1. Nursing Diagnosis: Ineffective family coping related to role changes as evidenced by disability progression. Interventions: encourage expression of feelings, refer client to support groups and community resources. Expected outcome: patient will have a better understanding of disease progression and communicate effectively with family.
2. Nursing Diagnosis: Fatigue related to pain and discomfort as evidenced by patients complaints of lack of energy and uncontrolled pain. Interventions: plan rest periods between activities, prioritize activities, administer analgesics as ordered. Expected outcome: Client will have ability to participate in ADL's and maintain a level of independence. Clients pain will be controlled by administering medication as ordered.
3. Nursing Diagnosis: Disturbed sensory perception related to altered sensory perception as evidenced by patient complaints of vision changes. Interventions: Maintain a safe space for patient. Always leave call bell within reach as well as other personal items. Assess client for the need for adaptive equipment. Expected outcome: Client will understand the reason for vision changes, and will follow safety measures put in place.
4. Labs and tests: MRI to look for changes in the myelin sheath. No specific blood test, however CBC/BMP may be done to rule out other conditions.
5. Etiology: Unknown, but possibly autoimmune Psychophysiology: myelin sheath covering the nerves is destroyed resulting in weak electrical impulses and weak muscle contractions.
6. Signs and symptoms: in the beginning difficulty walking, tremors, lack of coordination, "pins and needles" numbness, visual changes. More severe: paralysis, dysphagia, bowel and bladder dysfunction, cognitive dysfunction, depression, emotional upsets, headache, pain, fatigue, seizures, spasticity, nausea, vomiting, vision loss.
7. Medications: IV corticotropin, Avonex, Betaseron, fingolimont, teriflunomide, dimenthylfumarate. PT/OT are helpful as well.
