Nursing Care Plans for Mental Health

This assignment delves into the realm of mental health nursing, emphasizing the importance of effective care plans in addressing various conditions. It highlights the need to consider cultural influences, socioeconomic factors, and exercise's impact on mental well-being. The document provides examples of nursing interventions tailored to different patient needs, promoting stability and recovery.

Apply the theoretical
knowledge

Table of Contents
INTRODUCTION...........................................................................................................................1
PART 1............................................................................................................................................1
Case study...............................................................................................................................1
PART 2............................................................................................................................................2
Plan of care for Adam.............................................................................................................2
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................9

INTRODUCTION
Health care is an important factor that should be focussed by an individual in whole life
carefully to reduce risk of several critical diseases which facilitates to spend comfortable days. It
is necessary to have healthy balanced diet on regular basis, prefer regular exercise and avoid
those eatable items which are harmful for body (Marsella & White, 2012). This report is based
on case scenario in which an 67 years old person named as Mr. Adam having main health
problems of two co- morbidities including 'Alzheimer's disease' as well as 'Incontinence'. It is
common that several health issues are generated in people while they are facing their older age
due to less immunity of human body. Several symptoms are observed that are key issues that he
forget to attend certain events or appointments, getting lost from regular routes and repeat
questions. He was admitted to an emergency ward due to mental instability with critical health
issues as mentioned above and medical specialist conduct several tests for him to determine
actual cause to start diagnosing properly. However, one of the major reason behind admitting in
emergency ward is to control the probabilities of death, instant care for controlling major loss
and aiming is to safeguard the life of a person. The assignment will discuss about case scenario
of Adam to fulfil actual purpose of making an appropriate nursing plan of care including
interventions.
PART 1
Case study
The purpose of given case study is to determine issues and undertake process of analysis
to generate a comprehensive nursing plan of care. An elder person named Mr. Adam, who is 67
years old struggling with the 'Alzheimer's disease' along with 'Incontinence problem'. It is a
disease that completely demolish memory and other mental functions. This may notice mild
confusion and difficulty in remembering in case of Mr. Adam. In this condition, a person may
even forget essential people in their lives while undergo through dramatic personality changes.
'Alzheimer's disease' is caused by dementia that is brain disorder which cause loss of intellectual
and social skills (Clements and Koenig, 2014). In this condition, synthesis of brain cells is not
taking place in proper manner as compared to healthy person which causes regular decline in
memory and mental function (Morgan& Goldston, 2013). Several behavioural or personality
changes are observed such as depression, apathy, social withdrawal, mood swings, distrust in
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others, irritability and aggressiveness, changes in, sleeping habits, wandering, loss of inhibitions,
delusions like believing something has been identified in Mr. Adam. There are certain memory
loss issues which re also determined as repeat statements, forget conversations, skip
appointments, get lost familiar places, forget names of known people and have trouble to express
thoughts (Bloom and et. al., 2012).
Mr. Adam face several issues like he forgets regular familiar routes, skip medical
appointments, repeat statements, forget name of his family members and want to stay alone way
from social people by avoiding societal events or programmes. Moreover, all these problems are
observed by his son Mike and he decided to admit his father need to admit in nearby hospital to
facilitate effective treatment for curing health issues of Mr. Adam. After hospitalised, his
medical specialist conduct certain pathological treats to determine actual cause of his problems
and provide minor medication and kept him under observation.
Several environmental factors also impact on health of Mr. Adam due to exposure to
metals, air pollution and pesticides as well as diet which are risky for him. Thus, these natural
problems creates threats for Mr. Adam to conduct his daily routine work or remaining mentally
stable. There are various kinds of symptoms which are observed in daily routine activities that
helps to doctors for understanding real condition which render support to select an appropriate
medication for patient (Reiss, 2013). The care provider use to give medicines in proper time
along with immediate respond when he request help for toileting. It has disturbed the
surroundings of Mr. Adam and his health such as forgetting names of family members can be
riskier, address of home can lead to losing the way of home etc. After taking required treatment
from health carers, Mr. Adam get relief from his problem but at the same facing certain side
effects also.
PART 2
Plan of care for Adam
According to the case study, Mr. Adam is suffering from 'Alzheimer's disease' along with
issue of 'Incontinence' due to which he is not able to complete his regular routine activities
independently. It is necessary for medical professionals to thoroughly examine very relevant
aspect by conducting an accurate pathological tests to determine actual problems, this will
facilitates to prepare an appropriate plan of treatment including desired interventions to sort out
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health issue of patient in proper manner. According to the case of Mr. Adam, his specialists have
to build more effective as well as efficient plan of care which involves objectives, planning and
evaluation criteria are as under –
Objectives of nursing:
 Determine that patient will have preservation of sensory/perceptual function and
controlled effects of deficits within limits of disease process (Cohen & Cohen, 2013).
 Identify that patient will be able to identify sounds and objects correctly.
 Evaluation about ability of patient that he will be able to use assistive devices to
minimize deficits.
 Analyse family that they will be compliant with making adjustments and the patient’s
environment for prevention of accidents or injuries.
 Conduct treatment process in proper manner to get better results in terms to make patient
stable.
 The patient should receives assistance for toileting in a timely manner (Marin and et. al.,
2011).
 A person reduces or has no incontinent episodes.
 They can eliminates or overcomes environmental barriers to toileting.
 Patient uses adaptive equipment to reduce or eliminate incontinence related to impaired
mobility or dexterity.
 The patient should use portable urinary collection devices or urine containment devices
when access to the toilet is not feasible (Richards & Bergin, 2014).
Nursing interventions: There are various kinds of interventions which should be
fulfilled by medical specialists while carrying out an effective as well as efficient diagnosis of an
individual. In case of Mr. Adam, a nursing plan may applicable to solve his problems of
'Alzheimer's disease' along with 'Incontinence' is explained further –
Nursing Interventions Rationale
Assess for confusing state, disorientation,
difficulty and slowing of mental ability,
changes in behaviour and emotional responses.
The cognitive dysfunction behaviour changes
may result from sensory deficits caused by
physiologic, psychological of environmental
components.
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Evaluate about visual acuity, visual difficulties
or loss along with its effect from these changes
like presence of cataract, glaucoma, and status
of remaining vision.
The issue of presbyopia is observed and other
visual deficits which creates problem in
mobility & socialization changes.
According to Matt Vera, examine auditory
acuity, cerumen in ears, responses to noises,
effect on hearing, ability to communicate,
amount of loss & effect, difficulty in locating
and identifying sounds in proper manner.
Conductive hearing loss results in false
interpretation of words and creates poor
communication, isolation and depression.
Determine olfactory or gustatory loss, changes
in appetite, eating patterns, amount of loss and
effect on nutritional status.
Several physiological changes of old age
results into loss of interest and pleasure of
eating (Townsend & Morgan, 2017).
Identify several problems like tactile changes
or numbness in extremities, loss of sensation,
pain or pressure.
Moreover, tactile perception is reduced in old
people, discriminating various sensations along
with generating risks of injury.
Assess kinaesthetic perception, expressions,
behaviour, extent and direction for movement.
Several ageing neurological changes are
observed which prevent awareness, control of
muscles, muscle movements and generate risks
of falls.
Administer eye drops as per order. Mydriatics act to improve vision with cataracts;
miotics facilitate flow of aqueous humour
through canal of Schlemm.
Apply softening agent to ear and irrigate with
bulb syringe or low pulsating water pik.
Making soft and emulsified cerumen facilitates
easy removal of improve hearing efficiency.
Promote utilisation of assistive devices such as
hearing aid, corrective glasses or contact
lenses.
It includes to render visual aids that allow for
more control and independence.
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Suggest magnifying glasses, reading stand with
magnifier attached with brighter lights.
It provide support to boost up visual acuity.
Recommend sunglasses to use of visor to
patient.
It helps to decrease glare which is considered
as a common complaint in elder citizens.
Put efforts to arrange articles similar to present
trend like food on table, personal hygiene
articles, furniture including clothing.
It helps to make patient independent wit limited
vision as well as improve safety of an
individual.
Suggest use of bright and contrasting colours
along with ignoring hues of blues or greens.
It render support patient for determining items
from one another as colour tend to blend.
Provide for adequate lighting at the time of
night through avoiding abrupt movement from
bright to dim light.
This will facilitate to prevent confusion and
accidents as capability to adjust to differences
in lightning is reduced.
Render device like telephone amplifier on
receiver or bell tone, flash light on phone, loud
speaker for T.V. or radio.
It will help to promote auditory perception and
acuity.
Examine about a kind of hearing loss if head
turned to hear, asks for repeat of conversations
frequently or has an inability to conduct verbal
communication with someone.
It is observed that loss of experience for
hearing of all frequencies and will able to catch
loud sounds or words (Grob, 2014).
Eliminate background noise It may interrupts the hearing efficiency of
person.
Observe patient by proper eye contact, speak
slowly & clearly with accurate pitch, maintain
position and use touch to hold.
Proper hearing improve conversation as well as
promotes felling of warmth & caring.
Rephrased messages to reduce confusion,
puzzled or inappropriate response.
They may not understand certain frequency
sounds.
Utilise hand held devices if it is suitable for
person.
Hearing horns and speaking tubes enhances
communication.
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Offer sweet and salty substitutes to an
individual.
It provide support to determine different tastes
as taste- buds are decreased in old people.
Provide alarm and flashing light type smoke
detector, and safety alarms for stoves and
heating units.
It will help to decrease risk of injury if
olfactory perception is reduced.
Put efforts to prevent any exposure to extreme
temperatures and pressure to skin.
It provide support to reduces risk of burns or
injury if tactile perception is impaired.
Render assistance when ambulating or
performing ADLs which are appropriate for
patient.
It facilitates to reduce risks of falls or injury if
visual acuity is decreased.
Conduct certain activities and encourage
participation in physical and social
interactions.
It helps to prevent isolation as well as sensory
deficits of an individual.
Provides instructions to person or family
members in application of eye and ear
medications. Stress importance of drug
compliance.
Preserves visual acuity and prevents vision
loss, and otic solutions promote auditory
acuity.
Render guideline to patient or family member
for removing hearing aids at least after 2 weeks
and lean them.
Prevents cerumen build up and enhances
hearing.
Provide indications for carrying out screening
exams for vision and hearing at least yearly.
It will facilitates to adjust in corrective devices.
Render information about several precautions
in environmental changes to enhance vision,
hearing, taste, smell and touch as appropriate.
This will provide support for patient safety by
preventing injury in the presence of sensory
impairment (Halpern, 2014).
Inform and instruct patient about pet therapy. It states that pets render sensory stimulation,
improve movement as well as facilitating social
interaction and non verbal communication.
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Provide instructions to family regarding
horticulture activities and their healing along
with therapeutic properties.
Plants grow and provide patients with the
prospect of caring & nurturing as well as
sensory stimulation when working in garden.
Prepare record of incontinence including
duration, frequency, severity of leakage
episodes, alleviating and aggravating factors.
This will render evidences of causes, severity
of condition and its management.
Set a toileting schedule. A toileting schedule guarantees the patient of a
designated time for voiding and reduces
episodes of functional incontinence.
According to Gill Wayne, monitor elderly
patients for dehydration in the long-term care
facility, acute care facility, or home.
Provide functional toileting facilities such as
working toilet, bedside commode.
It render support to immobile patient.
Give loose fitting clothes with stretched
waistbands rather than buttoned or zippered
waist.
Clothing may be a barrier to functional
continence if it takes time to remove before
voiding.
Provide information to care givers and family
members about importance of immediate
response to patient's request for assistance with
voiding (Bateman& Fonagy, 2012).
It is helpful to promote functional continence
when caregivers responding promptly to
patient's request.
Evaluation criteria: There are various kinds of pathological test which are required to be
conducted by medical professionals to monitor actual results of particular treatment process. It is
essential to evaluate overall diagnosis to determine its positive or negative impacts on patient.
Moreover, it provide support to identify problems at correct time which can be easily solved by
changing certain medicines or other medications immediately but it may become critical if
ignored. In case of Mr. Adam, they several steps can be taken by his specialist which are
explained further –
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 Assess formal neuropsychological evaluation of cognitive function which helps to know
actual situation or help to determine speed of recovery of patient.
 To conduct several diagnostic neurological imaging such as CT Scan, MRI or PET.
 Clinical laboratory screening to determine about psychological stability of person
regularly to evaluate desired benefits of medication (Zeidner, Matthews & Roberts,
2012).
 Conduct inspection of care giver to ensure about their medical services that whether they
are appropriate or not for welfare of patient.
 To carrying out certain effective activities for behavioural evaluation and management of
patient to identify extra needs of other required medicines or therapies.
 To evaluate routine neurological and neurobehavioural follow up which helps to know
about stability of patient along with determining certain side effects of particular
medications.
CONCLUSION
From the above report discussion, hence it is concluded that, health care is an eminent
part that should be take care to bring down the various risk of severe disease that facilitates to
spend their day easily. In case of senior citizens, with age, numerous disease and physical
problems emerged in their bodies which can harm their health vitally. Hence, it is essential to
focus on an individual balanced diet on daily basis, avoid junk food that increases calories very
fast and should do exercise or yoga to burn the extra fat. This helps them to keep safe and
healthy from these kind of diseases. An effective nursing plan should be prepared which
facilitates to carrying out treatment of patient in proper manner to get better results. It includes
various nursing interventions according to present physical as well as medical position to make
them stable properly.
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REFERENCES
Books and journals
Marsella, A. J., & White, G. (2012). Cultural conceptions of mental health and therapy (Vol. 4).
Springer Science & Business Media.
Morgan, W. P., & Goldston, S. E. (2013). Exercise and mental health. Taylor & Francis.
Reiss, F. (2013). Socioeconomic inequalities and mental health problems in children and
adolescents: a systematic review. Social science & medicine, 90, 24-31.
Cohen, P., & Cohen, J. (2013). Life values and adolescent mental health. Psychology Press.
Richards, P., & Bergin, A. E. (2014). Handbook of psychotherapy and religious diversity.
American Psychological Association.
Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care
in evidence-based practice. FA Davis.
Grob, G. N. (2014). From asylum to community: Mental health policy in modern America (Vol.
1217). Princeton University Press.
Halpern, D. (2014). Mental health and the built environment: more than bricks and mortar?.
Routledge.
Bateman, A. W., & Fonagy, P. (Eds.). (2012). Handbook of mentalizing in mental health
practice. American Psychiatric Pub.
Zeidner, M., Matthews, G., & Roberts, R. D. (2012). What we know about emotional
intelligence: How it affects learning, work, relationships, and our mental health. MIT
press.
Clements, W. M., & Koenig, H. G. (2014). Aging and God: Spiritual pathways to mental health
in midlife and later years. Routledge.
Bloom, D. E. and et. al., (2012). The global economic burden of noncommunicable diseases (No.
8712). Program on the Global Demography of Aging.
Marin, M. F. and et. al., (2011). Chronic stress, cognitive functioning and mental
health. Neurobiology of learning and memory, 96(4), 583-595.
Online
13 Alzheimer’s Disease and Dementia Nursing Care Plans. 2018. [Online]. Available
through :<https://nurseslabs.com/alzheimers-disease-nursing-care-plans/9/>
Memory Evaluation and Treatment Services. 2018. [Online]. Available through
:<https://www.burke.org/outpatient/services/memory-evaluation>
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