Help needed please re:assignement in Internal med.

[Amandine]

Hi everybody,

I am nearly finished with my assignement in Internal Medicine, I've been working on it for days now so I can't wait to be over with it!

Anyway I have three questions that I would be very grateful if you could help me with them.

The first one is about Multiple Sclerosis, it's a multiple choice question about the areas most frequently affected by multiple sclerosis. I have 4 choices: -lateral, third and fourth ventricles

- optio nerve and chiasm

- pons, medulla and cerebellar peduncles

- all of the above

I am thinking about the first option but I'm not too sure. Every info. I manage to get about this give me different results

Secondly another multiple choice question : When a person with arthritis is temporary confined to bed, the position recommended to prevent flexion deformities is:

- prone

- semi-Fowler's

- side lying with pillow supporting the shoulders and legs

-supine with pillow under the knee

Now my problem with this is that according to my book none of those positions should be used! I'm hesitating between option 3 and 4...

The other question I need help on is "what are the cornerstones of patient education for a diabetic patient". So far I have put basic survival skills (with description), in-depth and prevention (same with description). But I doubt I have it right somehow... What do you think?

[Daytonite, BSN, RN]

Hi, Amandine! Glad to see you came back to post a question to the forum. For your multiple sclerosis questions I would go with pons, medulla and cerebellar peduncles. The first signs of M.S. are usually seen in the eyes due to effects on the cranial nerves which are collected in the brainstem which is where the pons and medulla are. With arthritis you want to make sure there is no stress on the joints, nor too much flexion on them when a patient is confined to bed. I would go with supine with pillow under the knee because that is a comfortable position and in the long run is going to avoid flexion deformities. I won't mislead you, however, because the nurse in me says that you can't leave a bed ridden patient on their back all the time--they have to be turned. I looked in my pathophysiology text on this and all it mentions is "whole body rest". The first and foremost focus of patient education in diabetes is the management of the disease. This includes learning how diabetes affects the body, the medication used to treat it, glucose monitoring and control, diet restrictions and exercise. The second major focus once the disease is under control is the prevention of complications (foot ulcers, hypoglycemia, hypertension and coronary artery disease).