help with assignment!

  1. Hi! My name is Margie, I'm a 1st yr nursing student. I was wondering if someone would like to help me with my first written assignment in Introductory Nursing 1.
    It's about on how to assess the patient hygiene needs. The patient has had sclerosis for 10 yrs. She is married but her husband is working full time during the day.She was recently hospitalised for an acute exacerbation of the disease.Her nurse makes an initial home visit and in her assessment reveals that she has reduced hearing, has muscular weakness of both her upper extremities, making it difficult for her to to raise her arm above her shoulders. She has some foot dragging and ataxia so she bathes in a chair placed infront of the bathroom sink. Recently her sister has assisted with her bathing. She has some spasticity in her right dominant arm,has difficulty in grasping objects.She had increased spasticity while bathing and became very fatigue after only about 5 minutes but still continues to be very independent in making decisions about her care. She tells the nurse, "It is important for me to be able to bathe myself."

    If anyone has an answer to this ...please , please share it to me.
    Your help will be very much appreciated. TY
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    Joined: Feb '04; Posts: 10


  3. by   ceridwyn
    As this nurse is doing an initial assessment, she would have to talk to the patient about her deficits that are happening and explain that help from the community can be put in place for her to continue her independence without family support.

    Services as the district nursing that this nurse may be employed, home help and to inquire as to her affilitation to the local MS society for more support.

    I may be wrong in the answer your lecturer requires, but as from what I remember they start wanting you to look out in the community first before you start thinking about the hospitals.
  4. by   Jay-Jay
    since this lady is JUST out of hospital, you can assume that her self-care ability will improve as she resumes her normal at-home routines. But it definitely sounds to me like she would benefit from the assistance of a health care aide/personal support worker to help with bathing.

    We often treat MS exacerbations right in the home with IV solumedrol. Hospitalization isn't normally necessary unless the disease progresses past the point where the patient can safely stay at home (respiratory complications, for instance.) First dose of solumedrol is usually given in hospital, however, just to make sure patient will not have an adverse reaction. Though, if the client has had solumedrol many times in the past, with no ill effects, the whole course of treatment may be given in the home.