Question

1. Week 4: Day 2-Case study

“Confusion in Motion”

Patty is a 74-year-old woman who worked as a hotel custodian. She is constantly pacing the halfway with a broom, sweeping the floor as she goes. Patty has lost 14 pounds in the 3 months since her admission to the nursing home. She is unable to sit at the table long enough to eat her meals and resumes her constant walking after eating only a few bites.

What nursing diagnosis would the nurse assign to Patty’s situation?

What nursing interventions could be used to address the problem? Discuss the care needs of an older adult who responds with answers that indicate depression.

Answer 1

Above scenario shows that patient is 74 yrs old and the problems associated with physical mobility,loss of perception on the surrounding and age related problems .There is special care and attention in all all aspects and will see one by one in detail

1) Dysfunctional grieving related real or perceived loss as Evidenced by inability to carry out activities of daily living of the individual .

Interventions are

Asking to the patient and understanding her condition

Specifically asses the stage if grieving process

Explore the feeling of the patient

Give diversion therapy to the individual

Provide simple activity and help in regain her perception in environment

Spend more time with the patient

2. Risk for fall related commom age problems.

Identify the risk factors associated with fall and identify the patients sensory and motor deficits and provide appropriate mobility aids to her as required . Secure with a wristband as well as provide fall precautious to her ,provide all necessary things like call bell, telephones and ,water should be kept close to the patient. Always keep bed in lowest position as possible and always keep the side rails up and bed breaks on. Oriient the patient in the room and the equipments as possible

2) impaired communication process related to depressive cognition Evidenced by not interacting with others

Help the patient to improve communication skills

Use short sentences to communicate with the patient

Use silence when the situation demands

Introduce her to other people in the old age home

3.Imbalance nutrition less than body requirements related to insufficient nutrients intake by the patient

check the weight of the patient and identify caloric and nutritional requirements and if it is met by the patient diet . Take the nutritional history of the patient as well as the t likes and dislikes of her .Feed the patient in a small amount and increase the frequency of food intake. If there  is any difficult in chewing provide liquid form or tube feeding also acceptable to her if and only if required. Review the laboratory test of her and provide additional supplements based on the values and maintain a balance diet . Close monitor for any signs of poor nutritional intake . Follow up with dietician recommendation and provide more food as possible

4 impaired social interaction related to depressed state as evidence by lack of communication

Nurses must be able to recognize the symptoms of depression in the patient and identify the severity of the depression. Allow the patient to perform personal care activities and it should be made sure that she is maintained her personal body hygiene . make the person to feel confidence. Give  small task which they can to do and appreciate them once they have completed the task . Encourage them in group activity with similar group as long as possible and increase their social interaction

5.Imparedsleep pattern related to depression as evidenced by lack of socialisation and communication

Provide regular sleeping pattern with comfort measures as possible. If the patient is lack of sleep discuss with doctors and provide adequate sleeping pills and get prescription .Do not allow sleep more during day time. Patient feels worthy and valuable their life makes more relaxed and may get adequate sleep.