1. The client/caregiver can define multiple sclerosis.
   1. It is a progressive degenerative disease caused by the destruction of the myelin sheath of the nerve tissue, which interrupts nerve impulses.
   2. It is characterized by remissions and exacerbations.
   3. It usually affects adults between the ages of 20 and 40 years.
2. The client/caregiver can list factors that increase risk of multiple sclerosis.
   1. Cool, temperate climates
   2. Allergic reactions to infections
   3. Familial tendency
   4. Viral infection
3. The client/caregiver can recognize signs and symptoms.
   1. Slow, monotonous slurred speech
   2. Visual disturbances
   3. Weakness of lower extremities
   4. Dizziness
   5. Numbness or tingling in extremities
   6. Bladder or bowel dysfunction
   7. Impaired sense of touch and pain
   8. Spasticity of muscles
   9. Mood swings
   10. Fatigue
   11. Difficulty swallowing or chewing
4. The client/caregiver can list measures for management of multiple sclerosis.
   1. Avoid factors that can cause exacerbation:
      1. Infections
      2. Excess heat: hot tubs or sauna
      3. Excess cold
      4. Physical and emotional stress
      5. Pregnancy
      6. Trauma
   2. Exercise regularly with frequent rest periods.
   3. Plan regular rest periods to avoid fatigue.
   4. Take medications as prescribed.
   5. Avoid over-the-counter medications unless recommended by physician.
   6. Consider air conditioning for home.
   7. Eat a well-balanced, high-fiber diet with fluid intake of at least six to eight glasses per day to promote bowel function.
   8. Use safety measures to prevent injury (safety measures teaching guide).
   9. Use assistive and self-help devices as needed to promote maximum independence.
   10. Keep follow-up appointments with physician and therapists.
   11. Continue hobbies and social interests as tolerated.
   12. Be aware of signs of depression and how to seek help.
   13. Use stress-management techniques.
   14. Report any early signs and symptoms of urinary tract or respiratory infections.
   15. Practice bladder and bowel retraining.
   16. Wear Medic Alert bracelet.
5. The client/caregiver is aware of possible complications.
   1. Renal insufficiency
   2. Respiratory infections
   3. Suicidal tendencies from depression
   4. Falls
   5. Constipation
   6. Incontinence
   7. Urinary tract infections
   8. Poor coordination, staggering gait
   9. Spasticity of extremities

Resources

National Multiple Sclerosis Society
https://www.nationalmssociety.org

Counseling, including sexual counseling

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Nutrition made incredibly easy. (2003). Springhouse: Lippincott, Williams & Wilkins.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, D., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott Williams & Wilkins. Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott
Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com