The nurse is caring for a client.

Which of the following 4 orders or prescriptions should the nurse anticipate?
Select the 4 orders or prescriptions that the nurse should anticipate.

Rationale for correct choice

• Fall risk: The client experiences sudden episodes of leg weakness, intermittent muscle spasms, and gait changes, all of which significantly increase the risk of falls. Falls in clients with multiple sclerosis can lead to serious injury and further functional decline. Addressing safety and fall prevention is the most immediate priority to prevent harm while other concerns, such as memory or employment, are addressed.

Rationale for incorrect choices

• Memory: Although the client reports struggling to remember things, cognitive issues are not immediately life-threatening. Memory deficits should be addressed through ongoing assessment and cognitive support interventions, but they are not the first priority compared with safety risks.

• Blood pressure: Vital signs are within normal limits, and there is no evidence of hypertensive crisis or acute cardiovascular instability. Blood pressure monitoring remains part of routine care but does not require immediate intervention.

• BMI: The client’s BMI indicates overweight status but does not pose an immediate safety threat. Weight management is important for long-term health but is not the first priority in the context of neurological deficits and fall risk.

• Employment: Reduced work hours due to exacerbation episodes reflect functional limitations and psychosocial impact. Employment concerns are important for quality of life but are secondary to preventing physical injury from falls.

A. Depression: Selegiline transdermal patches are indicated for the treatment of major depressive disorder. As a selective monoamine oxidase-B (MAO-B) inhibitor, it increases the availability of neurotransmitters such as dopamine, which can improve depressive symptoms in adults.

B. Anxiety: While selegiline may have indirect effects on mood, it is not primarily indicated for treating anxiety disorders. Anxiety may require other pharmacologic or therapeutic interventions specifically targeted to anxiety symptoms.

C. Tardive dyskinesia: Tardive dyskinesia is a movement disorder often associated with long-term antipsychotic use. Selegiline does not treat or prevent tardive dyskinesia; it is not indicated for movement disorder management in this context.

D. Bipolar mania: Selegiline is not indicated for the management of bipolar disorder or acute manic episodes. Treating mania typically involves mood stabilizers or antipsychotics rather than MAO-B inhibitors.