# A client with relapsing-remitting multiple sclerosis is admitted for an acute exacerbation with new right-sided weakness and optic neuritis. Which interventions should the nurse anticipate? Select all that apply.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=374981&lang=en  
> language: en  
> subject: Management of Care  
> category: MOC

## Question

A client with relapsing-remitting multiple sclerosis is admitted for an acute exacerbation with new right-sided weakness and optic neuritis. Which interventions should the nurse anticipate? Select all that apply.

1

Administer IV methylprednisolone 1 gram daily for 3 to 5 days

2

Initiate fall precautions and physical therapy consult

3

Apply heating pads to weak muscles to reduce spasticity

4

Hold the client disease-modifying therapy permanently because of the relapse

5

Screen for occult infection (urinalysis, CBC) before starting steroids

## Explanation

Acute MS relapse is treated with high-dose IV methylprednisolone (typically 1 gram daily for 3-5 days), which shortens but does not change long-term outcome. Infection screening is essential because pseudo-relapse from infection mimics true relapse and steroids in unrecognized infection are harmful. Fall and mobility precautions are routine. Disease-modifying therapy is generally CONTINUED — a single relapse on therapy is not an automatic indication to stop. HEAT worsens MS symptoms (Uhthoff phenomenon); cooling techniques are preferred.

## In-depth explanation

Pseudo-relapse: fever or infection unmasks old MS deficits without new demyelination. Treat the infection — symptoms resolve.

## Clinical scenario

On disease-modifying therapy with ocrelizumab. Past relapses every 8-10 months. Currently afebrile.

## Key concepts

- **relapsing-remitting MS** — Most common MS subtype with discrete relapses and recovery between attacks.
- **Uhthoff phenomenon** — Heat-induced worsening of MS symptoms due to slowed conduction in demyelinated nerves.
- **ocrelizumab** — Anti-CD20 monoclonal antibody disease-modifying therapy for MS.

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