and cognitive dysfunction. Symptoms vary depending on lesion location.

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Option B: Deep tendon reflexes may be increased or hyperactive — not absent. Babinski’s sign may be positive. The diagnosis of RR MS is made with at least two CNS inflammatory events. Although different diagnostic criteria have been used for MS, the general principle of diagnosing the RR course has involved establishing episodes separated in “time and space.”

Option C: Tremors at rest aren’t characteristic of multiple sclerosis; however, intentional tremors, or those occurring with purposeful voluntary movement, are common in clients with multiple sclerosis. Symptoms from relapses frequently resolve, however over time, residual symptoms relating to episodes of exacerbation accrue. This accrual of symptoms, generally after 10 to 15 years, results in long-term disability over time. Neurologic manifestations are heterogeneous in severity and degree of recovery.

Option D: Affected muscles are spastic, rather than flaccid. Clinical symptoms characterized by acute relapses typically first develop in young adults. A gradually progressive course then ensues with permanent disability in 10 to 15 years. Relapses often recover either partially or completely over weeks and months, frequently without treatment. Over time, residual symptoms from relapses without complete recovery accumulate and contribute to general disability.

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