Nursing Assessment, Management and Treatment of Autoimmune Diseases
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● Certain infections : Viral infections have been linked to MS development. An example is infection with the Epstein-Barr virus, which causes infectious mononucleosis. ● Climate : MS is more common in countries with temperate climates, including the northern US, Canada, New Zealand, Europe, and southeastern Australia. ● Race : Whites, especially those of Northern European ancestry, have the greatest risk of developing MS. People of Asian, African American, or Native American descent have the lowest risk. ● Family history : Risk increases if one’s parents or siblings were diagnosed with MS. ● Sex : Research shows that women are more than two to three times as likely as men to have relapsing-remitting MS. ● Smoking : Research shows that smokers are more likely than non- smokers to have a second event that confirms a diagnosis of relapsing- remitting MS. ● Vitamin D : Low levels of vitamin D and low exposure to sunlight increases the risk of MS. Complications Complications associated with MS in - clude the following (Mayo Clinic, 2020b): ● Muscle stiffness and spasticity. ● Paralysis. ● Bowel and bladder problems. ● Sexual dysfunction. ● Mental changes such as forgetfulness and/or mood swings. ● Depression. ● Epilepsy.
Treatment Treatment goals are to shorten exac- erbations, relieve neurologic deficits (if possible), and facilitate the maintenance of maximum health and wellness (Rebar et al., 2019). To date, MS treatment falls into three categories: abortive therapies, preventive therapies, and symptomatic therapies (Johns Hopkins Medicine, n.d.). Abortive therapies An MS exacerbation is defined as “new or returning neurological symptoms that have evolved over at least 24-48 hours and have not been provoked by a meta- bolic cause, such as a fever” (Johns Hop- kins Medicine, n.d.). For acute exacerbations of symptoms, steroids may be prescribed to shorten both the duration and the intensity of the attack. The typical regimen involves in- travenous administration of methylpred- nisolone once a day for 3 to 5days. In- travenous therapy may be followed with oral steroids such as oral prednisone. These oral steroid pills are given in taper- ing doses for an additional 1 to 2 weeks (Johns Hopkins Medicine, n.d.; Mayo Clinic, 2020b). Plasma exchange (plasmapheresis) may also be used during acute attacks follow- ing steroid therapy. During plasmapher- esis, blood plasma is removed from the body and separated from the blood cells. The blood cells are mixed with albumin and returned to the body. Plasmapheresis is most often used if patients’ symptoms are new, severe, and have not respond- ed to steroids (Johns Hopkins Medicine, n.d.; Mayo Clinic, 2020b). Preventive therapies The Food and Drug Administration (FDA) has approved, to date, a number of preventive therapies to reduce the fre- quency and severity of exacerbations or
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