9 Multiple Sclerosis Nursing Care Plans

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Multiple sclerosis (MS) is the most common of the demyelinating disorders and the predominant CNS disease among young adults. MS is a progressive disease caused by demyelination of the white matter of the brain and spinal cord. In this disease, sporadic patches of demyelination throughout the central nervous system induce widely disseminated and varied neurologic dysfunction. MS is characterized by exacerbations and remissions, MS is a major cause of chronic disability in young adults.

The prognosis varies. multiple sclerosis may progress rapidly, disabling some patients by early adulthood or causing death within months of onset. However, 70% of patients lead active, productive lives with prolonged remissions.

The exact cause of MS is unknown, but current theories suggest a slow-acting or latent viral infection and an autoimmune response. Other theories suggest that environmental and genetic factors may also be linked to MS. Stress, fatigue, overworking, pregnancy or acute respiratory tract infections have been known to precede the onset of this illness. MS usually begins between ages 20 and 40. It affects more women than men.

Nursing Care Plans

The nursing care plan goals for patients with multiple sclerosis is to shorten exacerbations and relieve neurologic deficits so that the patient can resume a normal lifestyle.

Here are nine (9) nursing care plans (NCP) and nursing diagnosis for multiple sclerosis:

  1. Fatigue
  2. Self-care Deficit
  3. Low Self-Esteem
  4. Powerlessness/Hopelessness
  5. Risk for Ineffective Coping
  6. Ineffective Family Coping
  7. Impaired Urinary Elimination
  8. Deficient Knowledge
  9. Risk for Caregiver Role Strain
  10. Other Possible Nursing Care Plans
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Powerlessness/Hopelessness

Nursing Diagnosis

May be related to

  • Illness-related regimen, unpredictability of the disease
  • Lifestyle of helplessness

Possibly evidenced by

  • Verbal expressions of having no control or influence over situation
  • Depression over physical deterioration that occurs despite patient compliance with regimen
  • Nonparticipation in care or decision making when opportunities are provided
  • Passivity, decreased verbalization/affect
  • Verbal cues
  • Lack of involvement in care/passively allowing care
  • Isolating behaviors/social withdrawal

Desired Outcomes

  • Patient will identify and verbalize feelings.
  • Patient will make use of coping mechanisms to counteract feelings of hopelessness.
  • Patient will identify areas over which the individual has control.
  • Patient will participate/monitor and control own self-care and ADLs within limits of the individual situation.
Nursing Interventions Rationale
Note behaviors indicative of powerlessness or hopelessness. The patient may say statements of despair. The degree to which patient believes own situation is hopeless, that he or she is powerless to change what is happening, affects how patient handles life situation.
Acknowledge the reality of the situation, at the same time expressing hope for the patient. Although the prognosis may be discouraging, remissions may occur, and because the future cannot be predicted, hope for some quality of life should be encouraged. Additionally, research is ongoing and new treatment options are being initiated.
Encourage and assist the patient to identify activities he or she would like to be involved in within the limits of his or her abilities. Staying active and interacting with others counteract feelings of helplessness.
Discuss plans for the future. Suggest visiting alternative care facilities, taking a look at the possibilities for care as condition changes. When options are considered and plans are made for any eventuality, the patient has a sense of control over own circumstances.
Determine the degree of mastery the patient has exhibited in life to the present. Note locus of control. A patient who has assumed responsibility in life previously tends to do the same during difficult times of exacerbation of illness. However, if the locus of control has been focused outward, patient may blame others and not take control over own circumstances.
Assist patient to identify factors that are under own control. List things that can or cannot be controlled. Knowing and accepting what is beyond individual control can reduce helpless or acting out behaviors, promote focusing on areas individual can control.
Encourage patient to assume control over as much of own care as possible. Even when unable to do much physical care, an individual can help plan care, having a voice in what is desired or not.
Discuss needs openly with patient/SO, setting up agreed-on routines for meeting identified needs. Helps deal with manipulative behavior, when the patient feels powerless and not listened to.
Incorporate patient’s daily routine into home care schedule or hospital stay, as possible. Maintains a sense of control and self-determination and independence.
Refer to vocational rehabilitation as indicated. Can assist the patient to develop and implement a vocational plan incorporating specific interests and/or abilities.
Identify community resources. Participation in structured activities can reduce a sense of isolation and may enhance the feeling of self-worth.
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See Also

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Neurological Care Plans

Nursing care plans for related to nervous system disorders:

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