Extended Care Planning Essay

Running head: EXTENDED CARE PLANNING ESSAY
Extended care planning essay
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EXTENDED CARE PLANNING ESSAY
The impact of a severe or a delimiting disease is extreme on the patient, affecting the
lifestyle and abilities of the patient. However, for diseases that are intricately associated with
bringing forth nerve damage, the impact of the nerve damage causing disease is far more
deleterious on the patients (Dendrou, Fugger & Friese, 2015). Researchers are of the opinion
that for the patients that are elderly and are suffering from the co-morbid disorders, the care
planning must be patient centered and individualized. The clinical reasoning cycle serves as a
potent framework or tool that helps the nurses address each and every care need on a priority
based format, delivery care and reflecting on the procedure so that the care is safe, effective
and individualized for the patient (Levett-Jones, 2013). This essay will attempt to utilize the
clinical reasoning cycle to address to the care priorities that the patient is suffering from with
respected to the Miller’s functional framework taking the aid of the case study of Dinh Nguyen.
The first and foremost, the nurse while assessing the patient considering the patient
situation is extremely beneficial for the nurses to attain a basic understanding of the issues
presented by the patient (LeMone et al., 2015). Here the patient under consideration is an 83
year old patient named Dinh Nguyen, an old Widower who had been a diagnosis of Multiple
sclerosis 6 years ago. The comorbidity that Dinh had been suffering from includes osteoarthritis
which is medically managed. Dinh has been living alone in the two storied house since the
death of his wife and even though he has a brother, he is not willing to involve him with his life.
He has some extent of financial independence and he is careful with money but with reduced
investment returns, his earnings are only covering his own expenses.
The next step is for the nurse to collect and process all different kinds of information
about the patient and then review and process the information to arrive at a verdict regarding
bthe cared needs expressed by the student (Dalton, Gee & Levett-Jones, 2015). Considering the
past medical history, it has to be mentioned that Dinh had a diagnosis of multiple sclerosis 6
years ago and has also been suffering with osteoarthritis from last 4 years. The presenting
symptoms of the patient includes blurred vision, numbness in the face, feeling of electric shock
while moving head and neck that travels down his neck and into his legs and associated activity
intolerance, affecting his ability to cook, shower or dress up.

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EXTENDED CARE PLANNING ESSAY
Processing the information, it is crucial for the nursing professional to interpret,
discriminate, relate, infer and match the collected cues with best practice evidence to be able
to arrive at an outcome. In this case, the most important health issue that Dinh is facing is the
Multiple sclerosis which is also causing most of the symptoms for him. As mentioned by
Dendrou, Fugger and Friese (2015), symptoms such as blurred vision, numbness, and electric
shock sensation and unsteady gait are very common symptoms of multiple sclerosis and
resultant brain lesions. Along with that, the impact osteoarthritis have also been reported to
deteriorate the gait balance and mobility status of the patient, which can be the case for Dinh
as well. On a more exploratory note, the impact of multiple sclerosis on the normal physiology
of an adult body and its possible link with the osteoarthritis symptoms cannot be ignored
either. Montalban et al. (2017), have mentioned that the risk factors of the osteoarthritis
include muscular weakness, especially in the quadriceps which has been reported to be caused
by MS. Along with that, people suffering with MS often have affected knee joints due to gait
imbalance and muscular atrophy which leads to joint degeneration associated with OA.
The next step of the care planning will need to focus on the identifying the care needs
based on the cues collected and processed by the nurse. In this case, the first and foremost
care need for him is the mobility restriction and the fall risk. Dinh had been suffering from
mobility resistance due to his MS symptoms which is known for causing unsteady gait. Along
with that, his diagnosis of osteoarthritis and blurred vision will also facilitate a significant
restriction in functional mobility for him. He lives in a two storied house alone, the mentioned
health issues can potentially lead to considerable fall risk for him (Dennett, Coulter, Paul &
Freeman, 2017). The second care issue that needs priority based intervention is the self-care
deficit; as mentioned in the case study, Dinh had blurred vision and electric shock sensation
which is caused by the multiple sclerosis which has affected his ability to move and participate
in activity drastically. As a result, he is incapable of cooking, showering and dressing himself
which is indicative of his self-care deficit affecting his hygiene and activities of daily living
(Munsell, Locklear, Phillips, Frean & Menzin, 2015). The third care priority for him is the
depression and anxiety that he is facing due to his perception of worsening symptoms and the
uncertain future due to his disorders. Exploring further, it is very important to analyze that old