A nurse is planning care for a client who has multiple sclerosis and is receiving methylprednisolone. Which of the following adverse effects should the nurse anticipate? (Select all that apply.)

Choice A Reason:

Placing the client on clear liquids might not be appropriate in this situation because absent bowel sounds in the lower abdominal quadrants could indicate a more serious gastrointestinal issue such as ileus or bowel obstruction. Clear liquids may exacerbate these conditions and are not sufficient to address the underlying problem. Therefore, this option is not recommended until the cause of absent bowel sounds is identified and addressed.

Choice B Reason:

Performing a hemoccult blood test is not directly relevant to the situation described. Hemoccult tests are used to detect occult (hidden) blood in stool, which can be indicative of gastrointestinal bleeding. While it's important to assess for gastrointestinal bleeding in some cases, absent bowel sounds in the lower abdominal quadrants suggest a more immediate concern related to gastrointestinal motility rather than bleeding. Therefore, this option is not the most appropriate action at this time.

Choice C Reason:

Inserting a nasogastric tube is the most appropriate action in this scenario. Absent bowel sounds in a client with a spinal cord injury can indicate neurogenic bowel dysfunction, which may lead to abdominal distention and discomfort. Inserting a nasogastric tube can help decompress the stomach and intestines, reducing the risk of complications such as aspiration and providing relief from discomfort. It can also help manage gastrointestinal complications until further assessment and interventions can be implemented.

Choice D Reason:

Forcing the intake of fluids may not be appropriate without further assessment and could potentially worsen the client's condition if there is an underlying gastrointestinal issue leading to absent bowel sounds. Additionally, forcing fluids may not address the potential issue of gastrointestinal bleeding.

Choice A Reason:

African American clients is appropriate. Research suggests that African Americans have a lower prevalence of MS compared to White Americans, but they tend to have more severe disease progression and higher disability rates when diagnosed with MS.

Choice B Reason:

White American clients: Individuals of European descent, including White Americans, have the highest prevalence of MS, particularly those of northern European ancestry. MS is more common in populations of northern European descent compared to other racial and ethnic groups.

Choice C Reason:

East Asian clients: East Asians, including individuals of Chinese, Japanese, and Korean descent, have historically had lower rates of MS compared to individuals of European descent. However, MS prevalence appears to be increasing in East Asian populations, possibly due to changes in lifestyle and environmental factors.

Choice D Reason:

Hispanic or Latino clients: Studies suggest that the prevalence of MS is lower in Hispanic/Latino populations compared to White Americans but higher than in African Americans. However, there is considerable variation in MS prevalence among different Hispanic/Latino subgroups.

Choice E Reason:

Navajo Indian clients: Native American populations, including Navajo Indians, have been reported to have a lower prevalence of MS compared to individuals of European descent. However, limited data are available on MS prevalence and incidence in specific Native American tribes, and more research is needed to fully understand the disease burden in these populations.