Famyotrophic Lateral Sclerosise (ALS) is an insidiously degenerative neurological disorder that affects the nerve cells controlling voluntary muscle control. This condition prematurely destroys motor neurons, leading to progressive and irreversible muscle weakness, especially in the arms and legs. So, nurses have an important role to play in the nursing care management of patients affected by this chronic disorder.
Assessment of ALS includes the following parameters:
- Muscle Strength: Muscle weaknesses can be assessed through hand grip tests, observation of gait pattern and evaluation of postural stability.
- Neurological Exam: To assess the affected muscles for changes, a physical examination is done to identify reflexes, sensation and strength of the muscles.
- Pulmonary Function Tests: Pulmonary function tests are conducted if there are difficulties in breathing or ventilation.
The nursing diagnosis for ALS involves the following:
- Ineffective airway clearance: This is due to the progressive respiratory muscle weakness that leads to difficulty in clearing secretions from the airways.
- Impaired mobility: This diagnosis is related to muscle weakness and impaired coordination, which restricts movement.
- Risk for Infection: This diagnosis is due to the patient’s inability to fight infection due to their elevated muscle weakness.
The outcomes that the patient with ALS should expect after the nursing intervention include:
- Improved airway clearance: The patient should experience a decrease in secretions due to improved airway clearance.
- Improved mobility: The patient should experience an improved range of motion due to improved muscle coordination and decreased muscle stiffness.
- Decreased risk of infection: The patient should experience a decrease in the risk of infection due to improved immune system functioning.
Interventions that should be used in caring for the patient with ALS include:
- Airway clearance: The nurse should use suctioning or assisted coughing techniques to clear secretions.
- Range-of-motion exercises: The nurse should provide exercise regimens that target specific muscle groups to promote mobility.
- Nutritional support: The nurse should assist the patient in setting up a nutritious diet that optimizes their nutrient intake and support healthy muscle growth.
- Infection prevention: The nurse should focus on promoting hand hygiene, avoidance of contact with people with infections, and maintenance of proper oral health.
The rationale behind the chosen interventions is as follows:
- Airway clearance: Clearance of secretions will reduce airway obstruction and improve respiration.
- Range-of-motion exercises: Exercises will strengthen muscles, increase range of motion and reduce muscular stiffness.
- Nutritional support: Nutrients promote growth and development of healthy muscle tissue, reduce fatigue, and maintain overall well-being.
- Infection prevention: Prevention of infections reduces the risk of complications and helps the patient maintain optimal health.
The nursing care plan for ALS should be evaluated to determine the effectiveness in achieving the desired outcomes. Nurses should monitor for improvements in muscle strength, improved range of motion, better airway clearance, and reduced risk of infection.
Nursing care for ALS patients is essential to ensure that they receive the best possible care and treatment. Nurses should be aware of the various interventions available to help maintain and improve the patient’s quality of life. Additionally, they should also monitor for improvements in the patient’s condition and evaluate their responsiveness to the nursing care plan.
- Is airway clearance important for ALS?
Yes, airway clearance is important for patient with ALS to improve breathing and reduce risk of infection.
- What kind of diet should ALS patients follow?
ALS patients should follow a nutritious diet that meets their individual nutritional requirements and optimizes their nutrient intake.
- Are there any preventive measures for ALS?
Unfortunately, there are no preventive measures for ALS. However, medical interventions can delay its progression and improve the patient’s quality of life.
- Are there any treatments for ALS?
Yes, there are various treatments available for ALS, including medications and physical therapies.
- What kind of exercise should ALS patients do?
ALS patients should do exercises that target specific muscle groups and promote mobility, such as range-of-motion exercises.