Multiple Sclerosis Management and Nursing Care

The assignment explores the management of multiple sclerosis (MS) through a case study of Andrea, who experiences symptoms such as lack of control over bladder, mobility issues, pain, weakness, and fatigue. The analysis covers nursing care plans, medication, dietary services, and the importance of stress management to prevent relapse. It also references relevant research articles and online resources for further information.

NURSING Q & A

TABLE OF CONTENTS
QUESTION 1...................................................................................................................................1
QUESTION 2...................................................................................................................................1
QUESTION 3...................................................................................................................................3
QUESTION 4...................................................................................................................................3
QUESTION 5...................................................................................................................................3
QUESTION 6...................................................................................................................................4
QUESTION 7...................................................................................................................................5
QUESTION 8...................................................................................................................................5
QUESTION 9...................................................................................................................................6
REFERENCES................................................................................................................................7

QUESTION 1
ASSESSMENT RATIONALE
Physical This will assist in managing risks of falling, restlessness and
impairment felt by Andrea due to Multiple Sclerosis. This will
assist in boosting sense of living and will help in motivating her for
moving body(Sawcer and et.al., 2011).
Environmental Support from Daniel and children by assisting her in household
chores, hygiene, and dressing.
Psychological For improving her level of managing daily life functions such as
kids and household work. The assistance is the motive, which will
help in alleviating Andrea to cope up with entire situation and
impairment of speech, lack of control over body etc.
Psychosocial Development of relationship in order to manage stability of mind to
avoid situations like separation from Daniel can hamper central
nervous functioning of Andrea. The motive behind managing
development of relationship between Daniel and Andrea is to make
her comfortable in surroundings.
QUESTION 2
ASSESSMENT INTERVENTION EVALUATION
Physical Physical therapies aims at
exercising to promote
mobility which will include
electroencephalography, joint
therapy, stretching and
meditation.
Involvement in therapies will
assist to promote mobility of
body, which will help in
promoting development of
Andrea. Moreover, it will
assist in reducing her fear of
falling and walking.
Environmental It will be based on dietary
modification, proper
The person suffering from MS
lost control over basic living
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medication and healthy
surrounding (Kappos and
et.al., 2010).
habits like Andrea who has
lost control of her bladder.
Further, she chokes while
eating food and she struggles
through eating and sleeping
disorder. However, to control
this it is necessary for the
family and community care
nurse to assist her in basic
environmental necessity.
Psychological In this, the focus will be on her
behavioural factors, which
regulates her health. Providing
emotional stability and
cognition therapies for
promoting her inclusion with
surrounding.
In accordance to psychological
development of Andrea, the
focus of family and nurse will
be on involving her in
surrounding and different
situations. Further, it is
necessary of Daniel, her
husband and children to
support her in social and
psychological development.
The support and inclusion of
Andrea will help in coping
with impairment, pain and
other assessments.
Psychosocial Prevention from relapse by
managing control over
surrounding is the best
intervention which aims at
improving neurological
functioning. Here focus of
It is essential to control
psychosocial because it is
directly concerned with
Andrea. These interventions
will aim at promoting stability
for her with regard to situation
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practitioner will be on
substance cessation and social
disorders.
where she is worried about her
marriage.
QUESTION 3
As per the condition of Andrea, it has been analysed that she is unable to deal with the
basic living conditions because of lack of control over her body. With regard to severity of
Multiple Sclerosis, it can be said that there are various disorder and health condition which will
influence and are impacting her married life with Daniel such as:
 Due to her ignorance over symptoms of MS, now she has continence where she lost
control over bladder especially during night (Lublin and et.al., 2014). This situation
caused inconvenience for Daniel, because of which he was wondering to separate beds,
where she felt her health condition will end their marriage.
 Daniel performs all household work and also helps Andrea in maintaining hygiene and
daily living activities due to which he works late night. Increased work pressure and no
emotional and physical support is another condition, which are the cause of influenced
behaviour of Daniel.
 Sexual dysfunction is the disorder of MS, which is impacting relationship of Andrea with
Daniel.
QUESTION 4
1. Physical therapy is the intervention, which can assist in comforting Andrea with
regard to pain and fatigue (Vera, 2014). This will assist in reducing nausea and
encouraging sense of living in service users.t to assist Daniel in developing
positivity in their relationship.
2. Monitoring and reviewing dietary routine of Andrea will assist in increase
mobility of body. Review will assist in reducing inadequacy of medication and
nutrition will assist in overcoming weakness.
3. Seeking help from continence service providers is an intervention which will
assist Daniel in reducing bowel issues of Andrea, which will aid in promoting
hygiene in living condition and will assist in managing sexual dysfunction.
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QUESTION 5
TYPE OF PAIN POTENTIAL CAUSES
Neuropathic pain Sensation of pain on face muscles is due to unstable neurological
functioning. Further, it caused due to damaged covering of brain
nerves, which increases feeling like needles, burning, pins,
numbness and crawling. Nerve pain is reflected by lhermitte sign
where patient experiences feelings of electric shock. Further, there
is MS Hug, in which patient feels acute chest and rib pain.
Musculoskeletal pain In this, patient experiences pain in muscle, joints, back and hip.
However, hip pain is caused due to alternation and stiffness in
muscles. Further, back pain is experienced due to difficulty in
walking and fatigue (Krupp and et.al., 2013).
MS treatment-related pain The cause of this pain can be caused due to injection, intravenous
setting. Further, it can be caused due to antiseptic agents who are
used by nurse for maintaining hygiene of Andrea.
MS unrelated pain It comprises of body weakness, headache, and pain caused due to
therapies.
QUESTION 6
NON-
PHARMACEUTICAL
INTERVENTION
JUSTIFICATION
Massage Gentle massage to Andrea can assist community nurse in managing
her pain caused due to stiffness and walking difficulty. It is the
activity that helps in relaxing patient by reliving their pain and
symptoms of illness (Managing Pain: Beyond Drugs, 2018).
Physical exercising It encourages mobility in human body to assist nurse in enabling
confidence to Andrea for walking and managing pain with own
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physical movement.
Gel packs It is the simplest method of managing pain with the help of chill or
warm water packs. It helps in setting comfortable and relaxed
atmosphere around patient which assists in easing illness.
Acupuncture It is a technique of inserting needles in specific joints and points of
body. It is done to regulate and diverse flow of energy, which assist
in relieving acute pain caused due to major therapies such as
chemotherapy. However, it can also be used for Andrea for
irresistible pain caused due to stiffness and body movements.
QUESTION 7
DRUG CLASS OF DRUG INDICATION
Baclofen 10 – 30 mg Tablet
PRN max 30mg per day
Muscle relaxants –
Musculoskeletal System
To suppress voluntary muscle
spasm in multiple sclerosis and
in spinal lesions of infectious,
neoplastic, traumatic,
degenerative and unknown
origin, resulting skeletal
hypertonus and dyssynergic
and spastic bladder
malfunction.
Diazepam Antianxiety agents – Central
Nervous System
For the short-term relief of the
symptoms of anxiety and to
treat anxiety disorders.
Gabapentin Anticonvulsants - Central
Nervous System
Management of partial
seizures including secondary
generalised tonic clonic
seizures in adults.
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QUESTION 8
In accordance to present condition of Andrea and children, it has been determined that
Daniel is involved in all household work and hygiene of Andrea whereas for kids, Jasmine who
is eldest among children prepares breakfast and helps Olivia and Sophia in getting ready for
school. Further, being an elder one, if Daniel is late from work then Jasmine also assist Andrea
and her two sisters with bedding.
In accordance to situation, it is necessary for the family to manage stability in living condition of
children with the help of multidisciplinary services such as:
 Continence service: It includes quality nursing team member who assists the patient
with bladder problem. In case of Andrea, it is a treatable cause and therefore needs to be
managed with quality team members (Continence Service, 2017). Daniel should focus on
implementing continence service of Andrea, which will help the family in managing
bowel issues with clinical process.
 Dietary services: Daniel and Andrea should focus on dietary services, which will help
the family in maintaining healthy routine. In these services' dietician focuses on
providing full patient care by assessing individuals nutritional needs and diet plans.
Further, the focus of service provider is on making patient aware about the needs of
modifying diet plans to encourage healthy living.
QUESTION 9
Prognosis for Multi sclerosis is related to severity of diseases and situation. In case of
Andrea where she was experiencing lack of control over bladder, mobility issues, pain, weakness
and fatigue in clinical terms. Apart from this, she was experiencing stress from family and
relationship concerns where her children were involved in household work and husband wanted
to separate their bed. These are the core issues which are been analysed with diagnosis and
medication. However, as per the situation, it can be said that stress due to financial pressure
which can be dangerous of the health stability of Andrea.
However, relapsing of MS is possible due to worsening of neurological function, steady
decline in health, avoiding diet plans. In addition, relapse can be possible when body of Andrea
stops reacting to medication and interventions (Kappos and et.al., 2010). Apart from this,
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Infection such as urinary tract infections can trigger Andrea's immune response to medications.
Thus, it can be concluded that stress of health and family condition holds the risk of relapse,
which will be hard to manage.
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