Question

Mr. Jones is 92 years old black male lives alone at home. He ambulates slowly, with the use of a cane and has no help at home for his ADL’s. He drinks occasionally and has a poor eating habit;

a.What safety concerns do you anticipate for this patient?

b. What would be an actual nanda-1 diagnosis?

c.Risk nanda-1 diagnosis?

2. What are some of the factors that influence patient safety? explain

3. Explain the infectious process?

4. What are the different types of isolation precautions? explain each

5. How does immobility affect the following systems?

-Cardiovascular

Respiratory

Integumentary

musculoskeletal

Answer 1

Question 1

a) Safety concerns for Mr. Jones

As Mr. Jones is an elderly citizen staying alone without help/aid. He is at risk of:

Slips and falls

Side effects of alcohol Consumption

Fire and electrical hazards

Medicine and accidental poisoning

Difficulty food preparation

Difficulty in getting the household chores done

b) Actual NANDA Diagnosis

Impaired walking related to poor muscle strength as evedenced by the use of a cane

c) Risk NANDA Diagnosis

Risk for Imbalanced nutrition: less than body requirements related to decreased intake as evidenced by poor eating habit

Risk for falls related to impsired walking patterns.

Risk for self care deficit related to gradual deterioration of health

Question 2: Risk Factors influencing Patient Safety:

Factors influencing Patient Safety Include:

· Patient‐related: The patients’ characteristics like age, gender, relationships, etc affect the safety of the patient.

· Illness‐related: illness severity affects safety

· Health‐care professional‐related: health care professionals’ knowledge and beliefs affects safety.

· Health care setting‐related: The facilities available in the health care setting affect the patient safety.

· Task‐related: The patient’s safety behavior challenges and the clinicians’ clinical abilities affect safety

Question 3: Infections Process

Infectious disease process includes the following components:

Agent, Reservoir, Portals of entry and exit, Mode of Transmission, and Immunity.

(1) Agent

Types of agents range from the submicroscopic to the large parasites.

(2) Reservoir

The reservoir is the normal habitat in which the agent lives and multiplies. It is where the agent propagates itself in nature. Reservoirs includes:

• Symptomatic cases
• Carriers
• Animals
• Inanimate objects (Water, Food, Soil, Air, Fomites)

(3) Portals of entry and exit

Portals of infection include the

• Respiratory tract (upper and lower)
• Conjunctiva (lining of the eyes and eyelids)
• Urogenital tract
• Gastrointestinal tract (upper and lower)
• Placenta (mother to child transmission)
• Skin (broken and unbroken skin)

(4) Mode of transmission

Modes of transmission include:

• Contact (requiring proximity to an infected host or discharge from an infected host)
• Vehicle (an inanimate intermediate carrier)
• Vector (an animate intermediate carrier, often an insect)
  • Mechanical
  • Developmental
  • Propagative
  • Cyclopropagative

(5) Immunity.

Immunity includes all factors that alter the likelihood of infection and disease once the agent is encountered.

Innate Immunity includes:

• Physical barriers: skin, mucosa, mucus sheaths, respiratory tract cilia, cough and gag reflex
• Chemical barriers: acidity of stomach and vagina, enzymes in saliva and GI tract, lipids, interferons, and other miscellaneous biologically active substances
• Cellular and physiologic barriers: macrophages, polymorphs, reticular endothelial cells, NK cells, inflammation, fever.

Acquired Immunity includes:

· Vaccinations

· Previous contact.

Question 4: Isolation Precautions

Isolation precautions create barriers between people and germs thus helping to prevent the spread of germs in the hospital.

Standard Precautions Include:

· Use of PPE that may be required include gloves, masks, goggles, aprons, gowns, and shoe covers

· Hand washing and cleaning up is also important

Transmission-based precautions are followed in addition to standard precautions.

Airborne precautions include a negative pressure room for the patient and a well-fitted respirator mask for anyone who enters the room.

Contact precautions include hand washing and wearing gown and gloves.

Droplet precautions include maintaining a distance of 3 feet (90 centimeters) from the patient and wearing a surgical mask

Question 5: Effects of Immobility:

On Cardiovascular System

· Venous stasis

· Venous dilation

· Decreased blood pressure

· Edema

· Embolus formation

· Thrombophlebitis

· Orthostatic hypotension

On Respiratory System

· Thickening of respiratory secretions

· Pooling of respiratory secretions

Inability of the client to mobilize and expectorate these secretions can lead to

· Atelectasis (Collapse of bronchioles)

· Hypostatic pneumonia

· Inbility to exchange oxygen and carbon dioxide that cause hypoventilation and hypoxemia

On Integumentary System

· Skin breakdown

· Pressure ulcers

· Poor skin turgor

On Musculoskeletal System

· Loss of muscle strength and endurance

· Bone weakening.

· Bones undergo a progressive loss in mass (disuse osteoporosis)

· Muscles weaken and undergo atrophy (waste away)