Nursing Assignment on Multiple Sclerosis: Clinical Reasoning Cycle and Self-Management Interventions

This nursing assignment discusses the clinical reasoning cycle and self-management interventions for patients with multiple sclerosis. It includes identification of problems, establishment of goals, and evaluation of outcomes. The paper also highlights the nursing priorities for managing the condition of the patient.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student:
Name of the University:
Author Note:

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Introduction
A potential disease of the nervous system, mainly causing disability of the system is
referred to as Multiple sclerosis. This disease effects the protective sheath of the brain and
thus severely affecting the cells of the immune system. Individuals at times also suffer from
paralysis along with loss of vision and loss of functioning of the brain (Sanai et al., 2016).
The case presented here shows that the patient has been diagnosed with multiple sclerosis six
years ago. However his symptoms show signs of reoccurrence of multiple sclerosis.
Therefore this paper, through the implementation of a clinical reasoning cycle will highlight
the nursing care plan that will be required for proper management of the health condition of
the patient. Additionally the paper will discuss the nursing priorities that are well identified
from the case presented in order to manage the condition of the patient. The paper shows that
using the self-management interventions, the health deficits of the patient can be addressed.
These self-management interventions have proved to be helpful for such patients as they have
shown to decrease the anxiety and depression in patients hence improving their psychological
well-being.
Clinical reasoning cycle
Through the use of the clinical reasoning cycle, the following assessments are accrued
out. In order to collect cues and process the given information evaluation is conducted
considering each aspect of the clinical reasoning cycle:

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1. Consider the patient
The patient here is Mr. Dinh Nguyen, who is a widower of 83 years of age. Six years prior he
had been diagnosed to have Multiple Sclerosis. He was additionally diagnosed to have
osteoarthritis four years back, however right now it was controlled taking drugs. In the year
1976, Nguyen's moved from Vietnam.
Dinh currently lives alone in his own two story home where already he had lived with
his partner , Ngoc. She had died a year back. Dinh stayed independently after the demise of
his partner. With the expansion of his pain, his confinement had expanded. There was a
evident decrease in his wellbeing alongside the declining of his intensifications because of
MS. Dinh and Ngoc were childless, in this manner Dinh had no close family. Be that as it
may, Dinh had a sibling, Bao, who alongside his family lived close by. Anyway Dinh did not
want to get involved with them and did not need trouble them. Dinh had a little wage which
he got from his self-guided superannuation hence was sufficiently cautious with his cash. His
funds were sufficiently only to cover his costs. He took relaxes once consistently, anyway
this year he was not able do as such because of his weakened mobility.
2. Collection of cues
Aside from being determined to have multiple sclerosis, he was likewise diagnosed to
have osteoarthritis. He experienced different issue like some obscured vision alongside
confront deadness that happened regularly. Furthermore he regularly had sensations like
"electric stun" while moving his head and neck. This sensation regularly went down his back
and into his legs. This affected his versatility and step in a serious way. This is making his
day by day tasks troublesome like cooking, washing and dressing. Acts like twisting down to
do up his shoe bands have turned out to be most hard to perform. There were likewise evident
scenes of urinary incontinence which Dinh had begun encountering recently. Dinh has seen

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that the procedure of his sickness is step by step exacerbating. Along these lines he is
beginning to be troubled that in what capacity will be ready to confront the vulnerability of
his future. He is as of now on medications like Panadol Osteo 4/24 Oral prn (most extreme 8
every day), Teriflunomide 14mg Oral day by day and Prednisolone 25mg Oral BD.
3. Process information
The data identified with the wellbeing of the patient gives prove that he had been
experiencing multiple sclerosis. The patient had demonstrated obscured vision that are some
early indications of MS. Furthermore manifestations like deadness of the face, bladder issues,
agonies and fits, unsteadiness and adjust issues, alongside psychological issues (Belbasis et
al., 2015). The greater part of this signs and manifestations were depicted by Dinh which
were identified with different sclerosis. Most presumably the lack of kids was identified with
sexual inability which is another indication of numerous sclerosis. In agreement to the
utilitarian outcomes hypothesis, the accompanying elements can be considered in connection
to various sclerosis. There are the age related changes, the hazard factors and the negative
utilitarian results. The factor of maturing is very noteworthy over the span of various
sclerosis. Literature demonstrates that the people who are beyond 65 years a years old more
prone to have a dynamic course showimg essential dynamic (PP), 29%. Moreover optional
dynamic (SP) is 26% alongside dynamic backsliding (PR) demonstrating 8%. In contrast with
the more youthful counterparts,there are 57% have backsliding transmitting various sclerosis
(RRMS) (Dendrou, Fugger& Friese, 2015).
4. Identification of the problems
Multiple sclerosis is a standout amongst the most widely recognized groups that is
demyelinating and is a prevalent ailment of the central nervous system, happening
particularly in the young adults. It is a sort of dynamic illness that is caused because of

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demyelination happening in the white matter of the cerebrum and additionally the spinal line
(Gold., 2013).
The best needs in dealing with different sclerosis are to abbreviate the intensifications
alongside soothing of the neurological shortfalls, to make the patient resume a standard
way of life.
A portion of the nursing care designs that can be received to lessen the issues of
different sclerosis incorporate weakness, shortage of self-mind, bringing down of
confidence.
Moreover solution for social isolation, adapting of family inadequacy with end of
urinary weakness is also provided (Kidd et al., 2017). Furthermore, administration ought to
be improved the situation information insufficiency and other nursing care designs.
5. Establish goals
Considering the best needs of nursing care plan, for this investigation the issue of self-
care deficit has been picked. The objectives are to be specific included have been built up
keeping in mind the end goal to advance self-administration interventions in the everyday
existence of the patients. With the assistance of interminable care demonstrate, the self-
administration procedures can be produced which makes it measurable. Objectives ought to
be actualized in way which will empower the patient to deal with their own particular
wellbeing to make the goal attainable and this help must be given by the doctors and other
medicinal services suppliers to make it realistic (Olsson, Barcellos and Alfredsson, 2017).
The objective will be tried to be accomplished within a time frame of two to three weeks.
Here the objective is to advance self-administration by nursing care display.

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6. Take actions
The self-administration interventions may incorporate medicinal manifestations
administration through which medications must be taken appropriately, adhering to the diet
that is prescribed. Utilization of medicinal devises must be taken after and life cleanliness
activities ought to be actualized like proper rest and activities. There ought to be part
administration, by creation and upkeep of new and important practices inside the existence
parts, which incorporates change of obligations inside the family. At long last there
passionate administration ought to be attempted. Circumstances of incited feelings must be
dealt with appropriately that incorporates misery alongside despondency, dread and outrage.
Intercessions incorporate remote, convey, face to face support, subjective conduct assemble
mediations alongside unending ailment self-administration course, motivational meeting and
phone guiding and wellbeing advancement instruction program (Ma, Chan &Carruthers,
2014).
7. Evaluate outcomes
The self-administration interventions adopted for the patients experiencing multiple
sclerosis helped the patients to enhance their mental prosperity. There were clear changes as
far as tension and depression diminishing. There was improvements of the patient that was
identified with the facilitators and the plausible obstructions related with the accomplishment
of self-administration interventions (Lublin., 2014). This can help the improvement of altered
interventions those are based on individual profiles of the patient and their inclinations. These
incorporate up close and personal and the remote conveyance. There is additionally a need to
consider the part of guardians in future for the advancement of self-administration mediations
as they are frequently required for the evident side effect administration in people
experiencing Multiple Sclerosis. There is a lot of confirmation as far as mental trouble in the
carers of people with MS (Belbasis et al., 2015). However there has been no noteworthy

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improvement regarding administrations and arrangements required to facilitate the caregiver
of the burden of these group of people.
Reflection
The identification of self-care deficit points to the disability of the capacity to perform
errands like showering, dressing bolstering or exercises of toileting all alone. This leads on to
conditions like dissatisfaction and poor individual cleanliness. In this way with a specific end
goal to oversee such patients, I would try to recognize the zone of shortcoming in the people.
Moreover I will make attempts to show the strategies of way of life changes so the patients
can meet their self-care needs.
The nursing intervention which I will try to execute will join the affirmation of the
present development level of the patient and their physical condition. I will encourage the
patient to perform self-care to the most extraordinary of limit as portrayed by tolerant,
anyway I will do whatever it takes not to be surge tolerant. Help will be given as
demonstrated by level of inadequacy alongside allowing self-administration to a level that
will be worthy. I will attempt to commit towards developing a proper plan of nursing (Gunn
et al., 2013). It is required to take note of the nearness of exhaustion at legitimate
interventions. It is required to imagine clean requirements for the patients and easily help as
essential with care of nails, skin, and hair; mouth mind; shaving. Arrangement of assistive
gadgets and enables like shower to situate, lifted toilet arrange with arm supports is required.
I will eliminate the chance to reposition the patient from time to time when tolerant is steady
(bed or seat bound). Giving of solid skin to weight centers, for instance, sacrum, bring down
legs, and elbows (Sanai et al., 2016). Stimulate broadening and molding exercises and usage

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of medications, cool packs, and backings and upkeep of legitimate body arrangement, when
shown (Hunter, 2016).
Conclusion
From the above investigations utilizing the clinical thinking cycle, the
pathophysiological and the mental states of the patient was distinguished. The hazard factors
alongside the age related issues and the negative results were likewise recognized. This
examination additionally distinguished the needs of the nursing care designs that are expected
to deal with the patients experiencing multiple sclerosis. Here the best need was distinguished
as self-care after which the mediations of self-administration. These self-administration
mediations have ended up being useful for such patients as they have appeared to diminish
the uneasiness and depression in patients consequently enhancing their mental prosperity.

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