Assessment using Clinical Reasoning Cycle
A potential disease of the nervous system, mainly causing disability of the system is referred to as Multiple sclerosis. This disease effects the protective sheath of the brain and thus severely affecting the cells of the immune system. Individuals at times also suffer from paralysis along with loss of vision and loss of functioning of the brain (Sanai et al., 2016). The case presented here shows that the patient has been diagnosed with multiple sclerosis six years ago. However his symptoms show signs of reoccurrence of multiple sclerosis. Therefore this paper, through the implementation of a clinical reasoning cycle will highlight the nursing care plan that will be required for proper management of the health condition of the patient. Additionally the paper will discuss the nursing priorities that are well identified from the case presented in order to manage the condition of the patient. The paper shows that using the self-management interventions, the health deficits of the patient can be addressed. These self-management interventions have proved to be helpful for such patients as they have shown to decrease the anxiety and depression in patients hence improving their psychological well-being.
Through the use of the clinical reasoning cycle, the following assessments are accrued out. In order to collect cues and process the given information evaluation is conducted considering each aspect of the clinical reasoning cycle:
The patient here is Mr. Dinh Nguyen, who is a widower of 83 years of age. Six years prior he had been diagnosed to have Multiple Sclerosis. He was additionally diagnosed to have osteoarthritis four years back, however right now it was controlled taking drugs. In the year 1976, Nguyen’s moved from Vietnam.
Dinh currently lives alone in his own two story home where already he had lived with his partner , Ngoc. She had died a year back. Dinh stayed independently after the demise of his partner. With the expansion of his pain, his confinement had expanded. There was a evident decrease in his wellbeing alongside the declining of his intensifications because of MS. Dinh and Ngoc were childless, in this manner Dinh had no close family. Be that as it may, Dinh had a sibling, Bao, who alongside his family lived close by. Anyway Dinh did not want to get involved with them and did not need trouble them. Dinh had a little wage which he got from his self-guided superannuation hence was sufficiently cautious with his cash. His funds were sufficiently only to cover his costs. He took relaxes once consistently, anyway this year he was not able do as such because of his weakened mobility.
Nursing Priorities for Managing Multiple Sclerosis
Aside from being determined to have multiple sclerosis, he was likewise diagnosed to have osteoarthritis. He experienced different issue like some obscured vision alongside confront deadness that happened regularly. Furthermore he regularly had sensations like “electric stun” while moving his head and neck. This sensation regularly went down his back and into his legs. This affected his versatility and step in a serious way. This is making his day by day tasks troublesome like cooking, washing and dressing. Acts like twisting down to do up his shoe bands have turned out to be most hard to perform. There were likewise evident scenes of urinary incontinence which Dinh had begun encountering recently. Dinh has seen that the procedure of his sickness is step by step exacerbating. Along these lines he is beginning to be troubled that in what capacity will be ready to confront the vulnerability of his future. He is as of now on medications like Panadol Osteo 4/24 Oral prn (most extreme 8 every day), Teriflunomide 14mg Oral day by day and Prednisolone 25mg Oral BD.
The data identified with the wellbeing of the patient gives prove that he had been experiencing multiple sclerosis. The patient had demonstrated obscured vision that are some early indications of MS. Furthermore manifestations like deadness of the face, bladder issues, agonies and fits, unsteadiness and adjust issues, alongside psychological issues (Belbasis et al., 2015). The greater part of this signs and manifestations were depicted by Dinh which were identified with different sclerosis. Most presumably the lack of kids was identified with sexual inability which is another indication of numerous sclerosis. In agreement to the utilitarian outcomes hypothesis, the accompanying elements can be considered in connection to various sclerosis. There are the age related changes, the hazard factors and the negative utilitarian results. The factor of maturing is very noteworthy over the span of various sclerosis. Literature demonstrates that the people who are beyond 65 years a years old more prone to have a dynamic course showimg essential dynamic (PP), 29%. Moreover optional dynamic (SP) is 26% alongside dynamic backsliding (PR) demonstrating 8%. In contrast with the more youthful counterparts,there are 57% have backsliding transmitting various sclerosis (RRMS) (Dendrou, Fugger& Friese, 2015).
Multiple sclerosis is a standout amongst the most widely recognized groups that is demyelinating and is a prevalent ailment of the central nervous system, happening particularly in the young adults. It is a sort of dynamic illness that is caused because of demyelination happening in the white matter of the cerebrum and additionally the spinal line (Gold., 2013).
Self-Management Interventions for Multiple Sclerosis Patients
The best needs in dealing with different sclerosis are to abbreviate the intensifications alongside soothing of the neurological shortfalls, to make the patient resume a standard way of life.
A portion of the nursing care designs that can be received to lessen the issues of different sclerosis incorporate weakness, shortage of self-mind, bringing down of confidence.
Moreover solution for social isolation, adapting of family inadequacy with end of urinary weakness is also provided (Kidd et al., 2017). Furthermore, administration ought to be improved the situation information insufficiency and other nursing care designs.
Considering the best needs of nursing care plan, for this investigation the issue of self-care deficit has been picked. The objectives are to be specific included have been built up keeping in mind the end goal to advance self-administration interventions in the everyday existence of the patients. With the assistance of interminable care demonstrate, the self-administration procedures can be produced which makes it measurable. Objectives ought to be actualized in way which will empower the patient to deal with their own particular wellbeing to make the goal attainable and this help must be given by the doctors and other medicinal services suppliers to make it realistic (Olsson, Barcellos and Alfredsson, 2017). The objective will be tried to be accomplished within a time frame of two to three weeks. Here the objective is to advance self-administration by nursing care display.
The self-administration interventions may incorporate medicinal manifestations administration through which medications must be taken appropriately, adhering to the diet that is prescribed. Utilization of medicinal devises must be taken after and life cleanliness activities ought to be actualized like proper rest and activities. There ought to be part administration, by creation and upkeep of new and important practices inside the existence parts, which incorporates change of obligations inside the family. At long last there passionate administration ought to be attempted. Circumstances of incited feelings must be dealt with appropriately that incorporates misery alongside despondency, dread and outrage. Intercessions incorporate remote, convey, face to face support, subjective conduct assemble mediations alongside unending ailment self-administration course, motivational meeting and phone guiding and wellbeing advancement instruction program (Ma, Chan &Carruthers, 2014).
The self-administration interventions adopted for the patients experiencing multiple sclerosis helped the patients to enhance their mental prosperity. There were clear changes as far as tension and depression diminishing. There was improvements of the patient that was identified with the facilitators and the plausible obstructions related with the accomplishment of self-administration interventions (Lublin., 2014). This can help the improvement of altered interventions those are based on individual profiles of the patient and their inclinations. These incorporate up close and personal and the remote conveyance. There is additionally a need to consider the part of guardians in future for the advancement of self-administration mediations as they are frequently required for the evident side effect administration in people experiencing Multiple Sclerosis. There is a lot of confirmation as far as mental trouble in the carers of people with MS (Belbasis et al., 2015). However there has been no noteworthy improvement regarding administrations and arrangements required to facilitate the caregiver of the burden of these group of people.
Implementation of Nursing Intervention
The identification of self-care deficit points to the disability of the capacity to perform errands like showering, dressing bolstering or exercises of toileting all alone. This leads on to conditions like dissatisfaction and poor individual cleanliness. In this way with a specific end goal to oversee such patients, I would try to recognize the zone of shortcoming in the people. Moreover I will make attempts to show the strategies of way of life changes so the patients can meet their self-care needs.
The nursing intervention which I will try to execute will join the affirmation of the present development level of the patient and their physical condition. I will encourage the patient to perform self-care to the most extraordinary of limit as portrayed by tolerant, anyway I will do whatever it takes not to be surge tolerant. Help will be given as demonstrated by level of inadequacy alongside allowing self-administration to a level that will be worthy. I will attempt to commit towards developing a proper plan of nursing (Gunn et al., 2013). It is required to take note of the nearness of exhaustion at legitimate interventions. It is required to imagine clean requirements for the patients and easily help as essential with care of nails, skin, and hair; mouth mind; shaving. Arrangement of assistive gadgets and enables like shower to situate, lifted toilet arrange with arm supports is required. I will eliminate the chance to reposition the patient from time to time when tolerant is steady (bed or seat bound). Giving of solid skin to weight centers, for instance, sacrum, bring down legs, and elbows (Sanai et al., 2016). Stimulate broadening and molding exercises and usage of medications, cool packs, and backings and upkeep of legitimate body arrangement, when shown (Hunter, 2016).
Conclusion
From the above investigations utilizing the clinical thinking cycle, the pathophysiological and the mental states of the patient was distinguished. The hazard factors alongside the age related issues and the negative results were likewise recognized. This examination additionally distinguished the needs of the nursing care designs that are expected to deal with the patients experiencing multiple sclerosis. Here the best need was distinguished as self-care after which the mediations of self-administration. These self-administration mediations have ended up being useful for such patients as they have appeared to diminish the uneasiness and depression in patients consequently enhancing their mental prosperity.
References
Asano, M., & Finlayson, M. L. (2014). Meta-analysis of three different types of fatigue management interventions for people with multiple sclerosis: exercise, education, and medication. Multiple sclerosis international, 2014.
Belbasis, L., Bellou, V., Evangelou, E., Ioannidis, J. P., & Tzoulaki, I. (2015). Environmental risk factors and multiple sclerosis: an umbrella review of systematic reviews and meta-analyses. The Lancet Neurology, 14(3), 263-273.
Dendrou, C. A., Fugger, L., & Friese, M. A. (2015). Immunopathology of multiple sclerosis. Nature Reviews Immunology, 15(9), 545.
Gold, R., Giovannoni, G., Selmaj, K., Havrdova, E., Montalban, X., Radue, E. W., … & Elkins, J. (2013). Daclizumab high-yield process in relapsing-remitting multiple sclerosis (SELECT): a randomised, double-blind, placebo-controlled trial. The Lancet, 381(9884), 2167-2175.
Gunn, H. J., Newell, P., Haas, B., Marsden, J. F., & Freeman, J. A. (2013). Identification of risk factors for falls in multiple sclerosis: a systematic review and meta-analysis. Phys Ther, 93(4), 504-13.
Hunter, S. (Ed). (2016). Miller’s nursing for wellness in older adults (2 nd Australia and New Zealand ed.) North Ryde, NSW: Lippincott, Williams and Wilkins.
Kidd, T., Carey, N., Mold, F., Westwood, S., Miklaucich, M., Konstantara, E., … & Cooke, D. (2017). A systematic review of the effectiveness of self-management interventions in people with multiple sclerosis at improving depression, anxiety and quality of life. PloS one, 12(10), e0185931.
Levett-Jones, T. (Ed.). (2013). Clinical reasoning: Learning to think like a nurse. Frenchs Forest, NSW: Pearson.
Lublin, F. D., Reingold, S. C., Cohen, J. A., Cutter, G. R., Sørensen, P. S., Thompson, A. J., … & Bebo, B. (2014). Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology, 10-1212.
Ma, V. Y., Chan, L., & Carruthers, K. J. (2014). Incidence, prevalence, costs, and impact on disability of common conditions requiring rehabilitation in the United States: stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, osteoarthritis, rheumatoid arthritis, limb loss, and back pain. Archives of physical medicine and rehabilitation, 95(5), 986-995.
Olsson, T., Barcellos, L. F., & Alfredsson, L. (2017). Interactions between genetic, lifestyle and environmental risk factors for multiple sclerosis. Nature Reviews Neurology, 13(1), 25.
Sanai, S. A., Saini, V., Benedict, R. H., Zivadinov, R., Teter, B. E., Ramanathan, M., & Weinstock-Guttman, B. (2016). Aging and multiple sclerosis. Multiple Sclerosis Journal, 22(6), 717-725.
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