Case Study: Mr. M. NRS 410
Case Study: Mr. M. NRS 410
Nursing Assessment and Possible Abnormalities
When doing a nursing assessment, various abnormalities are expected. For instance, for the case of dementia, a PET scan would show tau protein abnormal accumulation in the nerve cells. In addition, some other abnormalities would include changes in the patient’s vital signs, such as changes in respiratory rate, blood pressure, and temperature, all of which can be higher than the expected range. In practice, older individuals with various conditions are usually assessed to evaluate cognitive impairment since they have many risks of mental impairment (Weller & Budson, 2018). During such assessments, various scales can be used. In the case of Alzheimer’s dementia, abnormal findings may include cognitive impairment and impaired function.
Possible Emotional, Psychological and Physical Effects on the Patient and The Family
The Case Study: Mr. M. NRS 410 patient’s current health condition may have various impacts on the patient and the family members. Among the physical impacts are impairments in physiological and physical functioning. For instance, the patient may have a diminishing ability to carry out his daily activities, which may proceed to muscle loss (Weller & Budson, 2018). The muscle loss eventually makes the patient incapable of withholding urine and bowel movement. The patient may also experience various psychological and emotional impacts. For instance, the patient may experience apathy, aggression, anxiety, fear, anger, depression, and loneliness.
Apart from the patient, the current condition may impact the family members in various ways. One of the major impacts is the burden associated with caregiving. Such burdens may make the family members have feelings of fear, frustration, anger, and sadness (Weller & Budson, 2018). In some cases, the family members may be called upon to make crucial decisions surrounding the patient’s conditions, such as making adjustments to the patient’s and the family’s living conditions, end-of-life care decisions, treatment options, and financial decisions. Such decisions may lead to family feuds resulting in more psychological and emotional misery.
Possible Interventions to Support the Patient and the Family: Case Study: Mr. M. NRS 410
Patients living with various conditions or illnesses need various interventions to help them have better life quality by relieving the symptoms. As such, Mr. M and the family need various interventions. This case requires offering medications and life coping skills that would help in alleviating the signs and symptoms like depression and emotional effects. The patient needs to use medications that help him to manage hypertension, diabetes, and hyperlipidemia better. Alzheimer’s dementia is a long-time condition. Therefore, one of the long-term care plans and interventions would be to administering the patient and the family home-based care and support (Weller & Budson, 2018). Such caregiving efforts would also focus on offering home health programs and social support to both the patient and the family members.
The long-term care plan would require that the caregiver performs a detailed assessment on the home setting and the prevailing living conditions within the care home environment and formulate a patient-centered care plan. Such a plan would be instrumental in helping the caregiver to conduct a frequent assessment of the family and the patient as the need arises (Weller & Budson, 2018). Mr. M also needs various medications to help in the management of Alzheimer’s dementia to foster the patient’s mental abilities. These medications can help slow the disease progression and relieve symptoms even though they cannot reverse the damage done or stop the disease. Community support groups would also greatly help Mr. M and the family since sharing experiences with other individuals and families affected by the same problem would help them better manage the symptoms.
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.
Evaluate the Health History and Medical Information for Mr. M., presented below.
Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.
Health History and Medical Information
has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.
Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.
- Temperature: 37.1 degrees C
- BP 123/78 HR 93 RR 22 Pox 99%
- Denies pain
- Height: 69.5 inches; Weight 87 kg
- WBC: 19.2 (1,000/uL)
- Lymphocytes 6700 (cells/uL)
- CT Head shows no changes since previous scan
- Urinalysis positive for moderate amount of leukocytes and cloudy
- Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L
Critical Thinking Essay
In 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:
- Describe the clinical manifestations present in Mr. M.
- Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.
- When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
- Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. Discuss the impact it can have on his family.
- Discuss what interventions can be put into place to support Mr. M. and his family.
- Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.