Question

Life expectancy for older Australians is increasing due to advances in nutrition, healthcare and medications. Increasing longevity, however, can lead to a gradual decline in physical and mental capacity and growing risk of disease, with many health conditions, and associated impairments associated with ageing. Nursing care for the older person must include consideration of these impairments, particularly when patient safety is compromised.

This assignment requires you to write an essay discussing the implications of nursing care for a patient with one of the conditions associated with ageing listed below.

• Parkinson’s disease
• Dementia (including Alzheimer’s disease)
• Osteoarthritis
• Cerebrovascular accident

In your assignment, consider the following:

1. Discuss the issues associated with this condition which impact patient safety in the clinical environment, (for example, confusion, deteriorating mobility etc.)
2. Explain how the condition affects the older persons’ ability to safely perform their activities of daily living

Consider the implications for patient safety that should be considered in the development of nursing care plans for patients suffering from this condition (consider basic, patient centred nursing care and communication requirements)

Answer 1

Osteoarthritis also known as degenerative joint disease(DJD) or osteoarthrosis is the common kind of arthritis associated with progrresiive degeneration of articular cartilage in synovial joints.usually weight bearing joints and the spine are affected.

Nursing management of the aptient with OA includes both nonpharmacologic and pharmacologic approaches,

Nursing assessment

Nursing assesment for OA focuses mainly on history and physicial assessment.

• Physical assesment ;Assesment of the area over the affected joint may reveal tender and enlarged joonts.
• Patient history;The nurse must take note of any past injury to the joints,as this is a risk factor for OA.

NURSING CARE PLAN AND GOALS

• Identify negative factors affecting activity intolerance and eliminate or reduse their effects when possible
• Use identified techniques to enhance activity intolerance
• Report measurables increase in activity intolerance
• Report pain is relieved or controlled
• Follow prescribed pharmacologic regiment
• Participate in ADLs and desired activities.

Osteoarthritis is a degenerative diasease that worsens over time,often resulting in chronic pain.joint pain and stiffness can become severe enough to make dialy tasks difficult.depression and sleep disturbances can result from the pain and disability of osteoarthritis.

People with OA also experiences spontaneous pain for which there is no obvious stimulus,it is not caused by movement,pressure or loading.there is a long way to go before we completely understand what caused OA pain.but we do not know that it does not depend on the amount of joint damage nor on the amount of activity undertaken.

Physical impact of OA,Pain often makes people with OA in the knee favour one side over the other,as a strategy to reduse the pain and the risk of the joint giving way.those with hip pain tend to lie on the other side to control the pain.

People with arthritic or painful complaints experience a high level of sleep disturbences.poor sleep contribute toi higher level of pain and can increase distress.

Psycological impact of OA,People with OA often suffer fronm depression and anxiety exacerbating by a lack of self efficiency and catastrophisation-a tendency to focus on the negative aspects of an experiences.

As activity decrese over the time so does muscle bulk and strength ,which may lead to decreased joint stability worsening of joint degenaration,and further decline in functional status which can have major systemic consequences affecting cardiovascular health ,emotional health and sence well being.

There is no cure for OA ,mild to moderate symptoms are usually well managed by a combination of pharmacological and non pharmacological treatments.Medical treatments and recommendations include

• medications
• Exercise
• Intermittent hot and cold pack
• Physical ,occupational and exercise theraphy
• weight loss for over weight patient
• healthy eating,managing diabetes and cholestrerol
• Supportive devices such as braces,orthotics ,shoe inserts,cane or walker
• Intra articular injection therapies
• complementary and alternative medicine strategies,including vitamins and suppliments.

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