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What is Multiple Sclerosis?
- Chronic autoimmune disease that affects the myelin sheath and conduction pathway of the CNS
- Marked by exacerbations & remissions
Patho of MS.
- Inflammatory response that results in diffuse random or patchy areas of plaque in the white matter of the CNS
- Axons that connect the neurons in the brain and spinal cord are generally involved in MS
Types of MS
- Primary progressive
What is relapsing-remitting MS?
- Occurs in most cases
- Symptoms develop and resolve in a few weeks to months
- Pt returns to baseline
What is primary progressive MS?
- Steady and gradual neurologic deterioration
- WITHOUT remission of symptoms
Assessment of MS (Hx)
- Getting good hx is crucial
- MS looks like other neurologic diseases, it's difficult to diagnose and catch early
- Ask about vision, mobility, and sensory changes (early sign)
Assessment of MS (physical)
- Muscle weakness/spasticity
- Uthoff's sign
- Decreased visual/hearing acuity
- Bowel/bladder dysfunction
- Alterations in sexual function
- Cognitive changes
Triggering factors for MS
- Temp extremes
- Hot shower/bath
Diagnostics of MS
- MRI-can see plaque
- CSF-elevated protein, WBC's
Interventions for MS
- Encourage fluids: risk for UTI
- Cognitive changes: re-orient/calendar
- Effective comm.: ST/comm. board
- Eye patches: diplopia
- Energy conservation
- Control body temp
- Proper catheterization technique
- Safe home/hospital environment
- Plan for disease progression
Meds For MS
- Immunosuppressive agents
- Stool softeners
Complications of MS
- Neurogenic bladder
What to do for spasticity?
- ROM exercises-maintain function
- Antispasmodics-relieve spasms
- Spinal injections/surgery-cut tendons
What to do for neutrogenic bladder?
- Faulty nerve comm btwn brain/bladder
- Control fluid intake
- Regulate elimination-self catheterization