Author Question: A client diagnosed with multiple sclerosis is admitted with an acute onset of visual changes, ... (Read 29 times)

Chloeellawright · **on:** Jul 22, 2018

A client diagnosed with multiple sclerosis is admitted with an acute onset of visual changes, fatigue, and leg weakness.

The client tells the nurse that the last time this happened, recovery occurred in a few weeks and the client was able to return to work. The nurse realizes the client is experiencing which classification of multiple sclerosis? 1. Primary progressive
2. Relapsing-remitting
3. Secondary progressive
4. Progressive-relapsing

Question 2

The nurse is examining the client's mouth and discovers leukoplakia. In questioning the nurse the client reveals it has been there for more than a month. The nurse documents the condition and informs the doctor, anticipating:

1. An order to provide thorough mouth care.
2. A biopsy will be performed.
3. An antifungal medication order.
4. A dental consult.

diesoon · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

2. Relapsing-remitting

Rationale:
There are four classifications of multiple sclerosis. The client is admitted with an exacerbation of symptoms and has a history of full recovery. This is classified as relapsing-remitting and is the most common type. Primary progressive is a steady worsening of the disease with occasional minor recovery. Secondary progressive begins as relapsing-remitting but the disease becomes worse between exacerbations. Progressive-relapsing is rare, with the disease progressing from the onset with periods of exacerbation.

Answer to Question 2

2. A biopsy will be performed.

Rationale:
Leukoplakia is a smooth irregular white patch found on the tongue, lips, cheeks, or oral mucosa that can be rubbed off with force and is considered a precursor to oral cancer. A patch that lasts more than 2 weeks is generally biopsied. Mouth care and antifungal medication would not address the possibility of oral cancer. A dental consult may be advised, but a biopsy would take priority.