The client diagnosed with multiple sclerosis (MS) is at risk for fatigue. Which priority intervention would the nurse implement to address this issue?
Schedule activities late in day and in the evening
Provide supplemental oxygen when fatigued
Teach the importance of hot showers to help relax
Have the client prioritize activities for the day
The Correct Answer is D
A. Schedule activities late in the day and in the evening:
Scheduling activities late in the day is not an ideal approach for managing fatigue in clients with MS. Fatigue typically worsens as the day progresses, and clients with MS often experience more energy depletion in the late afternoon and evening. Therefore, the best time to schedule demanding activities is earlier in the day when the client may have more energy. Scheduling strenuous tasks late in the day may exacerbate fatigue and lead to physical and emotional exhaustion.
B. Provide supplemental oxygen when fatigued:
While oxygen therapy is appropriate for clients with respiratory issues or other conditions that affect oxygenation, it is not the most relevant intervention for addressing fatigue in MS. Fatigue in MS is primarily caused by neurological factors, muscle weakness, or impaired mobility, not by a lack of oxygen. The priority for MS-related fatigue is managing energy levels through activity planning and rest, not providing supplemental oxygen unless there is a specific indication of respiratory distress or hypoxia.
C. Teach the importance of hot showers to help relax:
Hot showers may help some individuals relax, but they are not the best intervention for managing fatigue in MS. In fact, heat can sometimes worsen symptoms in clients with MS, a phenomenon known as Uhthoff’s phenomenon, where heat increases neurological symptoms such as muscle weakness, fatigue, or visual disturbances. It is important to educate clients to avoid overheating, which could exacerbate fatigue or other symptoms. Instead, clients should focus on rest, energy conservation, and temperature regulation.
D. Have the client prioritize activities for the day: Fatigue is a common and debilitating symptom in clients with multiple sclerosis (MS), and it can significantly affect their daily functioning. One of the most effective interventions for managing fatigue in MS is to encourage the client to prioritize activities and manage their energy levels throughout the day. By scheduling the most important or demanding tasks earlier in the day when energy levels tend to be higher, clients can conserve energy for essential activities. Additionally, teaching clients to break tasks into smaller, manageable steps and incorporating frequent rest periods can help minimize fatigue and prevent overexertion. Prioritizing activities ensures that the client is not overwhelmed and can still maintain independence while managing their symptoms effectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. A systolic murmur: A systolic murmur is often associated with valvular heart disease, particularly mitral regurgitation, which can sometimes result from papillary muscle dysfunction after a myocardial infarction. However, a systolic murmur is not a typical or immediate complication following an anterior-lateral wall MI. The focus in the early hours after an MI should be on more acute complications, such as dysrhythmias and hemodynamic stability, rather than a murmur, which may develop more gradually over time.
B. Ventricular dysrhythmias: Ventricular dysrhythmias are one of the most common and life-threatening complications in the immediate hours following an acute myocardial infarction (MI), especially with an anterior-lateral wall MI. These dysrhythmias occur due to the electrical disturbances caused by myocardial injury and ischemia. The heart muscle becomes more susceptible to abnormal electrical activity after the infarction, and monitoring for ventricular tachycardia or fibrillation is crucial. These arrhythmias can lead to sudden cardiac arrest, which is why they are a high priority for monitoring in the immediate post-MI period.
C. A pericardial friction rub: A pericardial friction rub is a sign of pericarditis, which can occur after an MI, particularly several days to a week later, rather than in the immediate post-MI period. While pericarditis is a possible complication of MI, it is less likely to present immediately after the infarction, especially in the first few hours. The nurse should monitor for pericarditis, but it is not as high a priority as dysrhythmias during the first hours after MI.
D. Renal insufficiency: While renal insufficiency can develop as a result of poor perfusion or shock following a myocardial infarction, it is not one of the most immediate or common complications to watch for in the first hours after an anterior-lateral MI. The primary concern in this acute phase is monitoring for cardiovascular complications, such as dysrhythmias, rather than renal function. Renal insufficiency would be a secondary concern, particularly if the patient is hypotensive or experiencing other signs of multi-organ involvement.
Correct Answer is A
Explanation
A. Muscle rigidity and bradykinesia: Parkinson's disease (PD) is characterized by a combination of motor symptoms due to the degeneration of dopamine-producing neurons in the brain. The hallmark motor symptoms include muscle rigidity (stiffness of muscles, making movement difficult) and bradykinesia (slowness of movement). These symptoms are typically present early in the disease and can lead to difficulties with daily activities such as walking, speaking, and performing fine motor tasks. These two signs are primary indicators of Parkinson's disease.
B. Facial pain and ptosis: Facial pain and ptosis (drooping eyelids) are not typical symptoms of Parkinson's disease. PD can affect facial expression (resulting in a masked face), but it does not usually cause facial pain. Ptosis is more commonly seen in conditions like Horner's syndrome, myasthenia gravis, or as a side effect of medications, but it is not a hallmark symptom of Parkinson's disease.
C. Diarrhea and nausea: While gastrointestinal symptoms such as constipation can be seen in Parkinson's disease due to autonomic dysfunction and decreased gut motility, diarrhea and nausea are not typical primary symptoms. In fact, constipation is a more common issue in PD. Nausea could result from the use of medications like levodopa, but it is not a defining feature of the disease itself.
D. Ecchymosis and petechiae: Ecchymosis (bruising) and petechiae (small red or purple spots on the skin) are not characteristic of Parkinson's disease. These findings are more often associated with platelet disorders, bleeding disorders, or vascular conditions. While Parkinson's disease can involve complications like falls (which could lead to bruising), these are not direct symptoms of the disease itself. The primary symptoms involve motor and autonomic dysfunction.
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