Multiple Sclerosis
NURSING CAREMed-Surg
Four Type• Relapse Remitting• Primary Progressive• Secondary
Progressive• Progressive Relapsing
Relapse Remitting• Unpredictable acute
attacks with worsening of symptoms followed by full, partial, or no recovery
• Then complete or partial absence of symptoms (Remission)
Primary Progressive • Steady gradual progression of
disability, without any obvious relapses and remissions
• Most common after age 40
Secondary Progressive• Starts with a relapse
remitting• Advance to
progressive disease
Progressive Relapsing• Steady progressive
disability • Acute Attacks• Possible recovery
Precipitating Factors• Infection• Cold climate• Physical injury• Emotional stress• Pregnancy• Fatigue• Overexertion• Hot shower/bath
Complications
• Spasticity• Neurogenic bladder• Aspiration• Paralysis
Diagnostic Procedures
MRI
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
Electrophysiological Testing
Medications
Immunosuppressants
Immunomodulators
Antispasmodic
Anticonvulsant
Stool Softener
Nursing Diagnosis
• Fatigue• Activity intolerance• Disturbed sensory
perception (visual)• Impaired physical mobility• Impaired urinary
elimination• Chronic pain• Imbalanced nutrition:
Less than body requirements
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
Thanks….
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