A 52 year old man with multiple sclerosis is wheel chair bound and has a neurogenic bladder.?

Question

A 52 year old man with multiple sclerosis is wheel chair bound and has a neurogenic bladder. he complains of a sudden onset of generalized weakness,fever, and chills and is admitted to the hospital. what priorities should be set for his care? what do generalized weakness, fever, and chills suggest in any client? if your client has not been following good bladder management, how can you intervene?"

Answer 1

The first question is, is he mentally competent? If so, any decision is his to make. Talk to him about what's happening, what is likely to happen, what depends on his choices. What choices he has. What will happen if he does not choose.

What does he want to happen if he develops an illness that can be cured but, if not treated, will lead to his death?

What does he want to happen if he becomes comatose or in a persistent vegetative state, and there is no medical likelihood he will regain mental functioning?

Does he want medicine for pain, even if the dose need to alleviate the pain may cause his death?

Does he want to be resuscitated if his heart stops?

The symptoms are so general, they could mean anything, but on arrival at the hospital, if that's where he goes, he will be asked to sign a health care proxy or a "living will" and he should be prepared to say what he wants this person to do if he cannot decide. He should also discuss these matters before he goes to the hospital, and may want to ask his doctor(s) about these issues and tell them what he wants.

If his unwillingness to follow good bladder management means he really wants to die, he needs to make that clear. On the other hand, if he is just pissed off at how he is being taken care of, somebody needs to deal with that.

If he is not mentally competent, someone needs to be appointed his guardian, preferably with the powers of a health care proxy.

Answer 2

The generalized weakness, fever and chills may possibly be a sign of a UTI (urinary tract infection) or bladder infection...especially if he has a neurogenic bladder. The main priorities would be to assess mental status, collect a urine specimen for culture and sensitivity (means check it for infection and if it's infected..what appropriate med would treat it). The client needs to have bladder managment reviewed as far as adequate fluid intake and if patient has a foley catheter in his bladder, appropriate catheter maintenance such as catheter care (making sure the catheter is cleansed properly where bacteria are not reintroduced into the bladder, ensuring if patient has foley that bag is kept lower than waist level to prevent urine reflux into the bladder)also making sure that patient gets foley catheter changed every 30 days--these are just a few considerations to intervene with bladder management.

Answer 3

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Answer 4

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Answer 5

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