This document contains concept maps about Multiple Sclerosis and Systemic Inflammatory Response Syndrome. The MS concept map outlines signs and symptoms like spastic weakness and ataxia. It also covers risk factors, pathophysiology, nursing management including skin care and physical therapy, medications, and patient education. The SIRS concept map describes signs of compensatory mechanisms, nursing management of fever and fluids, risk factors like age and immune status, potential complications, and etiologic factors like trauma and infection. Both concept maps provide overviews of the conditions.

1. Republic of the Philippines
CAMARINES SUR POLYTECHNIC COLLEGES
Nabua, Camarines Sur
GRADUATE SCHOOL
Master of Arts in Nursing
N 217: Advanced Medical-Surgical Nursing 2
Asynchronous Activity No. 2
Concept Disease Mapping
Problems related to movement and Coordination & Nursing Care in
Critical Care Settings
MARY BENJIE R. BANDELARIA, RN
MAN Student
DR. MODESTO P. FUCIO
Professor
(MULTIPLE SCLEROSIS &
SYSTEMIC INFLAMMATORY RESPONSE SYNDROME)

2. Republic of the Philippines
CAMARINES SUR POLYTECHNIC COLLEGES
Nabua, Camarines Sur
GRADUATE SCHOOL
Multiple Sclerosis Concept Map
ADVANCED MEDICAL-SURGICAL NURSING 2
MARY BENJIE R. BANDELARIA, RN
MAN Student
DR. MODESTO P. FUCIO
Professor
SIGNS AND SYMPTOMS
*Spastic weakness – the most common sign
*Charcot’s Triad: A combination of symptoms that includes nystagmus,
intention tremor (motor weakness in coordination), scanning speech which
is elicited by slowing enunciation with tendency to hesitate at beginning of
a word.
*Hyper in emotions as well as euphoria
*Visual disturbances
*Nausea and vomiting
*Urinary retention or urinary incontinence
*Dysphagia – difficulty in swallowing
*Ataxia – a problem in coordination
NURSING MANAGEMENT
*The goal of management is focused only on alleviating the symptoms. *Symptomatically, allow
the patient to work on his or her own in order to let him or her to know that the situation is still
under control.
*Comply with the medications such as cortisone or corticotrophin. These medications help in
decreasing edema and inflammation at areas of demyelination.
*Coordinate with a physical therapist in order to facilitate daily living. This prevents complications
of immobility.
*Provide proper skin care as the patient is prone in decubitus ulcers as the demyelination
progresses.
*Allow the patient to get in touch with the world, his family and friends to emotionally support as
he keeps his mind intact in battling this degenerative condition.
*Provide a safe environment for the patient always.
* Use prescribed equipment for transport, transferring the patient as well as in mobilization
RISK FACTORS
*Genetic
*Obesity
*Smoking
*Traumas
*EBV and other viruses
*Temperate Latitude
POTENTIAL COMPLICATIONS
*Infections
*Respiratory Conditions
*Depression
*Blindness
*Sexual dysfunction
PATHOPHYSIOLOGY AND ETIOLOGY
*An autoimmune life-long disease
*Chronic, progressive, degenerative disorder of CNS
*During exacerbation-demyelination occurs
*Occurs most frequently between 25-35 y.o.
*Affects woman more
*Affects the brain, spinal cord and optic nerve
*No cure
HEALTH TEACHINGS
*AVOID: Fatigue, extreme heat or cold and exposure to infection
*Recognize triggers that worsen symptoms
*Avoid temperature extremes
*Good Balance of rest and exercise
*Measures to minimize injury due to sensory loss
Encourage patient to verbalized concerns.
CAUSES
The cause of MS is unknown. Some evidence
suggests that an infective agent causes a
predisposition to MS, although that agent has not been
identified. Some evidence supports immunologic,
environmental, or genetic factors as possible causes of
the disease. The risk of developing MS is 15 times
higher when the disease is present in the patient’s
immediate family. Conditions such as pregnancy,
infection, and trauma seem to precipitate the onset of
MS or cause relapses
MEDICATION
*Corticosteroids agents, such as Prednisone (Orasone);
methylprednisolone or (Solu-Medrol); dexamethasone
(Decadron) maybe used to help decrease symptoms and
induce remissions through anti-inflammatory effects.
Immunomodulatory agents, such as Interferon,
cyclosporine, azathioprine, methotrexate maybe used to
help decrease symptoms and induce remissions;
treatment includes combination therapy using two or more
of these agents.
*Other Drugs: Antianxiety agents, such as
chlordiazepoxide hydrochloride (Librium), may be
prescribed to manage mood swings; baclofen (Lioresal) or
dantrolene (Dantrium) may be used to relieve muscle
spasticity; and patients with urinary symptoms may require
behanechol (Urecholine) or oxybutynin (Ditropan).*Ataxia
– a problem in coordination
REFERENCES:
 https://www.rnpedia.com/
 https://nurseslabs.com/
MULTIPLE SCLEROSIS

3. Republic of the Philippines
CAMARINES SUR POLYTECHNIC COLLEGES
Nabua, Camarines Sur
GRADUATE SCHOOL
Systemic Inflammatory Response Syndrome (SIRS) Concept Map
SIGNS AND SYMPTOMS
*Since the ability of the body to provide oxygen and nutrients is interrupted,
the heart compensates by pumping faster.
*Hypotension occurs because of vasodilation. To compensate for the
decreased oxygen concentration, the patient tends to breathe faster, and
also to eliminate more carbon dioxide from the body.
*The inflammatory response is activated because of the invasion of
pathogens.
*Decreased urine output. The body conserves water to avoid undergoing
dehydration because of the inflammatory process.
*Changes in mentation. As the body slowly becomes acidotic, the patient’s
mental status also deteriorates.
*Elevated lactate level. The lactate level is elevated because there is
maldistribution of blood.
NURSING MANAGEMENT
*Infection control. All invasive procedures must be carried out with aseptic technique after
careful hand hygiene.
*Collaboration. The nurse must collaborate with the other members of the healthcare team to
identify the site and source of sepsis and specific organisms involved.
*Management of fever. The nurse must monitor the patient closely for shivering.
*Pharmacologic therapy. The nurse should administer prescribed IV fluids and medications
including antibiotic agents and vasoactive medications.
*Monitor blood levels. The nurse must monitor antibiotic toxicity, BUN, creatinine, WBC,
hemoglobin, hematocrit, platelet levels, and coagulation studies.
*Assess physiologic status. The nurse should assess the patient’s hemodynamic status, fluid
intake and output, and nutritional status.
RISK FACTORS
*Age: Infants and people over 65 are most at risk.
*Weakened immune system: People with weakened immune
systems, such as from cancer treatment, HIV or an organ
transplant, are at increased risk.
*Chronic conditions: Certain chronic conditions can put you more
at risk, like diabetes, cirrhosis and COPD.
*Existing infection: Having a current infection like pneumonia,
meningitis or cellulitis increases your risk of SIRS.
POTENTIAL COMPLICATIONS
*Organ Dysfuntion
*Hypoperfusion
*Severe Sepsis
*Hypotension
PATHOPHYSIOLOGY AND ETIOLOGY
Systemic inflammatory response syndrome is a
systemic inflammatory response to a variety of
insults, including infection (sepsis), ischemia,
infarction, and injury. Generalized inflammation in
organs remote from the initial insult characterizes
SIRS
HEALTH TEACHINGS
* Prevent shock episodes. The nurse should instruct the patient and the family
strategies to prevent shock episodes through identifying the factors implicated in
the initial episodes.
*Instructions on assessment. The patient and the family should be taught about
assessments needed to identify the complications that may occur after discharge.
*Treatment modalities. The nurse must teach the patient and the family about
treatment modalities such as emergency administration of medications, IV therapy,
parenteral or enteral nutrition, skin care, exercise, and ambulation.
ETIOLOGIC FACTOR
*Mechanical tissue trauma: Burns, crush injuries,
surgical procedures
*Abscess formation: Intra-abdominal, extremities
*Ischemic or necrotic tissue: Pancreatitis, vascular
disease, MI
*Microbial invasion: Bacteria, viruses, fungi, parasites
*Endotoxin release: Gram-negative and positive
bacteria
*Global perfusion deficits: Post cardiac resuscitation,
shock states
*Regional perfusion deficits: Distal perfusion deficits
MEDICATION
*There is no drug of choice for the treatment of SIRS.
Medications target specific diagnosis, preexisting
comorbidities and prophylaxis regimens for prevention of
complications.
*Medical care includes the prompt initiation of pertinent
laboratory testing and imaging studies after obtaining a
history and performing a physical examination.
*Treatment should be focused on possible inciting causes
of SIRS (i.e. appropriate treatment of acute myocardial
infarction will differ from the treatment of community
acquired pneumonia or pancreatitis, etc.).
*Hypotensive patients should receive adequate
resuscitation with intravenous fluids and if still
hypotensive, vasopressor agents should be administered
with carefully hemodynamic monitoring.
*All patients should have adequate intravenous access
and often require 2 large bore IV’s or a central venous
catheter.
SIRS
REFERENCES:
 https://www.rnpedia.com/
 https://nurseslabs.com/
 https://www.coursehero.com/