ANSWER:
1. Clinical Symptoms: Mr M exhibits cognitive decline, including memory loss, trouble remembering names, and disorientation. He exhibits signs of anxiety, hostility, terror, and nocturnal wandering. Furthermore, compared to his former level of freedom, he is now more reliant on activities of daily living (ADLs).
2. Medical Diagnoses: Alzheimer’s disease or another kind of dementia should be taken into consideration as Mr M’s primary medical diagnosis. His cognitive deterioration, memory problems, behavioural modifications, and functional decline all corroborate this. Potential secondary medical diagnoses include delirium, depression, and urinary tract infections (UTIs). Due to his symptoms’ abrupt start and erratic progression, delirium is possible. Leukocytes and cloudiness in the urinalysis point to a UTI, which can impair older persons’ cognitive function. Due to its link to cognitive deterioration and functional impairment, depression should also be considered.
3. Nursing evaluation Findings: Abnormal findings during the nursing evaluation may include changes in cognitive function, such as confusion, disorientation, and trouble focusing and paying attention. Physical examination results may show modifications in gait, mobility, and balance due to Mr M’s shaky gait and ambulation difficulties. Mr M may show indicators of anguish, dread, and anxiety psychologically. He can become frustrated and have mood swings emotionally. These results are consistent with the clinical signs and possible medical diagnoses.
4. Impact on Mr M and His Family: Mr M’s current state of health may substantially impact him physically, mentally, and emotionally. He might struggle with functional decline, growing dependency on others, and the possibility of falls or injury on a physical level. He might go through psychological disorientation, annoyance, and self-identity loss. He might experience emotional fear, anxiety, and loneliness. Due to these impacts, his family may experience emotional exhaustion, overwhelm, and stress. Guilt, loss, and the necessity to make difficult choices regarding his care may cause them to suffer.
5. Interventions to Support Mr M and His Family: Several interventions can be used to support Mr M and his family. These include fostering social engagement and intellectual stimulation, delivering person-centred care, working with a multidisciplinary team, and providing support and education to the family to help them cope and comprehend the disease process. A thorough care plan should also be created, considering the patient’s physical, mental, emotional, and social requirements.
6. Present or Future Issues for Mr M: a) Falls and injuries due to shaky gait and functional deterioration.
b) Communication problems and trouble communicating needs.
c) He became more agitated and aggressive, harming his relationships with others and his well-being.
d) The stress placed on families and carers due to the obligations associated with managing behavioural changes and providing care.
The case of Mr M illustrates the difficulties in providing care for older people experiencing cognitive deterioration. Healthcare professionals can assist people like Mr M in maintaining their well-being, improving their quality of life, and support their families by conducting a thorough assessment, considering potential medical diagnoses, and implementing appropriate interventions.
QUESTION:
Mr. M., a 70-year-old male, 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.
Case Scenario
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.
Objective Data
1. Temperature: 37.1 degrees C
2. BP 123/78 HR 93 RR 22 Pox 99%
3. Denies pain
4. Height: 69.5 inches; Weight 87 kg
Laboratory Results
1. WBC: 19.2 (1,000/uL)
2. Lymphocytes 6700 (cells/uL)
3. CT Head shows no changes since previous scan
4. Urinalysis positive for moderate amount of leukocytes and cloudy
5. Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L
Critical Thinking Essay
In 900-words, critically evaluate Mr. M.’s situation. Include the following:
1. Describe the clinical manifestations present in Mr. M.
1. 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.
2. When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
3. 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.
4. Discuss what interventions can be put into place to support Mr. M. and his family.
5. 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 2 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. Also, you must have a conclusion with a minimum of 5 sentences to wrap up the case study.