Nurses Notes

Here is the concept you need to know about Multiple Sclerosis. Spread the awareness of this Neurologic Disorder.

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Etiology and Pathophysiology
■ Autoimmune response → demyelination of CNS neurons and formation of sclerotic plaques → ↓impulse conduction
■ Remissions and exacerbations with downward plateaus
■ S&S vary depending on nerves involved

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Risk Factors
■ Caucasian race 20-40yr old
■ Female gender

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Signs and Symptoms
■ Charcot’s triad (intention tremor, nystagmus, scanning speech)
■ Visual disturbances (diplopia, visual field deficits)
■ Fatigue, paresthesias of face and/or extremities, incoordination, slurred speech, spasticity
■ Bladder dysfunction

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Treatment
■ Disease modifying therapy (interferon beta-1a and -1b, glatiramer acetate)
■ Meds: Corticosteroids, antispasmodics (baclofen)
■ Palliative care

Nursing Care
■ Monitor S&S, balance activity/rest, provide cool environment, ↓fat diet
■ Safe mobility: Wide base of support, assistive devices
■ ↓Pressure ulcers: Change position q1-2hr, skin care, pull sheet to ↓shearing, pressure relieving devices
■ Improve elimination pattern: Respond to urge, follow bowel and bladder toileting schedule, ↑fiber and fluids, ascorbic acid to acidify urine if ordered
■ Emotional support: ↑Ventilation of feelings, refer to National Multiple Sclerosis Society