Twenty-seven-year-old female presents at provider’s office complaining

Twenty-seven-year-old female presents at provider’s office complaining of increasing multiple sclerosis symptoms. Use the chart to answer the questions. The chart may update as the scenario progresses. History and Physical AssessmentMedical/Surgical history: Diagnosed with MS 9 years ago. First MS attack at age 18, with initial complaints of blurred vision and balance problems. Next MS attack 2 years later with main complaint of numbness and tingling beginning in distal right arm, progressing proximally. MS attacks at age 22 and 24 years with balance and vision problems as primary complaints. Social history: Laboratory technician in research science laboratory. Denies alcohol, tobacco, drug usage. Family history: Mother suffers from rheumatoid arthritis. Father in good health after suffering myocardial infarction (5 years ago). Great-grandmother is believed to have had scleroderma. Physical Assessment: Patient appears underweight and ashen. Pulses are normal. Eye exam reveals pain with eye movement. Lungs are clear. Breath sounds are normal. Abdomen is slightly descended with hypoactive bowel sounds. Normal range of movement in extremities with weakness noted in right arm. Patient says arm feels as if it is numb and “tingling.” She struggles to get the sensation to stop. Medications: Corticosteroids during MS attack, acetaminophen (over the counter) for general “aches” Nurses’ Notes Vital Signs Laboratory Results 5 of 6 The patient has been informed that a lumbar puncture is to be scheduled. The patient wants to know what clinical findings are expected for MS. Which of the following statements are correct regarding diagnosis of MS? Select all that apply. The patient should be informed that the symptoms of MS are cues for diagnosis, but further testing is needed.The patient should not be surprised if her blood laboratory results are normal.The patient’s lumbar puncture is likely to reveal no significant changes.The patient should be informed that some tests, such as for Lyme disease, are used to rule out conditions similar to MS.Oligoclonal bands may be an expected finding in the patient’s CSF.The Apley criteria will be applied to the patient to evaluate neurologic findings.The patient may be scheduled for an evoked potential test.The patient’s lumbar puncture results will likely reveal no IgGs within the CSF. SCIENCE HEALTH SCIENCE NURSING NURS 4313

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