For complex patients requiring staged anterior/posterior surgery, TPN appears to significantly lessen the decrease in nutritional parameters. Because depletion of nutritional parameters appears to correlate with an increased likelihood of perioperative infectious complications, use of TPN may result in a decrease of such complications in these patients.

No abstract

Persons with the chronic illness of multiple sclerosis now live longer than ever. Rehabilitation nurses encounter many of these patients in their work, helping them adapt to the constraints and limitations imposed by the disease. Although a diagnosis of multiple sclerosis is characterized by uncertainty, much can be done to help patients and theirfamilies deal with the complications of the disease process, which may affect many areas of daily living. To provide comprehensive care, an understanding of the pathophysiology and medical management of multiple sclerosis and a creative use of nursing expertise is necessary. Much of the care rendered to these patients and their families is provided by nurses. This care can be organized through the framework of nursing diagnosis, which identifies functional deficits amenable to nursing care.