Question

The patient is 70 years old. She is suffering from dementia. The woman is currently undergoing depression as well as anxiety. She is confused. She has decided to relocate from t plaza (where she has been for three months) to our place because of the deterioration of her medical condition. She has undergone unusual mental alteration. She had moved to new place so as to receive care as she wasn’t able to look after herself while in her apartment. The woman reveals to me that she has experienced intermittent diarrhea over the past one week. In addition, she has had chills. She experienced neither fever nor abdominal pain however. Whenever she urinates, there is tingling. The patient doesn’t however have hematuria. Not even the urinary frequency. It unfolds to me that the patient‘s PO intake has considerably declined as she has been occasionally nauseous too, once including vomiting. The conjunctiva are non-injected, with pupils equal and round. The patient is not hard of hearing, ears and nose have a normal external appearance, oropharynx is clear and mucus membranes appear dry. The neck is supple, has no masses. The heart has a regular rate and rhythm, there are no pathologic abdominal aortic pulsations and there is no jugular venous distention. Normal effort for respiration and the lungs are clear to auscultation bilaterally. The abdomen is soft, nontender, non-distended, and there are no palpable masses and no pathological hepatosplenomegaly. Bowel sounds were present. There is no clubbing, cyanosis or ischemia. There are no bony deformities pathologic asymmetry or masses. These is trace lower extremity edema. Patient can ambulate with a walker. The skin has no rashes pathologic indurations/nodules/tightening on the exposed areas. She has also had insomnia, GERD, IBS, kidney stones and acute kidney injury, and small bowel obstruction (resolved without surgery).

Base on the patient assessment please help me to write care plan with three patient problem and please help

Patient Problem #1: Risk for dehydration related to frequent loose stools and decreased oral intake.

Patient Problem includes:
1. Nursing diagnosis 

2. Supporting evidence (subjective and objective data) 3. One SMART* goal. 

4. Minimum of 3 EB* interventions.

What lab need to do for this patient

Answer 1

Answer: The patient is suffering from dementia as well as anxiety and depression. The assessment of the dementia as the desired outcome should be that patient should have increased satisfaction with memory improvement. Should establish factors related to self care protection.

Subjective data: Inability to remember past events, inability to perform normal task.

Objective data: fatigue, diseased condition.

Nursing interventions and rational:

1. Discuss the patient's about the beliefs and memory deficits.

• This will provide evidence and Information regarding the level of dementia.

2. Try to communicate with the patient by using short and simple words.

• This will reduce the anxiety level in the patient and patient may feel better.

3. Assessment of the patients ability to perform daily living process and encourage to take decision.

• This will help in maintaining the better degree of orientation and self care.

* Nursing plan for risk of dehydration:

1. Nursing diagnosis: It includes focus on the electrolyte balance, increase fluid intake.

2. Subjective data: Fatigue, weakness, Diarrhoea

3. Objective data: Elevated CVP, Tachycardia

4. Nursing interventions and rational:

1. Nurse should monitor the vital sign.

• This will provide information regarding the Hypertension and tachycardia as these are the common results of electrolyte imbalance.

2. Weigh the patient daily.

• Weighing patient daily will provide information regarding the intake of the fluid as 1 litre of the water increases 2.2 lb weight.

3. Monitoring infusion rate of parental fluids.

• Rapid or fast bolus and prolonged excessive administration increases the risk of cardiac problem.