Multiple Sclerosis (MS) case study

Multiple Sclerosis (MS)

Major assignment: Case Study (60%)(hurdle requirement)

Mrs A is a 43 year old female who has end stage multiple sclerosis (MS) and developed the wound pictured below. She has a very poor appetite, only eats a small amount of soft diet and has a minimal fluid intake. Her current weight is 40 kg. She is also incontinent of both urine and faeces.

Mrs A is being cared for at home by her husband James, with some assistance from family members and community nursing. James has learnt to attend to dressings if needed and is also responsible for transferring Mrs A from bed to chair. Mrs A spends much of her day in a wheel chair so that she can be close to her three young children.

Aggressive management options (e.g. surgical debridement with general anaesthetic) were considered inappropriate for Mrs A due to her current poor medical condition. A hydrocolloid sheet has been used to dress the wound which is changed weekly or as needed due to incontinence. Wound exudate is moderate to heavy, serous and currently malodorous.

Consider Mrs A’s situation and discuss her management plan in terms of the appropriate dressing options for this wound. In your discussion you should include:

• skin and wound assessment (using MEASURE or other acceptable wound assessment tool);
• establishing an aetiology for the wound (using assessment and clinical history);
• identifying factors which might affect healing in Mrs A’s case;
• a management plan that identifies the short and long term goals of therapy;
• a suitable dressing regimen (primary and/or secondary; fixation; frequency of care);
• providing a rationale for choice of dressing(s)(please ensure that you comment on the suitability of the current dressing regime);
• a discussion of alternative dressing options that highlights both appropriate and inappropriate dressings for this wound (2 of each from different categories); and
• Identification of any other factors that should be taken into consideration in the overall management plan for Mrs A.

Please note, if you use tables to present information, they should be presented in the body of the assignment, not as an appendix and are included in the word count.

Word limit (2500 words)