Multiple Sclerosis: Nursing Care Priorities and Interventions

RUNNING HEAD: MULTIPLE SCLEROSIS 1
Multiple sclerosis
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MULTIPLE SCLEROSIS 2
MULTIPLE SCLEROSIS
INTRODUCTION
Multiple Sclerosis (MS) is a condition that affects the brain and the spinal cord or the
nervous system and has the potential to lead to disability. It arises as a result of the immune
system attacking the myelin that protects the nerve fibers and this leads to difficulties in
communication between the brain and the body (Jacques & Lublin, 2015). The signs and
symptoms generally depend on the extent to which the nerves are damaged. Some notable signs
and symptoms however include fatigue, blurred vision and difficulties in the bladder functions
(Dendrou, Fugger, & Friese, 2015). In this assignment, there is a case study of a patient who is
likely to be suffering from MS. There will be presentation of the scenario, important information,
processing of the information, identification of problems, established goals, the nursing
interventions, evaluation, reflection and conclusion regarding the case study. This condition
commonly occurs in the older people. In this assignment, I will utilize the Millers Functional
Consequences Theory to identify the influences that impact old people and their level of
functioning. In so doing, I will utilize the Levett Jones Clinical Reasoning Cycle as the tool to
drive the whole process.
PART A: IDENTIFICATION OF THE THREE NURSING CARE PRIORITIES
THE PATIENT SCENARIO
The patient in this scenario is an 83 year old widower called Mr. Dinh Nguyen. The
patient was diagnosed with multiple sclerosis six years ago. He was also diagnosed with
osteoarthritis four years ago and currently he is on medication. The patient migrated from
Vietnam in 1976 and he currently lives alone in a two story home where he lived with his wife

MULTIPLE SCLEROSIS 3
called Ngoc until her death twelve Months ago. Since then, the patient has been independent.
With the ongoing grief however, the patient has noticed that there is a decline in his general
health because of the worsening exercabations of the Multiple Sclerosis. Since Dinh and Ngoc
never had any child, he has no immediate family. He only has his brother who is called Bao and
his family that lives close to Dinh. The patient does not however feel like involving them in his
life as it will be a bother to them.
The patient is always very careful with his little money .He said that he has a small
income from his superannuation which he cares by himself. This gives him some form of
financial independence. But since the investment are few, the returns are only used to cover his
expenses. He often goes on holiday once a year but this year he did not make due to the altered
mobility.
The patient noted that he has been experiencing blurred vision, numbness in the face as
well as an electric shock type of feeling whenever he tries to move his head and neck. This shock
usually travels down the back up to his legs and this negatively impacts his movements as well
as gait. It is this shock however that makes it difficult for him to accomplish tasks such as
cooking, showering and dressing very difficult. Bending down to do up the shoe laces is also
difficult for him. Recently Mr.Dinh has started experiencing urinary incontinences. Dinh feels
that the condition is getting worse and he has started getting worried with uncertainty of his
future. The current medications include Panadol osteo 6/24 oral prn a maximum of 6 per day.
There is also the Teriflunomide 14mg which is administered orally on a daily basis. Finally,
there is prednisolone 25 mg that is also administered orally BD whenever there is an
exacerbation.

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CUES/INFORMATION
Some of the important cues or information from the case study include urine
incontinence. Mr. .Dinh reported recent urine incontinence .The patient also noted of blurred
vision and numbness in the face. He also feels an electric shock kind of feeling whenever he tries
to move his head and neck. The patient was also diagnosed with Multiple Sclerosis four years
ago. There are also cases of exacerbations since the patient noted that the situation has begun to
get worse.
PROCESSING OF INFORMATION
From the case study, it was established that the patient had urinary incontinence. Urinary
incontinence is typical of the patients who are suffering from multiple sclerosis. Fatigue and
altered mobility are also common signs and symptoms. This is due to the electric shock kind of
feeling that starts at the head and the neck whenever the patient tries to move and it moves at the
back up to the legs and this renders the patient immobile therefore needing moving aids such as
wheelchairs.
IDENTIFICATION OF THE PROBLEM
From the case study, there are several health problems that can be identified. One of the
problems is impaired Urinary elimination .This is because Mr. Dinh mentioned in the assessment
that he had started experiencing urine incontinence. According to the Millers functional
consequences theory, ageing has the potential to affect the functioning of some parts of the
body(Bramble, 2012). For urine incontinence, the likely reason might be inelastic muscles in the
bladder that makes it impossible to eliminate urine. Self-care deficit is another problem identified
from the case study. The patient describe a form of electric shock that travels form the head and