multiple sclerosis

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Author:
nurse&dad
ID:
106529
Filename:
multiple sclerosis
Updated:
2011-10-05 18:36:09
Tags:
neuro muscularskeletal
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Description:
interventions
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  1. What is Multiple Sclerosis?
    • Chronic autoimmune disease that affects the myelin sheath and conduction pathway of the CNS
    • Marked by exacerbations & remissions
  2. 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
  3. Types of MS
    • Relapsing-remitting
    • Primary progressive
  4. What is relapsing-remitting MS?
    • Occurs in most cases
    • Symptoms develop and resolve in a few weeks to months
    • Pt returns to baseline
  5. What is primary progressive MS?
    • Steady and gradual neurologic deterioration
    • WITHOUT remission of symptoms
  6. 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)
  7. Assessment of MS (physical)
    • Muscle weakness/spasticity
    • Fatigye
    • Uthoff's sign
    • Tremors
    • Dysmetria
    • Numbness/tingling
    • Hypalgesia
    • Ataxia
    • Dysarthria
    • Dysphagia
    • Diploplia
    • Nystagmus
    • Scotomas
    • Decreased visual/hearing acuity
    • Tinnitus/vertigo
    • Bowel/bladder dysfunction
    • Alterations in sexual function
    • Cognitive changes
  8. Triggering factors for MS
    • Fatigue
    • Stress
    • Overexertion
    • Temp extremes
    • Hot shower/bath
  9. Diagnostics of MS
    • MRI-can see plaque
    • CSF-elevated protein, WBC's
  10. 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
  11. Meds For MS
    • Immunosuppressive agents
    • Corticosteroids
    • Antispasmodics
    • Interferon
    • Anticonvulsants
    • Stool softeners
    • Anticholenergics
    • Beta-Blockers
  12. Complications of MS
    • Spasticity
    • Neurogenic bladder
  13. What to do for spasticity?
    • ROM exercises-maintain function
    • Antispasmodics-relieve spasms
    • Spinal injections/surgery-cut tendons
  14. What to do for neutrogenic bladder?
    • Faulty nerve comm btwn brain/bladder
    • Control fluid intake
    • Regulate elimination-self catheterization

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