A nurse is caring for a client who has a new diagnosis of amyotrophic lateral sclerosis (ALS), and a new prescription for riluzole. The nurse understands that this medication works in which of the following ways?

It suppresses the virus which is responsible for causing the inflammation of the nerve.

It prevents the breakdown of acetylcholine to increase the amount available at the neuromuscular junction.

It reduces inflammation in the CNS to prevent further demyelination of nerves in the central nervous system.

It slows the progression of the disease by decreasing the release of glutamate in the brain.

Answer and Explanation

The Correct Answer is D

A.   ALS is not caused by a virus or inflammation of the nerves. It is a progressive neurodegenerative disease affecting the motor neurons in the brain and spinal cord.
B.   While acetylcholine breakdown is involved in other neurological conditions (such as myasthenia gravis), ALS primarily affects motor neurons and does not directly involve acetylcholine metabolism at the neuromuscular junction.
C.   ALS does not typically involve significant inflammation or demyelination (which is more characteristic of conditions like multiple sclerosis). Therefore, reducing CNS inflammation is not a therapeutic target in ALS.
D.   Riluzole, the medication prescribed for ALS, works by decreasing the release of glutamate, which is a neurotransmitter that can be toxic to nerve cells in high amounts. In ALS, excessive glutamate release is believed to contribute to motor neuron degeneration. By reducing glutamate release, riluzole may help protect motor neurons and slow the progression of the disease.

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Correct Answer is B

Explanation

A. This option is not directly related to preventing exacerbations in COPD. While managing fluid intake may be important for individuals with certain cardiovascular or renal conditions, it is not a recognized strategy for preventing COPD exacerbations.
B. Influenza vaccination is highly recommended for individuals with COPD. Respiratory infections, such as influenza (flu), can trigger exacerbations in COPD. By receiving an annual influenza vaccine, the client can reduce the risk of developing influenza-related exacerbations and complications.
C. Pursed-lip breathing is a breathing technique that can help improve ventilation and decrease the work of breathing for individuals with COPD. It can be beneficial during exacerbations or episodes of dyspnea (shortness of breath). While it does not directly prevent exacerbations, it is a useful technique to manage symptoms and potentially reduce the severity of exacerbations.
D. The tripod position, where a person leans forward with hands supported on their knees or another surface, can help COPD patients during exacerbations by allowing better chest expansion and improving breathing mechanics. It can relieve dyspnea and help stabilize breathing. While it does not prevent exacerbations, it is a helpful technique during episodes of increased respiratory distress.

A. Soles of the feet B. Palms of the hands C. Oral mucosa D. Nail beds

Correct Answer is C

Explanation

A. The soles of the feet are not typically assessed for cyanosis because they are not a reliable indicator of central cyanosis. Cyanosis is best evaluated in areas where mucous membranes are visible.
B. Similar to the soles of the feet, the palms of the hands are not a reliable indicator of central cyanosis. Cyanosis is not typically visible on the palms unless there are severe systemic circulation issues.
C. The oral mucosa (inside the mouth) is a reliable area to assess for central cyanosis. The nurse can inspect the lips, tongue, and buccal mucosa for a bluish discoloration, which indicates decreased arterial oxygen saturation.
D. The nail beds are also a reliable indicator of central cyanosis. The nurse can assess the color of the nail beds and look for bluish discoloration, which can be more apparent in darker-skinned individuals compared to the lips and oral mucosa.

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A nurse is caring for a client who has a new diagnosis of amyotrophic lateral sclerosis (ALS), and a new prescription for riluzole. The nurse understands that this medication works in which of the following ways?

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Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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