Nursing Care Plan for Multiple Sclerosis (MS)

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Pathophysiology

Chronic, progressive demyelination of the neurons in the CNS. This leads to spastic and slow nerve impulses. This impairs movement and sensation and can cause issues with bowels, bladder, and vision.  MS comes in cycles of remission and exacerbation.

Etiology

The cause of MS is unknown, though suspected to have a genetic component. It primarily is diagnosed between the ages of 20-40 years old.

Desired Outcome

Optimize patients’ level of functioning while managing symptoms such as pain, incontinence, and difficulty swallowing.

Multiple Sclerosis (MS) Nursing Care Plan

Subjective Data:

  • Fatigue
  • Weakness
  • Pain
  • Numbness
  • Visual Disturbances
  • Mood swings

Objective Data:

  • Tremors
    • Bowel dysfunction
    • Constipation
  • Diarrhea
  • Bladder incontinence
  • Decreased peripheral sensation

Nursing Interventions and Rationales

  • Administer medications as ordered:
    • Analgesics
    • Muscle Relaxants

 

Therapeutic management is mostly supportive. Analgesics can help with the aching joints, while muscle relaxants can calm some of the tremors and spastic muscles. Gabapentin is especially helpful.

 

  • Encourage activity independence

 

As the disease progresses, patients will lose their independence. Encourage them to stay active as long as possible to keep up their strength.

 

  • Educate patient on energy conservation techniques

 

Patients get fatigued easily, teach them to cluster their activities and provide frequent rest periods to conserve their energy for important tasks.

 

  • Educate patient on bowel and bladder training

 

Bowel and bladder training includes planning to go to the bathroom at specific intervals. This helps to minimize and avoid incontinence episodes.

 

  • Ensure patient maintains adequate fluid intake of at least 2000 mL/day.

 

Due to incontinence and weakness, patients often choose not to drink much to try to avoid accidents. It’s very important that they get adequate fluid intake.

 

  • Check temperature on water and heating pads, educate patient to adjust max temperature on water heater at home.

 

Decreased sensation for pain and temperatures means that MS patients are at risk for burns because they can’t feel how hot the water is. Turning the max temperature down can help to prevent this from happening.

 

  • Ensure safety from falls in the home (move rugs, cords, etc.)

 

Decreased sensation peripherally combined with weakness means that the patient’s response time will be diminished and their ability to catch themselves from falling is poor.

 


References

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