Question

System Disorder
Topic: Multiple sclerosis
Alteration in Health (Diagnosis)

Client Problem Related to Alteration in Health

Pathophysiology Related to Client Problem

Assessment

Past Medical History=

Risk Factors=

Objective and Subjective Data=

Medications=

Laboratory Data=

Diagnostic Procedures/Surgical Interventions=

Nursing Interventions (Evidence-Based)=

Client Education=

Outcomes/Evaluations=

Teamwork and Collaboration

Discharge Planning

Interprofessional Care

Coordination of Client Care

Answer 1

Alterations in health

While most people with MS have a close-to-normal life expectancy, it can be difficult for doctors to predict whether their condition will worsen or improve, since the disease varies so much from person to person. In most cases, however, MS isn't a fatal condition.

Pathophysiology

Multiple sclerosis is an inflammatory demyelinating disease of the CNS in which activated immune cells invade the central nervous system and cause inflammation, neurodegeneration, and tissue damage. The underlying cause is currently unknown.

There are three clinical phenotypes: relapsing-remitting MS (RRMS), characterized by periods of neurological worsening following by remissions; secondary-progressive MS (SPMS), in which there is gradual progression of neurological dysfunction with fewer or no relapses; and primary-progressive MS (MS), in which neurological deterioration is observed from onset.

Pathophysiology is a convergence of pathology with physiology. Pathology is the medical discipline that describes conditions typically observed during a disease state; whereas physiology is the biological discipline that describes processes or mechanisms operating within an organism. Referring to MS, the physiology refers to the different processes that lead to the development of the lesions and the pathology refers to the condition associated with the lesions.

in neuropathology, neuroimmunology, neurobiology, and neuroimaging, together with clinical neurology, provide support for the notion that MS is not a single disease but rather a spectrum.

Risk factors

These factors may increase your risk of developing multiple sclerosis:

Age. MS can occur at any age, but onset usually occurs around 20 and 40 years of age. ...

Sex. ...

Family history. ...

Certain infections. ...

Race. ...

Climate. ...

Vitamin D. ...

Certain autoimmune diseases.

Diagnosis

Blood tests, to help rule out other diseases with symptoms similar to MS. Tests to check for specific biomarkers associated with MS are currently under development and may also aid in diagnosing the disease.

Spinal tap (lumbar puncture), in which a small sample of cerebrospinal fluid is removed from your spinal canal for laboratory analysis. This sample can show abnormalities in antibodies that are associated with MS. A spinal tap can also help rule out infections and other conditions with symptoms similar to MS.

MRI, which can reveal areas of MS (lesions) on your brain and spinal cord. You may receive an intravenous injection of a contrast material to highlight lesions that indicate your disease is in an active phase.

Evoked potential tests, which record the electrical signals produced by your nervous system in response to stimuli. An evoked potential test may use visual stimuli or electrical stimuli. In these tests, you watch a moving visual pattern, or short electrical impulses are applied to nerves in your legs or arms. Electrodes measure how quickly the information travels down your nerve pathways.

Treatments for MS attacks

Corticosteroids, such as oral prednisone and intravenous methylprednisolone, are prescribed to reduce nerve inflammation. Side effects may include insomnia, increased blood pressure, increased blood glucose levels, mood swings and fluid retention.

Plasma exchange (plasmapheresis). The liquid portion of part of your blood (plasma) is removed and separated from your blood cells. The blood cells are then mixed with a protein solution (albumin) and put back into your body. Plasma exchange may be used if your symptoms are new, severe and haven't responded to steroids.

There are no specific tests for MS. Instead, a diagnosis of multiple sclerosis often relies on ruling out other conditions that might produce similar signs and symptoms, known as a differential diagnosis.