A patient with multiple sclerosis (MS) is receiving treatment with methylprednisolone during an acute exacerbation. Which of the following is the expected therapeutic effect of this treatment?
Reduction of inflammation and suppression of the immune responses
Stimulation of nerve regeneration
Improvement in cognitive function
Increase in muscle strength and coordination
The Correct Answer is A
A. Reduction of inflammation and suppression of immune responses. Methylprednisolone is a corticosteroid that reduces inflammation and suppresses immune responses, which can help manage the acute exacerbations of MS.
B. Stimulation of nerve regeneration. Methylprednisolone does not stimulate nerve regeneration; it focuses on reducing inflammation.
C. Improvement in cognitive function. Cognitive improvement is not a primary goal of methylprednisolone in MS management, though reducing inflammation may indirectly benefit cognition.
D. Increase in muscle strength and coordination. While reducing inflammation can improve symptoms, methylprednisolone itself does not directly increase muscle strength or coordination.
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Correct Answer is D
Explanation
A. Warfarin. Warfarin (Coumadin) is an anticoagulant used to prevent blood clots, but it typically requires several days to achieve a therapeutic effect and needs close monitoring of INR (International Normalized Ratio) levels. While it can be used for long-term prevention of DVT, it's not the immediate choice for post-operative prophylaxis.
B. Alteplase (tPA). Alteplase is a thrombolytic agent, used to break down existing clots, not prevent their formation. It is typically used in emergency situations, such as for treating ischemic stroke.
C. Clopidogrel. Clopidogrel is an antiplatelet agent, often used to prevent arterial clots, not DVTs. It is more commonly used in conditions like stroke and heart disease.
D. Enoxaparin. Enoxaparin, a low molecular weight heparin, is commonly used to prevent DVT after surgery by inhibiting specific clotting factors. It’s frequently prescribed for DVT prevention in orthopedic surgery patients.
Correct Answer is ["A","C","D","E"]
Explanation
A. Ensure that the client's urine output is at least 1 ml/kg/hr. Adequate urine output is essential before administering IV potassium to ensure the kidneys are functioning properly and can handle the increased potassium load, preventing hyperkalemia.
B. Ensure potassium infusion is prepared with 5% dextrose solution. While IV potassium can be mixed with normal saline or dextrose solutions, the specific diluent will depend on the clinical scenario. This isn't necessarily a standard requirement, so it may not be appropriate for all situations.
C. Educate the client regarding high-potassium foods. Education on high-potassium foods helps the client maintain potassium levels after treatment, reducing the need for future supplementation.
D. Repeat blood serum potassium levels. Rechecking potassium levels ensures the patient reaches a safe and therapeutic range and helps monitor for signs of overcorrection or continued hypokalemia.
E. Cardiac monitoring during infusion. Cardiac monitoring is critical, as hypokalemia and potassium replacement can affect heart rhythm and lead to arrhythmias.