Question

Mr. Miller has been having difficulty swallowing. He is diagnosed with amyotrophic lateral sclerosis (ALS).

1.) What are the priority nursing diagnoses for Mr. Miller?

2.) How can the client and his family be supported in coping with ALS?

3.) What health care team members should be consulted for his care?

Answer 1

ANSWER 1: PRIORITY NURSING DIAGNOSES FOR Mr. MILLER:

Mr. MILLER PRESENTED WITH DIFFICULTY IN SWALLOWING WHICH IS OTHERWISE CALLED AS DYSPHAGIA.

THE NURSING DIAGNOSES BASED ON THIS COMPLAINT OF DYSPHAGIA WOULD BE

• DEPLETION IN THE NUTRITIONAL STATUS.
• LACK OF AWARENESS ABOUT ALTERNATE METHODS OF FEEDING AND THE RIGHT DIET TO BE FOLLOWED.
• CHANCES TO BE PRONE FOR  INJURIES.

ANSWER 2: CLIENT AND FAMILY SUPPORT IN COPING WITH ALS:

PSYCHOLOGICAL ADAPTATION:

• MAKE THE CLIENT AND THE FAMILY REALIZE THE POSSIBLE REALITY EXPECTATION OF THE DISEASE.
• EMOTIONAL RESPONSE TO LOSS MUST BE EXPLAINED AS A NATURAL PHENOMENON.
• COPE WITH PRACTICAL-DECISION MAKING.
• SUPPORT THE CLIENT AND THE FAMILY WITH ESSENTIAL CARE AND IMPLEMENTS.
• CREATE AN ATMOSPHERE FOR EASY SHARING OF THE COMPLAINTS AND TO DISCUSS THE FEAR WITH THE HEALTH CARE TEAM.
• REFER THE CLIENT AND THE FAMILY FOR COUNSELLING TO PSYCHIATRISTS OR PSYCHOLOGISTS.

ANSWER 3: HEALTH CARE TEAM MEMBERS TO BE CONSULTED FOR HIS CARE INCLUDES:

• DIETICIAN: APPROPRIATE DIET AND THE METHOD OF FEEDING.
• PHYSICAL OR OCCUPATIONAL THERAPIST: FOR MUSCLE WEEKNESS IN ALS.
• PSYCHIATRIST/PSYCHOLOGIST/PSYCHIATRIC CLINICAL NURSE SPECIALIST: PSYCHOLOGICAL ADAPTATION FOR CLIENT AND FAMILY TO COPE UP WITH THE DISEASE.

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POINTS TO BE NOTED:

• AMYOTROPIC LATERAL SCLEROSIS (ALS) IS OTHERWISE CALLED AS LOU GEHRIG'S DISEASE.
• RARE MOTOR NEURON DISEASE WHICH LEADS TO DEATH OF NEURONS INVOLVED IN VOLUNTARY MUSCLE MOVEMENTS.
• NO CURE ONLY LIMITATION OF THE COMPLICATIONS OF THE DISEASE TO PROLONG LIFE TO A CERTAIN LIMIT.