Management of Care Q 4
Which patient should be assigned to the traveling nurse, new to neurologic nursing care, who has been in the neurologic unit for 1 week?
A. A 34-year-old patient newly diagnosed with multiple sclerosis (MS).
B. A 68-year-old patient with chronic amyotrophic lateral sclerosis (ALS).
C. A 56-year-old patient with Guillain-Barre syndrome (GBS) in respiratory distress.
D. A 25-year-old patient admitted with CA level spinal cord injury (SCI).
Correct Answer: B. A 68-year-old patient with chronic amyotrophic lateral sclerosis (ALS)
The traveling nurse is relatively new to neurologic nursing and should be assigned to patients whose conditions are stable and not complex.
Option A: The newly diagnosed patient will need to be transferred to the ICU. Multiple sclerosis (MS) is an immune-mediated inflammatory disease that attacks myelinated axons in the central nervous system, destroying the myelin and the axon in variable degrees and producing significant physical disability within 20–25 years in more than 30% of patients. The hallmark of MS is symptomatic episodes that occur months or years apart and affect different anatomic locations.
Option C: The patient with GBS is in respiratory distress and should be assigned to an experienced neurological nurse. Guillain-Barré syndrome (GBS) is a rare disorder in which a person’s own immune system damages their nerve cells, causing muscle weakness and sometimes paralysis. GBS can cause symptoms that usually last for a few weeks.
Option D: The patient with C4 SCI is at risk for respiratory arrest. A C4 spinal cord injury occurs when damage is dealt about mid-way down the cervical spinal cord — the topmost portion of the spinal cord that is located in the neck and upper shoulders.