MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic...
-
Upload
betty-allison -
Category
Documents
-
view
217 -
download
2
Transcript of MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic...
![Page 1: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/1.jpg)
MSاسکلروزیس مولتیپل
![Page 2: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/2.jpg)
Client with Multiple Sclerosis DescriptionChronic demyelinating disease of CNS associated with -abnormal immune response to environmental factorInitial onset followed by total remission making diagnosis difficult
-Most persons have disease with periods of exacerbations and remissions
Progression of disease with increasing loss of function - -Incidence is highest in young adults (20 – 40); onset
between 20 – 50Affects females more than males-
-More common in temperate climatesOccurs mainly in Caucasians -
![Page 3: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/3.jpg)
Pathophysiology Autoimmune response to prior viral infection Inflammation destroys myelin leading to axon dysfunction Myelin sheaths of white matter of spinal cord, brain, optic nerve
destroyed in patches called plaquesDemyelination slows and distorts nerve conduction resulting in
absence of impulse transmission Neurons in spinal cord, brain stem, cerebrum, cerebellum, and
optic nerve affected Recurrent demyelination and plaque formation result in
scarring of glia and degeneration of axons Disease follows different courses, most common is the
relapsing-remitting type Stressors trigger MS: febrile states, pregnancy, physical
exertion and fatigue; and these also can trigger relapses
![Page 4: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/4.jpg)
Manifestations 1. Fatigue2. Optic nerve involvement: blurred vision,
haziness3. Brain stem involvement: nystagmus, dysarthria
(scanning speech), cognitive dysfunctions, vertigo, deafness
4. Weakness, numbness in leg(s), spastic paresis, bladder and bowel dysfunction
5. Cerebellar: nystagmus, ataxia, hyptonia6. Blindness
![Page 5: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/5.jpg)
Collaborative Care
Focus is on retaining optimum functioning, limiting disability
![Page 6: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/6.jpg)
Diagnostic Tests • Neurological exam, careful history• Lumbar puncture with CSF analysis: increased
number of T lymphocytes; elevated level of immunoglobulin G (IgG)
• Cerebral, spinal optic nerve MRI: shows multifocal lesions
• CT scan of brain: changes• PET: measures brain activity• Evoked response testing of visual, auditory,
somatosensory impulses show delayed conduction
![Page 7: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/7.jpg)
Medications
ACTH Glucocorticosteroids Immunosuppressants: azathioprine (Imuran),
cyclophosphamide (Cytoxan) Cychophosphamide Antispasmodics to treat muscle spasms Medications to deal with bladder problems:
anticholinergics or cholinergics depending on problem experienced by client
![Page 8: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/8.jpg)
Rehabilitation
• Physical therapy to maintain abilities and deal with spasticity
![Page 9: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/9.jpg)
Health Promotion
• Client needs to develop strategies to deal with fatigue, exacerbations
• Prevention of respiratory and urinary tract infections
![Page 10: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/10.jpg)
Nursing Diagnoses
• Fatigue• Self care deficits
![Page 11: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/11.jpg)
Home Care
• Education• Referral to support group and resources• Referral to home health agencies when
condition requires
![Page 12: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/12.jpg)
![Page 13: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/13.jpg)
![Page 14: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/14.jpg)
![Page 15: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/15.jpg)
![Page 16: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/16.jpg)
![Page 17: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/17.jpg)
در میلین غالف MS تخریب
![Page 18: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/18.jpg)
![Page 19: MS مولتیپل اسکلروزیس. Client with Multiple Sclerosis Description Chronic demyelinating disease of CNS associated with - abnormal immune response to environmental.](https://reader036.fdocuments.net/reader036/viewer/2022082611/56649efa5503460f94c0bd0d/html5/thumbnails/19.jpg)