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.
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.
- Self-care Deficit
- Low Self-Esteem
- Risk for Ineffective Coping
- Ineffective Family Coping
- Impaired Urinary Elimination
- Deficient Knowledge
- Risk for Caregiver Role Strain
- Other Possible Nursing Care Plans
Risk for Caregiver Role Strain
- Risk for Caregiver Role Strain
Risk factors may include
- Severity of illness of the care receiver, duration of caregiving required,
- complexity/amount of caregiving task
- Caregiver is female, spouse
- Care receiver exhibits deviant, bizarre behavior
- Family/caregiver isolation; lack of respite and recreation
- Patient will identify individual risk factors and appropriate interventions.
- Patient will demonstrate/initiate behaviors or lifestyle changes to prevent the development of impaired function.
- Patient will use available resources appropriately.
- Patient will report satisfaction with plan and support available.
|Note physical/mental condition, therapeutic regimen of the care receiver.||Determines individual needs for planning care. Identifies strengths and how much responsibility the patient may be expected to assume, as well as disabilities requiring accommodation.|
|Determine caregiver’s level of commitment, responsibility, involvement in and anticipated length of care. Use assessment tool, such as Burden Interview, to further determine caregiver’s abilities, when appropriate.||Progressive debilitation taxes caregiver and may alter the ability to meet patient or own needs.|
|Discuss caregiver’s view of and about the situation.||Allows ventilation and clarification of concerns, promoting understanding.|
|Determine available supports and resources currently used.||Organizations can provide information regarding the adequacy of supports and identify needs.|
|Facilitate family conference to share information and develop a plan for involvement in care activities as appropriate.||When others are involved in care, the risk of one person’s becoming overloaded is lessened.|
|Identify additional resources to include financial, legal assistance.||These areas of concern can add to the burden of caregiving if not adequately resolved.|
|Identify adaptive equipment needs and resources for the home and vehicles.||Enhances the independence and safety of both caregiver and patient.|
|Provide information and/or demonstrate techniques for dealing with acting-out or violent or disoriented behavior.||Helps caregiver maintain a sense of control and competency. Enhances safety for care receiver and caregiver.|
|Stress importance of self-nurturing: pursuing self-development interests, personal needs, hobbies, and social activities.||Taking time for self can lessen the risk of “burnout”/being overwhelmed by the situation.|
|Identify alternate care sources (such as sitter or day care facility), senior care services, home care agency.||As patient’s condition worsens, SO may need additional help from several sources to maintain patient at home even on a part-time basis.|
|Assist caregiver to plan for changes that may be necessary for the care receiver (eventual placement in an extended care facility).||Planning for this eventually is important for the time when the burden of care becomes too great.|
|Refer to supportive services as need indicates.||Medical case manager or social services consultant may be needed to develop an ongoing plan to meet the changing needs of the patient and SO/family.|
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Neurological Care Plans
Nursing care plans for related to nervous system disorders:
- Alzheimer's Disease | 13 Care Plans
- Brain Tumor | 3 Care Plans
- Cerebral Palsy | 7 Care Plans
- Cerebrovascular Accident | 8+ Care Plans
- Guillain-Barre Syndrome | 6 Care Plans
- Meningitis | 7 Care Plans
- Multiple Sclerosis | 9 Care Plans
- Parkinson's Disease | 9 Care Plans
- Seizure Disorder | 4 Care Plans
- Spinal Cord Injury | 12 Care Plans