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Multiple Sclerosis

Multiple Sclerosis. Abigail Lee. Rationale for Chosen Topic. Determining appropriate mobility assistive technology (MAT) for patients with physical disability due to Multiple Sclerosis (MS). Introduction. Purpose Statement

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Multiple Sclerosis

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  1. Multiple Sclerosis Abigail Lee

  2. Rationale for Chosen Topic Determining appropriate mobility assistive technology (MAT) for patients with physical disability due to Multiple Sclerosis (MS).

  3. Introduction Purpose Statement Identifying factors that effect the choice of MAT for patients with MS and what MAT options are available.

  4. Evidence for Care • Pathophysiology • Clinical Manifestations • Nursing Considerations • And finally… (Smeltzer, Bare, Hinkle, Cheever, 2010, p. 1956-1962)

  5. Evidence for Care • Dorothea Orem’s Self-Care Theory (Maville, Huerta, 2013, p. 33)

  6. Evaluation of Evidence • Methods • Used multiple key words in search • Concerning MS patients with impaired mobility • Peer-reviewed • Results • Multiple MAT choice factors • Limited number of higher levels of evidence • Recommendations (Souza, Kelleher, Cooper, Cooper, Iezzoni, Collins, 2010)

  7. Evaluation of Evidence • Article Critique • Level of Evidence • Limitations (Souza, Kelleher, Cooper, Cooper, Iezzoni, Collins, 2010)

  8. Patient Care Design Situation: Steve is a 26 yom who has come to the clinic after a recent onset of numbness and tingling in his extremities, a noted loss of balance, and has felt unusually clumsy. He has no significant medical history. He lives an active lifestyle and works as a grade school teacher. He is married with no children. He is accompanied by his wife, Sara, who is concerned because of Steve’s family history of Multiple Sclerosis. Steve appears anxious and states he is fearful of an MS diagnosis because he won’t be able to live the same lifestyle he has now. TRUEPIC 1. Identify… 26 yom No significant medical history Experiencing numbness, tingling, loss of balance, and lack of coordination Works as a school teacher Active lifestyle Fear of MS diagnosis 2. Relate… Primary Proposition: Pt is experiencing an onset of MS as evidenced by symptoms and family history. Possible Assumptions: Pt understands the process of MS on the body because of family history. Possible Confounding Variables: Pt is fearful of complications of MS. 3. Understand… Proposition: Pt is showing symptoms associated with MS, however, further testing should be completed. Significance of Assumptions: If pt does not understand the process of MS, he may miss significant education on the disease. Possible Confounding Variables: Pt may not know treatment options for patients with MS causes him to be fearful of a diagnosis.

  9. Patient Care Design 4. Explain… Proposition: In a way meaningful to the pt, explain symptoms, diagnosis, and treatment of MS. Assumptions: Give a thorough explain of MS even if the pt already has background regarding the disease and answer questions. Confounding Variables: Explain the benefits of different treatment options and how to help maintain current lifestyle. TRUEPIC continued… 5. Predict… Proposition: If pt does have a diagnosis of MS, it is important to then provide information regarding MS treatment and self-care. Assumptions: Pt will understand the process of MS. Confounding Variables: If pt fear of a diagnosis of MS can be resolved, then an appropriate treatment plan can be set with goals and collaboration. 6. Influence… Proposition: Make sure the pt understands what is necessary to complete a diagnosis of MS. Assumptions: Make sure the patient understands the process, symptoms, complications, and treatment if MS is diagnosed. Confounding Variables: Share treatment options that may be helpful in maintaining quality of life and the pt’s current lifestyle. 7. Control… -Pt will understand the process of MS -Pt will state treatment options that are available -Pt will set goals and keep appointments for MS treatment Nursing Diagnosis for MS: 1. Impaired physical mobility r/t neuromuscular impairment 2. Self-care deficit r/t neuromuscular impairment 3. Risk for injury r/t sensory dysfunction and impaired mobility (Ladwig, Ackley, 2011, p. 99)

  10. Advocate Role • MAT • Assess patients individually to find an appropriate MAT for their lifestyle • Symptoms • Pain • Physical health • Others

  11. Advocate Role • Significance to Nursing Practice and Care

  12. References Ladwig, G. B., & Ackley, B. J. (2011). Mosby's guide to nursing diagnosis (3rd ed.). Maryland Heights, MO: Mosby. Maville, J. A., & Huerta, C. G. (2013). Nursing concepts and health promotion. In Health Promotion in Nursing (3rd ed., pp. 32-34). Clifton Park, NY: Delmar. Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Management of patients with neurologic infections, autoimmune disorders, and neuropathies. In Medical-Surgical Nursing (12th ed., pp. 1956-1962). Philadelphia, PA: Wolters Kluwer Health. Souza, A., Kelleher, A., Cooper, R., Cooper, R. A., Iezzoni, L. I., & Collins, D. M. (2010). Multiple sclerosis and mobility-related assistive technology: systematic review of literature. Journal of Rehabilitation Research & Development, 47(3), 213-23. Retrieved from http://0- dx.doi.org.libcat.ferris.edu/10.1682/JRRD.2009.07.0096

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