VI. Nursing Diagnosis
• Impaired bed and physical mobility related to weakness, muscle paresis, spasticity
• Risk for injury related to sensory and visual impairment
• Impaired urinary and bowel elimination (urgency, frequency, incontinence, constipation) related to nervous system dysfunction
• Impaired verbal communication and risk for aspiration related to cranial nerve involvement
• Disturbed thought process (loss of memory, dementia, euphoria) related to cerebral dysfunction
• Ineffective individual coping related to uncertainty of course of MS
• Impaired home maintenance management related to physical, psychological, and social limits imposed by MS
• Potential for sexual dysfunction related to lesions or psychological reaction
VII. Nursing Management
Promoting Physical mobility
• Instruction in the use of assistive devices may be needed to ensure their safe and correct use.
• Minimizing spasticity and contractures by using warm packs but hot baths should be avoided because of risk for burn injury secondary to sensory loss and increasing symptoms that may occur with elevation of the body temperature.
• Minimizing effects of immobility and measures to prevent such complications include assessing and maintaining skin integrity and having the patient perform coughing and deep breathing exercises.
Preventing Injury
Enhancing Bladder and Bowel control
• Increase OFI, high fiber diet (for constipation), acid-ash in diet to acidify urine to prevent bacterial multiplication (cranberry juice, prunes, grape juice, vitamin c, orange and pineapple juice.)
Enhancing communication and managing swallowing difficulties
Improving sensory and cognitive function
• Vision: An eye patch or a covered eyeglass lens may be used to block the visual impulses of one eye if the patient has diplopia (double vision)
• Cognition and Emotional responses: The patient is assisted to set meaningful and realistic goals. The family should be made aware of the nature and degree of cognitive impairment
• Strengthening Coping Mechanisms: alleviating stress, making appropriate referrals for counseling and support to minimize the adverse effects of dealing with chronic illness.
Improving Home management
Promote sexual functioning