Question

You are taking care of a newly admitted 78 year old resident, Ms. Wong, in the low care wing of an Aged Care unit. She suffered a stroke last year resulting in right sided weakness of both her right arm and right leg. She now walks with the help of a 4 wheel frame and needs assistance with her ADLs due to the weakness of her right arm. She is a retired Registered Nurse. She has a past medical history of Type 2 diabetes mellitus, hypertension and osteoporosis. She is currently on multiple drugs for all these conditions and is worried about forgetting to take her medications on time. When her medication was checked, it appeared that she had missed her doses on several occasions. She lives alone and has always been single. Her mother passed away 2 years ago and Ms. Wong, who was much attached to her, deteriorated both mentally and physically after the incident. Identify and discuss 3 chronic health problems faced by Ms. Wong (in 40-60 words each). Briefly discuss the problems associated with the pain management of an older person in aged care including how chronic pain might affect the person and their family/carer and their capacity to perform daily living activities (in 70-90 words). Alongside the RN, Identify what communication skills you may utilise when communicating with the client and her family/carers so that they understand the implications of her admission (in 50-70 words)? Determine the steps you would need to take in making a Nursing Care Plan (NCP) for Ms. Wong and the tools that you would use for her preventive health assessment (in 50-70 words).

Answer 1

The three chronic health problems are

• Diabetes Mellitus

The blood sugar level fluctuate when the medication are not taken regularly.This simultaneously leads to other major illnesses

• Hypertension

Forgetting medicine may lead to high blood pressure and causing other ailments.

• Osteoporosis

She has developed pain and needs a support and will be able to walk with the four wheel frame.There are risk she may fall and land up in fracture.

Pain management

Pain experienced by old age people are really very much unbearable because of age and low tolerance to pain level.

They can be managed by

• Providing analgesic as per the need
• Treating the underlying cause
• Hot application helps in circulation
• Light massage helps in soothing and comfort
• Providing psychological support
• Providing psychological support
• Help of a carer for assisting in daily activity
• Physiotherapy as per the need

Communication skill

The RN should communicate in the way which is easily understandable.She should follow a verbal communication skill.Explaining the patient family about the necessity of admission of her for further treatment.Listening is a form of communication which enables the nurse to take a firm decision and help the patient.

The nursing care plan includes the following

• Chronic pain related to fragile bones as evidenced by osteoporosis

Pain management has to be done and assessing the improvement

• High blood sugar level related to decreased insulin production as evidenced by skipped medicine

Monitor and control blood sugar level as per order

Diet control

Regular exercise to maintain sugar level.

• Risk for fall related to pain

Pain management

Equipment support vlike wheel chairs ,walking frame to avoid fall

• Altered sensorium related to loss of loved one as evidenced by forgetting

Provide psychological support

Reassure the patient

Divert the patient from thinking about it.