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  • Topic: Nursing, Motor neurone disease, Motor neuron
  • Pages : 7 (2239 words )
  • Download(s) : 25
  • Published : April 22, 2013
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Patient presenting with Motor Neuron Disease suffering with a Decubutis Ulcer: A Care Study. Word count: 4,800.

Table of contents
Introduction...............................................................page3 Patient presentation..................................................page4 Diagnosis....................................................................page Overview of nursing models and nursing process.....page

Roper, Logan, and Tierney
Model.............................................page
Assessment...............................................................page Planning....................................................................page Intervention..............................................................page Evaluation................................................................page Recommendations for practice................................page Conclusion................................................................page References................................................................page Appendix 1................................................................page

Introduction
Motor neuron disease (MND) is a progressive degenerative disease that affects the motor neurones in the corticospinal pathways, also those in the motor nuclei of the brainstem and the anterior horn cells of the spinal cord. The autonomic nervous system and the sensory nerves are unaffected (MND Association, 2010). There are no known reasons as to why a person suffers with MND; research across the world is being carried out to find out why some suffer with MND while others do not. There are no specific tests carried out to diagnosis MND. The physician will go on the patient’s symptoms to determine a diagnosis. There are three main types of the disease. Whilst the person may present initially with one type, they may later on develop a combination of two or even all three types of the disease. The common form of MND, which affects around 80% of people, is Amyotrophic lateral sclerosis (ALS). This predominantly affects the upper motor neurons but sometimes can affect lower motor neurones. Weakness of the small muscles of the hand or an asymmetrical foot drop is the common presenting symptoms of this type of MND. The person may also suffer from frequent night cramps, particularly in the calf muscles. As this disease progresses, the muscle weakness can impair walking and spasms become worse at night. The prognosis for this type is thought to be between three and five years from diagnosis. Progressive muscular atrophy (PMA) the lower motor neurones are affected most severely in this type of the disease. Wasting in the small muscles are usually the first signs of PMA and then it works its way towards the body, sometimes weakness starts in the shoulders. The prognosis for this type is better than the other types of the disease; many people are living with it for longer than five years and some even surviving for more than twenty years, unless bulbar signs are present. The third type of MND is progressive bulbar palsy (PBP) this affects the tongue, muscles of the palate, pharynx and larynx. Facial muscles, shoulders girdle, and arms weaken. It is common that the speech may become impaired due to the fasciculation and wasting of the tongue and in some severe cases the speech and the ability to swallow completely lost. The prognosis for this type is poor with people only surviving between six months to three from diagnosis (MND Association, 2010). Majority people who have the disease prefer to be cared for in their own homes and the community team can enable this to happen. The progression of the disease is closely monitored and care adapted to the needs of that person. The community team all work together in the care and this may include; GP’s, district nurses, community occupational therapists, and social services and the support of family and friends of the patient (NHS Direct, 2012).

Patient...
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