Question

Case Study 1 You are a RN working in ED, looking after Edith, an 87-year-old with an admitting diagnosis of Acopia. All acute interventions have been completed for Edith, but the wards are full, so she will spend the next 8 hours (+) on an ED trolley in a corridor. Case Study 1. The implication in this scenario is that a diagnosis of 'acopia' is a diagnosis based on functional abilities and is a form of labelling.

1. What is the impact of a diagnosis based on the labelling of a patient? Answer this using online learning materials provided and other peer reviewed evidence. Acopia itself is more of a symptom of underlying changes than a diagnosis. 'Acopia' refers to decreased ability to cope/ manage activities of everyday life and is a symptom of increasing frailty. Edith is 87 years of age. Normal ageing process eventually leads to frailty. We studied frail aged in week 8 tutorial (review recording if you have forgotten) and in week 6 online material. Nurses role - Include an analysis of how this labelling impact the care Edith receives.

2. How do normal changes of ageing increase the risk of Edith developing a pressure injury in this scenario? Here you need to consider normal physiological changes that occur as part of ageing to body systems that increase the risk of developing pressure injury. We covered this in week 6 and week 10 online learning and in additional readings. You could easily relate at least 3 systems to this answer. Nurses role - Also analyse the role of the nurse to prevent pressure injury for Edith. Remember the scenario context.

The nursing role is important in this answer

Answer 1

1. Impact of diagnosis based on labelling of patient:

• Hamper the diagnosis and treatment
• Affects standardised nursing practice
• Patient may be neglected by practitioners due to labelling
• Delayed care as compared with other patients

Nursing role

• Use Comprehensive Geriatric Assessment(CGA) to understand the patient problems and impact of labelling as well
• Trained professionals should perform analysis with CGA

2. Normal physiological changes in ageing that increase the risk of developing pressure injury

Basically, older people are prone to get pressure sore because of the ageing process happening in the body as their skin becomes fragile.

Some of the normal changes that causes pressure injury in elderly are listed below:

• Layers of the cell becomes thin
• Decreased blood supply
• Cell proliferation
• Delay healing

Nursing role in prevention of pressure injury:

• Assess the skin for any changes
• Keep the skin clean and dry
• Encourage the patient to move around
• Change the position every 2 hours if bedridden
• Use wrinkle free bed or air mattress can be provided that helps in circulation
• Provide back care frequently by applying appropriate pH skin cleanser and dry it to avoid moisture