# A nurse is caring for a client with multiple sclerosis who is experiencing an acute exacerbation. Which nursing intervention should be the priority? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=541182 > language: ko > subject: Adult Health ## 문제 A nurse is caring for a client with multiple sclerosis who is experiencing an acute exacerbation. Which nursing intervention should be the priority? ## 보기 1. Encourage increased physical activity to prevent muscle atrophy 2. Administer prescribed analgesics for pain management 3. Promote rest and stress reduction to minimize symptom progression **✔ 정답** 4. Implement aggressive range-of-motion exercises to maintain mobility **정답: 3** ## 해설 During an acute exacerbation of multiple sclerosis, promoting rest and stress reduction is the priority to minimize symptom progression and allow inflammation to subside. Other options may be appropriate during remission but can worsen symptoms during an exacerbation. ## 심화 해설 Understanding the Priority During an Acute MS Exacerbation During an acute exacerbation of multiple sclerosis (MS), the priority nursing intervention is to promote rest and stress reduction. This approach is grounded in the underlying pathophysiology of the disease and the physiological response to an acute inflammatory attack on the central nervous system. An exacerbation, or relapse, is caused by a new or worsening inflammatory lesion in the brain or spinal cord. This leads to demyelination and impaired nerve conduction, which generates the classic MS symptoms such as muscle weakness, balance problems, spasticity, and profound fatigue [1]. The nervous system is in a state of heightened vulnerability during this period. A critical factor that can worsen neurological function is an increase in body temperature, a phenomenon known as Uhthoff's phenomenon. Even a slight elevation in core temperature, as little as 0.5°C, can further impair the conduction of nerve signals in demyelinated fibers, temporarily worsening existing symptoms and bringing on new ones. This is a homeostatic mechanism disrupted by the disease, making patients with MS susceptible to thermal dysregulation . Physical activity and exercise, while beneficial for long-term disease management and preventing reconditioning, can be counterproductive during an acute relapse. Exercise generates metabolic heat, raising the body's core temperature. In a patient already dealing with an active inflammatory lesion, this heat stress can directly exacerbate neurological signs and symptoms . This is why interventions like encouraging increased physical activity or implementing aggressive range-of-motion exercises are not the priority and can actually be harmful during the acute phase. The fear of worsening symptoms from activity is a well-documented reason patients with MS decrease their physical activity, leading to deconditioning over time [1]. The goal during an exacerbation is to minimize factors that can further compromise neuronal function. Rest reduces metabolic demand and heat production. Stress reduction is equally vital because psychological stress can trigger the release of stress hormones, which may modulate the immune system and potentially worsen the inflammatory process. By prioritizing a cool, low-stress environment, the nurse directly protects the client from symptom progression caused by thermal and physiological stress. Once the acute inflammation subsides, a customized exercise prescription can then be safely introduced to address the resulting deconditioning and improve long-term function .References (research sources) - [1]Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations.GuidelineHalabchi F, Alizadeh Z, Sahraian MA, Abolhasani M. (2017) · DOI: 10.1186/s12883-017-0960-9 ## 임상 시나리오 Managing an Acute MS ExacerbationPrioritizing Thermoregulation and Energy Conservation During an acute relapse, the primary goal is to prevent worsening neurological function. The nervous system is vulnerable to Uhthoff's phenomenon, where even a 0.5°C rise in core temperature blocks nerve conduction in demyelinated fibers. Prioritize rest and stress reduction. Physical activity and aggressive exercises generate metabolic heat and increase fatigue, directly counteracting recovery. Defer structured exercise programs until the acute phase resolves. CautionAvoid interventions that elevate body temperature, including hot showers, heating pads, or strenuous activity. Cooling strategies (cool environment, cold packs) can help stabilize symptoms. ## 핵심 개념 - **Uhthoff's Phenomenon** — The temporary worsening of neurological symptoms in multiple sclerosis caused by an increase in body temperature, which further impairs nerve conduction in demyelinated fibers. - **Multiple Sclerosis Exacerbation** — An acute episode of new or worsening neurological symptoms caused by a new inflammatory lesion and demyelination in the central nervous system. - **Demyelination** — Damage to the protective myelin sheath that surrounds nerve fibers, leading to impaired and slowed transmission of electrical impulses. ## 같은 주제 문제 - [A nurse is assessing a 28-year-old male client who was recently diagnosed with multiple sc…](https://mymerci.kr/pages/nclex_q.php?qn_id=541178) - [A nurse is assessing a 32-year-old male client newly diagnosed with multiple sclerosis (MS…](https://mymerci.kr/pages/nclex_q.php?qn_id=541179) - [A nurse is assessing a 28-year-old female client who was recently diagnosed with multiple …](https://mymerci.kr/pages/nclex_q.php?qn_id=541180) - [A nurse is caring for a client with multiple sclerosis who is experiencing an acute exacer…](https://mymerci.kr/pages/nclex_q.php?qn_id=541181) --- More free questions: [기출문제](https://mymerci.kr/) _학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._