Question

Que 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.

What is the impact of a diagnosis based on the labelling of a patient?

How do normal changes of ageing increase the risk of Edith developing a pressure injury in this scenario?

Que 2, You are a RN working in community care, visiting Amita, a 76-year-old with a chronic and painful venous ulcer on her lower leg. She takes multiple medications for chronic illness, and a codeine-based medication for pain. Amita lives alone in her own home.

How would Amita’s chronic pain impact on her ability to maintain a safe environment?

Why is Amita, as an older adult, more vulnerable to adverse drug events?

Que 3, You are a RN working on an acute medical ward, looking after Oliver, an 80-year-old with painful cellulitis from hand to shoulder resulting from a small left hand scratch sustained while gardening. He is admitted for 7 days of QID IVABs via a right cubital fossa PIVC. Because of the cellulitis, PIVC and IVAB regime, Oliver’s mobility is limited.

Outline the normal changes of ageing on the respiratory system in predisposing Oliver to pneumonia during his hospital admission.

What are the benefits of increasing the mobility of an older adult during hospitalisation? How should the RN encourage incidental exercise during Oliver’s admission?

Answer 1

Acopia:- This term used to describe patients who are unable or not able to cope with activities of their daily living.

Q1. What is the impact of a diagnosis based on the labelling of a patient?

Ans:- patient is having Acopia means she is not able to cope up with her activities of daily living & due to busy ward she will spend the next 8 hours (+) on an ED trolley in a corridor. So this condition will make a impact on the patient because she is not able to her activities of daily living she need assistance for her daily activities, there is chance to fall also due to inadequate supervision. There is also risk to develop fracture to fall. Patient is having delirium or dementia also due to aging process so she got confused & anxious also about her stay.

Q; How do normal changes of ageing increase the risk of Edith developing a pressure injury in this scenario?

Ans;- 1. With ageing increases in this scenario age of the patient is 80 years the fragility of the skin also increases. Due to this there is thinning of cell layers, decreased vascularization, cell proliferation, and delayed healing process that leads to the pressure injury.

2. Immobility:- Due to ageing & poor health, spinal cord injury etc cause the patient to immobilize that leads to the pressure injury.

3. Pressure: Patient is on trolley Due to Constant pressure on any part of your body due to immobility can low the blood flow to tissues. Because Blood is essential for delivering oxygen and other nutrients to tissues. Without these nutrients, skin and nearby tissues are damaged and might eventually die that leads to pressure injury.

4.Incontinence:- Patient is unable to cope up with her daily living. If proper care is not provide Skin becomes more vulnerable with extended exposure to urine and stool that leads to injury due to infection.

5. friction also leads to the pressure injury.

Q2. How would Amita’s chronic pain impact on her ability to maintain a safe environment?

Ans; Chronic pain have seriously affects the patient’s daily activities and their quality of life. Due to the pain she is not able to fulfil her daily needs. With the chronic pain only patient is not affected with both her sensory and emotional problem but it also affects her social circle. Chronic pain leads to depression, mood fluctuations, anxiety, altered perceptions and cognition, and emotional instability in the patient. So in this way the chronic pain impact her ability to maintain a safe environment.

Q. Why is Amita, as an older adult, more vulnerable to adverse drug events?

Ans. With the increasing age the problems are faced by the patient is decreased body size, altered body composition like more fat, less water, and decreased liver and kidney function that may cause many drugs to accumulate in older people's bodies at higher levels for longer time that cause the adverse drug events.

Due to Decreased Ability of the Liver to Process Drugs Because liver is less able than younger people to process certain drugs so that they can be excreted from the body easily

Q3. Outline the normal changes of ageing on the respiratory system in predisposing Oliver to pneumonia during his hospital admission.

Ans:- with the aging The respiratory system undergoes various anatomical as well as physiological and immunological changes. The changes in the structure of lungs include chest wall and thoracic spine deformities that leads to impairment of the total respiratory system compliance of the patient & leading to increase work of breathing.

The lung parenchyma also losing its supporting structure causing dilation of air spaces.

Respiratory muscle strength also decreases with age and that can impair effective cough, which is important for airway clearance. That leads to the aspiration also and cause pneumonia also.

In the aging due to the low immunity there is chance to develop pneumonia.

Q What are the benefits of increasing the mobility of an older adult during hospitalisation?

Ans:- Benefits of mobility are:-

1. It helping to maintain the ability of the patient to live independent.

2. It helps in reducing the risk of falling of the patient and fracturing of bones

3. It helping to maintain healthy muscles, bones and joints and it also helps to control the pain of joints, swelling of joints that is associated with arthritis.

4. Other benefits are it helps in reducing the risk of colon cancer, diabetes, coronary heart disease and it also helps to reduce the blood pressure

5. It also helps to reduce the symptoms of anxiety, depression and promotes feelings of well-being.

It helps to prevent pressure injury