Jacqueline Butler is a 27 year-old woman who presented at your primary care practice with tingling in her left hand that had been persistent for the past week. She has also been experiencing increasing clumsiness and weakness when using her left arm, as well as fatigue and trouble concentrating. A surface examination of her extremities showed no swelling, inflammation of joints, or noticeable cysts. Her body temperature was normal, as was a complete blood count (CBC) including a blood glucose test. Subsequently, you order a lumbar puncture to rule out infection and an MRI with contrast dye. The lumbar puncture shows elevated levels of IgG antibodies and the MRI showed three small inflammatory lesions within the brain. Based on these results, you diagnose Jacqueline with Multiple Sclerosis (MS).

1) What possible conditions were ruled out by the surface examination, normal body temperature and CBC?

2) Explain the process and purpose of a lumbar puncture or “spinal tap”.

3) What is the purpose of myelin within the nervous system and how is it affected by Multiple Sclerosis?

4) You recommend immunosuppressant medications for Jacqueline. What precautions should she take when on these medications?

Please do research in order to answer questions thoroughly.

low context culture   (lc.):

association:    

relationships begin and end quickly. many people can be inside one's circle; circle's boundary is not clear.

things get done by following procedures and paying attention to the goal.

one's identity is rooted in oneself and one's accomplishments.

social structure is decentralized; responsibility goes further down (is not concentrated at the top).

interaction:

low use of nonverbal elements. message is carried more by words than by nonverbal means.

verbal message is explicit. context is less important than words.

verbal message is direct; one spells things out exactly.

communication is seen as a way of exchanging information, ideas, and opinions.  

disagreement is depersonalized. one withdraws from conflict with another and gets on with the task. focus is on rational solutions, not personal ones. one can be explicit about another's bothersome behavior.

territoriality:

space is compartmentalized and privately owned; privacy is important, so people are farther apart.

temporality:

things are scheduled to be done at particular times, one thing at a time. what is important is that activity is done efficiently.

change is fast. one can make change and see immediate results.

time is a commodity to be spent or saved. one’s time is one’s own.

learning:

reality is fragmented and compartmentalized. one source of information is used to develop knowledge. thinking is inductive, proceeds from specific to general. focus is on detail.

learning occurs by following explicit directions and explanations of others.

an individual orientation is preferred for learning and problem solving.

speed is valued. how efficiently something is learned is important.

hope that                                         : )

the right answer is: time

just be there for her.

explanation:

not necessarily literally but figuratively. also don't say things like "i understand how you feel", because even though you are trying to , you clearly don't understand how she feels (i'm gonna go out on a limb here and assume you've never had a heart attack). also just let her rest. that is one of the best things for you to do.