By June Halper
The nurse performs an essential position as an educator, care supplier, and suggest for sufferers and households tormented by a number of sclerosis (MS). The significant other ebook to an previous paintings, accomplished Nursing Care in a number of Sclerosis, complex suggestions in a number of Sclerosis Nursing Care, second variation examines advanced matters in MS administration and displays a brand new philosophy of MS care: one in all empowerment. the focal point is at the a variety of settings within which MS nurses perform, in addition to their many jobs and obligations in handling this hugely variable ailment. it's going to give you the reader with an up to date view of MS besides a better realizing of its lifelong impression. unique positive aspects of the second one variation contain: a brand new bankruptcy on maintaining wish in MS sufferers a brand new bankruptcy on remedy of acute exacerbations a brand new bankruptcy on rising intravenous cures increased sections on ache, melancholy, and skincare with common injections The e-book is split into sections facing the disorder itself, complicated perform specifications for nurses, and complicated symptom administration. members to complicated options in a number of Sclerosis Nursing Care, 2d variation are nurse clinicians and researchers who paintings in geographically varied perform settings all through North the USA and Europe. The e-book will offer nurses with instruments and techniques to enhance the lives suffering from a number of sclerosis and to enhance the position of the nurse in dealing with it. (20100503)
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Extra info for Advanced Concepts in Multiple Sclerosis Nursing Care, 2nd Edition
Given orally, azathioprine may reduce relapses, but it does not seem to have a statistically significant effect on the progression of disability. Markovic-Plese and colleagues studied azathioprine in six MS patients for a median of 15 months and found a 69% reduction in gadolinium enhancement (24). In 2005, Puliken and colleagues reported treating 15 patients with breakthrough relapses on interferon beta-1b with the addition of azathioprine 3 mg/kg (dose escalated and titrated to tolerance) and demonstrated a 65% reduction in enhancing lesions, as demonstrated by serial MRI scans and compared with their precombination therapy level.
Prevention of transplant rejection Mycophenolate Mofetil Cladribine CellCept Leustatin Bone marrow suppression Leukopenia, thrombocytopenia, nausea/vomiting, and pain, skin rashes, hepatotoxicity Leukopenia, thrombocytopenia, anemia, GI upset, alopecia Side Effects Antineoplastic agent for the treat- Myelosuppression, with prolonged ment of active hairy cell leukemia; pancytopenia, mild to moderate disease stabilization infections, fever, nausea Adjunct for the prevention of rejection in renal homotransplantation; management of severe, active, rheumatoid arthritis; relapse reduction Azathioprine Imuran Antineoplastic agent used alone or in combination with other agents for the treatment of various types of cancer; disease stabilization Indication/ Potential in MS Cyclophosphamide Generic Name Cytoxan Trade Name Sample of Immunomodulating and Immunosuppressant Agents TABLE 2-1 44 28 21, 23 41, 42, 66 Selected Reference 32 CHAPTER 2 Methotrexate Intravenous immunoglobulin Hematopoietic stem cell transplantation Rheumatrex Sandoglobulin Stem cell ransplantation During infusion: Facial flushing, chest tightness, chills, fever, dizziness, nausea, diaphoresis, and hypotension, anaphylaxis Infections, death, allergic reaction, transient worsening of neurologic symptoms Treatment of leukemia, lymphoma; induction of remission in progressive forms of MS Nausea, vomiting, diarrhea, anemia, leukopenia, thrombocytopenia, hepatoxicity, renal toxicity, lung disease Treatment of immunodeficiencies; autoimmune neurologic diseases such as MG, CIDP; relapse reduction, delay of disease progression Antineoplastic agent used in variety of cancers, treatment of psoriasis, and rheumatoid arthritis; decreased rate of disease progression, particularly upper extremity function 49, 68 30, 31, 67 48 Therapeutic Advances in the Treatment of Progressive Forms of MS 33 34 CHAPTER 2 Mycophenolate Mofetil Mycophenolate mofetil (CellCept) inhibits inosine monophosphate dehydrogenase and blocks the proliferative ability of T and B cells.
The establishment of multiple incremental goals is a motivational technique that encourages a person to strive toward a long-term goal. Provide experiences with other disabled people. Support groups provide opportunities for social modeling and for empathy by others who share similar feelings and experiences. Provide ongoing affirmation. “Cheerleading” is an important function of the nurse working with a patient who is facing a wide variety of challenges. It may consist of verbal “applause” or acknowledgment of both small and large accomplishments.
Advanced Concepts in Multiple Sclerosis Nursing Care, 2nd Edition by June Halper