Question

DIRECTION: Create an NCP in relation to the case scenario. (With Assessment, Nursing Diagnosis, Planning, Intervention, Rationale, and Evaluation)

Case Scenario: This is a case of a patient referred to a specialty memory clinic at the age of 62 with a 2-year history of repetitiveness, memory loss, and executive function loss. Magnetic resonance imaging scan at age 58 revealed mild generalized cortical atrophy. He is white with 2 years of postsecondary education. Retirement at age 57 from employment as a manager in telecommunications company was because family finances allowed and not because of cognitive challenges with work. Progressive cognitive decline was evident by the report of deficits in instrumental activities of daily living performance over the past 9 months before his initial consultation in the memory clinic. Word finding and literacy skills were noted to have deteriorated in the preceding 6 months according to his spouse. Examples of functional losses were being slower in processing and carrying out instructions, not knowing how to turn off the stove, and becoming unable to assist in boat docking which was the couple’s pastime. He stopped driving a motor vehicle about 6 months before his memory clinic consultation. His past medical history was relevant for hypercholesterolemia and vitamin D deficiency. He had no surgical history. He had no history of smoking, alcohol, or other drug misuse. Laboratory screening was normal. There was no first-degree family history of presenile dementia. Neurocognitive assessment at the first clinic visit revealed a poor verbal fluency (patient was able to produce only 5 animal names and 1 F-word in 1 min) as well as poor visuospatial and executive skills. He had fluent speech without semantic deficits. His neurological examination was pertinent for normal muscle tone and power, mild ideomotor apraxia on performing commands for motor tasks with no suggestion of cerebellar dysfunction, normal gait, no frontal release signs. His speech was fluent with obvious word finding difficulties but with no phonemic or semantic paraphrasic errors. His general physical examination was unremarkable without evidence of presenile cataracts. He had normal hearing. There was no evidence of depression or psychotic symptoms.

Answer 1

1)Care plan on impaired physical activity related to aging process

Assessment = the person is unable to do his daily activities

Nsg diagnosis= impaired physical activity related to aging

Planning = to help the pt in achieving daily activities and help them to maintain activity level

Intervention = assist pt in muscle exercise which improve the muscle strength, assist them in daily activities, provide them safety as they have risk of fall, provide them with the good nutrition , health checkups for musculoskeletal system, regular medications, ROM exercise pychological support

Rationale = these actions will improve the physical activity tolerance, good nutrition will help to gain strength

Evaluation= the activity tolerance was improved

2) disturbed thought process related to memory loss

Assessment = the pt is unable to recall the recent activities

Nsg diagnosis = disturbed thought process related to memory loss

Planning= to help patient to maintain mental health and participate in the community

Intervention = assess pts thought process every time . . . . . . . This will help to detect improvement or deterioration

Provide the environment which help pt to relieve stress, always orient the pt to the place time

Engage the pt in the activities which make pt comfortable, never leave the pt alone , pt should wear a bracelet indicates disturbed memory

Maintain regular routine which avoid confusion innthe pt , allow pt to read and write the books

Evaluation = the person feels comfortable without confusion