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This Concept Map, created with IHMC CmapTools, has information related to: Multiple Sclerosis, Problem: Muscle Weakness, Atrophy ND: Alteration in Ability to Perform ADLs. Data: Decreased fine motor control. Increased loss of function. Decreased ability to perform complex tasks. Outcome (Intermediate): Patient will remain independent in ability to perform ADLs. Interventions: Coordinate care with physical and occupational therapy. Perform range of motion exercises. Encourage patient to perform as many functions as possible with assistance from staff. may result in Problem: Dysphagia ND:Impaired Swallowing, Risk for Aspiration Data: Coughing and choking while eating and drinking, failed video swallow study Outcome (Intermediate): Patient will remain without aspiration event Interventions: Aspiration precautions Thickened Liquids, Patient: T. P., 66 year old female Diagnosis: Exacerbation Multiple Sclerosis, "a multifaceted, progressive condition of the central nervouse system with a myriad of physical, psychological, and social consequences (Falvo, 2009, p. 123). is complicated by Problem: Muscle Weakness, Atrophy ND: Alteration in Ability to Perform ADLs. Data: Decreased fine motor control. Increased loss of function. Decreased ability to perform complex tasks. Outcome (Intermediate): Patient will remain independent in ability to perform ADLs. Interventions: Coordinate care with physical and occupational therapy. Perform range of motion exercises. Encourage patient to perform as many functions as possible with assistance from staff., Patient: T. P., 66 year old female Diagnosis: Exacerbation Multiple Sclerosis, "a multifaceted, progressive condition of the central nervouse system with a myriad of physical, psychological, and social consequences (Falvo, 2009, p. 123). potential to develop Problem: Depression ND: Altered Self-Concept; Potential for Fear and Anxiety related to unpredictablity of disease process. Data: Withdrawn Affect Outcome (Long-Term): Patient will report reduced anxiety. Interventions: Provide information for all procedures and activities. Allow patient to share in making care decisions. Encourage patient to take part in group therapies when offered. (Falvo, 2009)., Problem: Muscle Weakness, Atrophy ND: Alteration in Ability to Perform ADLs. Data: Decreased fine motor control. Increased loss of function. Decreased ability to perform complex tasks. Outcome (Intermediate): Patient will remain independent in ability to perform ADLs. Interventions: Coordinate care with physical and occupational therapy. Perform range of motion exercises. Encourage patient to perform as many functions as possible with assistance from staff. can lead to Problem: Immobility ND: Risk for Impaired Skin Integrity Data: Wheelchair-bound Requires mechanical lift for transfer Outcome (Intermediate): Patient will maintain skin integrity Interventions: Reposition patient every 2 hours and prn. Keep skin clean and dry. Perform thorough skin assessment q shift., Patient: T. P., 66 year old female Diagnosis: Exacerbation Multiple Sclerosis, "a multifaceted, progressive condition of the central nervouse system with a myriad of physical, psychological, and social consequences (Falvo, 2009, p. 123). also being treated for Problem: Chronic Pain, Restless Leg Syndrome ND: Chronic Pain Data: Patient with spasticity of extremities, Reports pain 7/10 intensity Outcome (Intermediate): Patient will report pain as decreasing in intensity to tolerable levels. Interventions: Assess pain every 4 hours and prn Muscle relaxants and analgesics as presribed. Educate patient on use of relaxation techniques. (Falvo, 2009)., Problem: Dysphagia ND:Impaired Swallowing, Risk for Aspiration Data: Coughing and choking while eating and drinking, failed video swallow study Outcome (Intermediate): Patient will remain without aspiration event Interventions: Aspiration precautions Thickened Liquids places patient at risk for Problem: Pneumonia ND: Ineffective breathing pattern, Impaired Gas Exchange Data: CXR positive for infiltrate. Hypoxia on ABGs, Productive cough,short Adventitious breath sounds, Subjectives complaints of SOB Outcome (short-term): Patient will maintain osygen saturation greater than 90%. Interventions: Oxygen therapy, Continuous pulse oximeter, Antibiotic therapy, Nebulizer treatments, Problem: Immobility ND: Risk for Impaired Skin Integrity Data: Wheelchair-bound Requires mechanical lift for transfer Outcome (Intermediate): Patient will maintain skin integrity Interventions: Reposition patient every 2 hours and prn. Keep skin clean and dry. Perform thorough skin assessment q shift. increased risk for Problem: Pneumonia ND: Ineffective breathing pattern, Impaired Gas Exchange Data: CXR positive for infiltrate. Hypoxia on ABGs, Productive cough,short Adventitious breath sounds, Subjectives complaints of SOB Outcome (short-term): Patient will maintain osygen saturation greater than 90%. Interventions: Oxygen therapy, Continuous pulse oximeter, Antibiotic therapy, Nebulizer treatments