multiple sclerosis
TRANSCRIPT
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Multiple Sclerosis
NURSING CAREMed-Surg
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Four Type• Relapse Remitting• Primary Progressive• Secondary
Progressive• Progressive Relapsing
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Relapse Remitting• Unpredictable acute
attacks with worsening of symptoms followed by full, partial, or no recovery
• Then complete or partial absence of symptoms (Remission)
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Primary Progressive • Steady gradual progression of
disability, without any obvious relapses and remissions
• Most common after age 40
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Secondary Progressive• Starts with a relapse
remitting• Advance to
progressive disease
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Progressive Relapsing• Steady progressive
disability • Acute Attacks• Possible recovery
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Precipitating Factors• Infection• Cold climate• Physical injury• Emotional stress• Pregnancy• Fatigue• Overexertion• Hot shower/bath
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Complications
• Spasticity• Neurogenic bladder• Aspiration• Paralysis
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Diagnostic Procedures
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MRI
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CSF Analysis• Tell the patient that this test usually
takes at least 15 minutes• Headache is common adverse effect• VS• Pillow support• Place one arm around knee & neck• Remain calm and still• Label containers in which they were
filled• Allergy check initially• Remain flat • Encourage fluids• Check site for redness, swelling,
drainage hourly 4 1st 4 hours then Q4 for 1st 24hrs.
• Assess neurolgoic Q15 min for 4 hours; it stable assess Q2 then Q4
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Electrophysiological Testing
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Medications
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Immunosuppressants
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Immunomodulators
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Antispasmodic
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Anticonvulsant
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Stool Softener
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Nursing Diagnosis
• Fatigue• Activity intolerance• Disturbed sensory
perception (visual)• Impaired physical mobility• Impaired urinary
elimination• Chronic pain• Imbalanced nutrition:
Less than body requirements
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Nursing Care• Encourage fluid intake • Assist with bladder elimination
o intermittent self-catheterization,o bladder pacemakero Credé
• Reorient• Place Routine Objects in Routine Places• Communication Board 4 (dysarthria) • Speech language therapist referral• Apply alternating eye patches to treat diplopia. Teach
scanning techniques.• Utilize energy conservation measures.• Reduce injury—call lights, ask 4 assistance, home
safety• Encourage independence
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Thanks….