Health of older adult’s

This article discusses the health issues faced by older adults, specifically focusing on a case of a diabetic patient. It covers the primary medical diagnosis of diabetic retinopathy, medication management, nursing diagnoses related to the medical condition and medication, and the nursing role in providing inter-professional care. The article emphasizes the importance of proper treatment for diabetes and recommends other care measures.

Health of older adult’s
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Table of Contents
INTRODUCTION...........................................................................................................................3
PRIMARY MEDICAL DIAGNOSIS.............................................................................................4
MEDICATION MANAGEMENT..................................................................................................4
NURSING DIAGNOSES................................................................................................................5
Nursing problem related to medical diagnosis............................................................................5
Problem related to medication management................................................................................6
NURSING ROLE AND INTER-PROFESSIONAL PLAN OF CARE..........................................6
SUMMARY.....................................................................................................................................8
REFERENCES................................................................................................................................9
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INTRODUCTION
Health is termed as a state of entire physical, mental and social well-being as well as the
resource for living their entire life. In fact, it has been seen that common health situation is
related with ageing. Specifically, the common condition in older adult age consists of chronic
pulmonary disease, depression and Diabetic problems (Lipska and et.al., 2015). However, this
project is intent to provide specific information regarding an adult person who is suffering from a
diabetic disease. Therefore, to get more reliable data regarding the patient an “ISBAR clinical
handover framework” is taken into account.
According to the case scenario, it has been identified that Jackson was admitted with a
diabetic health issues. He was not able to see properly from his left eye. Mr. Hank Jackson who
is a 64 year old newly retired truck driver has been diagnosed with a diabetic retinopathy. He
was appearing overweight and has a flushed facial appearance. Jackson was also losing weight
for the last couple of months. It has been seen that the general practitioner has observed that he
was suboptimal blood pressure and diabetes control. The blood pressure level was
159mmHg/96mmHg as well as Glycated haemoglobin has never been less than 8%. Jackson is
also having part medical history that consists of 2 diabetes mellitus and hypertension. He used to
live alone in his own home because of self-described bachelor, but he has a daughter from past
20 years. It has been seen that Mr. Jackson wants to remain in his own home and take pride in
cooking and making its home-brew. Thus, an inter-professional community plan of care. The
primary responsibility as a nursing professional to take early decision of acute care to Mr
Jackson as well as avoid further risk that can affect their entire life in the future. A proper
treatment for diabetes is needed to be provided and also recommend certain other care measures.
PRIMARY MEDICAL DIAGNOSIS
According to the health condition of Mr. Jackson, it has been seen that diabetic
retinopathy is basically considered as major cause of blindness. In fact, he was having a problem
in his left eye because of this particular disease. It simply characterised by basement membrane
thickening and hyperglycaemia. It is important to diagnosed with a well-organize dilated eye
examination to Jackson. For this evaluation, a drop is placed in his eyes widen its pupils to allow
their medical professional to an effective view inside Jackson eyes. However, the drop tends to
cause its close visualization to blur until they are wearing off. It has been also observed that
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retinopathy generally does not found for all most five year after a type 1 diabetes is diagnosis.
After 15 years of this problem, 98 % of people with type 1 as well as 78 % of type 2 diabetes
tend to impact the retinal damage among the patient. Since, Jackson was 64 years old therefore it
is quite common to have type 1 diabetes symptoms (Lee and et.al., 2013).
It has been analyzed that preclinical stage of diabetes retinopathy is been indispensable
during the drug and development of new therapies. Sarbitol does not diffuse out of their cell
easily as well as increase intracellular concentration. The resultant tends to damage to their lens
epithelial cells that have a maximum concentration of aldose reductive which is responsible for
the cataracts found in the infected people (Doenges, Moorhouse and Murr, 2016). However, the
platelets tend to be abnormalities in case of diabetics that can contribute to retinopathy. It has
been seen that platelets in infected patients are stickier other than platelets of people without
having any diabetes problems.
Patho-physiology of DR:
 High rate of dysfunction of the retinal vasculature inferior to the chronic hyperglycaemia
 It will lead to vascular leakage, retinal hypoxia
 Thicken of BM as well as failure of pericytes and nutrient flow is common
MEDICATION MANAGEMENT
According to Mr. Jackson doctors, it has been asked to take Metformin 500mg twice in a
day and Metoprolol 50mg two times regularly.
Metformin 500mg: It is basically considered as an oral diabetes drug that assists the
control of blood sugar levels. However, it is used jointly with the diet and regular exercise to
improve blood sugar control in the adult those are having type 2 diabetes symptoms (Huang,
Castelino and Peterson, 2015). In some cases, it can also provide given with the insulin, but is
not useful for type 1 diabetic persons.
Side-effects: The people those are consuming this type of medication is need to face certain side-
effect of using overdose of this drug. It includes physical weakness, gas, muscle pain, low blood
sugar, abdominal pain and diarrhea (Foretz and et.al., 2014)
Precaution: Metformin is having moderate interaction with other 74 different types of drugs. It
has been recommend to keep out of the reach of children as well as extra overdose will sometime
create medical emergency to the patient. Instruction is clear to the patient to avoid using alcohol
as well as postpone therapy to a few other form of surgery.
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Metoprolol 50mg: This particular medicine is used with or without the other drugs in
order to control a high blood pressure. Further, it will be also effective in treating chest pain as
well as improve condition of patient after a heart attack. It acts by blocking the action of a
specific natural chemical in the patient body such as blood vessels and epinephrine (Metoprolol,
2015).
Interaction: The medicine interaction might change role of medication as well as risk for serious
side effects. It does not contain any possible interaction because some of them are having
ingredient that can increase heart rate or BP level.
Side-effects: There are certain key symptom that can impact the health of patient such as
Drowsiness, tiredness, diarrhea and low heartbeat. It will also reduce sexual capability that has
been report rarely (Westbrook and et.al., 2015).
Precaution: Before using this particular drug, inform doctors if patient are allergic to it or not,
because it consists of a inactive ingredients that can cause allergic reaction or sometime other
problems.
NURSING DIAGNOSES
Nursing problem related to medical diagnosis
In the case of any medical diagnosis that deal with a disease or other medical condition.
In fact, a nursing diagnosis tends to deal with people to actual or critical health issues. However,
they need to face lot of nursing problem while treating a diabetes patient such as risk of unstable
blood glucose, deficient knowledge, powerlessness, infection or injury and improper nutrition
level. As such there is not any proper cure for the diabetes; however management of patient that
is having diabetes consists of a dietary guidance, physical exercise and insulin regimen (Kirk and
et.al., 2012). It has been seen that care can also be tougher and complex as Jackson may suffer
from other future complication such as coronary artery disease. Henceforth, to guide the patient
as well as enable them to manage its diabetes situation.
Problem related to medication management
Nursing diagnosis tends to have also certain medication management problems. It can
lead to impact the critical condition of the patient. In fact, without having proper knowledge or
idea regarding the relevant medicine or drug to treat the diabetes patient the condition can get
verse sometime. Therefore, it is important to review the medicine prior giving it to the infected
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person in order to assess specific aspects such as long-term blood glucose, cholesterol level and
BP. Some key problems that are faced during diagnosis of Mr. Jackson condition such inability
to understand the composition of medicine and knowledge of deficit of disease. Furthermore, the
complexity of the drug prescription in context with the lack of experience and manual dexterity
that is seen normal in elderly patients (Knight and et.al., 2012).
NURSING ROLE AND INTER-PROFESSIONAL PLAN OF CARE
During the treatment of diabetes patient, it is important role of nurses to provide a
relevant care to manage their physical needs as well as prevent illness. In order to do this, they
need to analyze and look after the patient, recording specific information that can aid in
treatment decision. However, across the different patient experience as well as wherever there is
someone in need of care, nurse tend to work tirelessly to examine and protect the requirement of
the person. Moreover, no matter nurse are from any field and professional, they need to utilize
the same nursing process as scientific method that has been designed to provide an effective care
to the diabetes patient Jackson (Morgan, Coates and Dunbar, 2015.). They also make sure that
most accurate and reliable diagnoses to their future learning of public regarding health problems.
With the help of accurately formulating the care plan, the nurse needs to guarantee on
consistency of care for the Jackson whilst meticulously documenting their progress. Through,
close examination of the effectiveness of the care plan as well as analyse the Jackson responses.
However, this will results in attaining more accurate and reliable solution for the patient results.
Here are some key roles:
 They are liable to prescribe medication, diagnose and check minor illness within the
patient.
 The certified nurse-midwives used to deliver gynaecological as well as minimum risk
obstetrical care to the infected person (Nursing diagnosis, 2016).
 Speciality nurse tend to handle a large range of physical and other critical problems.
 They also identify vital sign and take appropriate measure to improve the condition.
 The most capable nurse used to make sure that patient remain comfortable and hydrated.
Care plan
Assessment: The Patient need to be verbalized and change in sensory acuity on regular
basis as well as the patient might be under the full observation of the medical staffs. However, it
is important to determine or note down the changes such as, weakness, imbalance of stance as
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well as posture, blurring of vision, fluctuation, distortion of image and recommend self-care
development to Jackson (Jha, Pakhira and Chakraborty, 2013).
Nursing Diagnosis: It is important role of nursing practitioner to analyse the change
sensory perception as well as micro vascular destruction 2 DM. Apart from this, Risk for fall
down r/t eyesight impairment or sometime cause blindness. However, it is probably related to the
duration of diabetes period, systemic hypertension and renal disease. Hence, an effective control
of the patient characteristics by changing in their illness within 2 hrs.
Objective: The primary motive is to examine the short-duration of the patient condition
after the period 1-2 hrs of NI, the PT will show the actual behaviour to the prevent the further
complication. After 2-3 hrs, the nurse needs to check the behaviour to overcome and protect
patient from future injury. Hard exudates within 500um of the fovea and check the blood sugar
level after 1-2 hrs duration. Encourage the patient of self-care measures to improve the health
condition.
Nursing intervention: It happens to be utmost important challenges for the nurse to
assess the vital sign of hyperglycemias by monitoring Jackson HbA1 C-glycosylated. Also, they
need to examine the physical activity performed by the Jackson during the course of their
treatment. Support education and precaution measures that are prescribed by the nursing and
healthcare professionals.
Rational: It is a crucial phase during the care planning to check the complication that are
occurs in case there is a lack of insulin level to glucose. Additional amount will create an
osmotic effect that can increase thirst, high urination and hunger. This can be measure the blood
sugar level over the previous few months. A range of 6.5% to 7% is applicable for the type 2
diabetes patients (Nursing roles, 2014). It is important to determine the course of regular exercise
which is an essential part of Jackson management because it can reduce the chance of
cardiovascular symptoms. Validating the knowledge regarding the self-care and medication that
are recommended for the positive well-being of the patient
SUMMARY
From the above care assessment, it has been summarised that health problems are
creating negative implication on the mental condition of the patients. It can lead to affect their
entire life because of consuming harmful substance. The diabetic patients need more care
because it will directly impact their eyes and sometime affect other organs of the body. However,
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it is vital for the nursing practitioner to have proper medication and care to those patient that are
having type 1 and 2 diabetes so that they can ensure the well-being of patient throughout the
entire healthcare journey. Further, the role of nursing is much crucial during the care services
because they can key regular eye on the changes that are occurs during the time. The primary
motive behind using an interprofessional method is to facilitate the interdisciplinary plan of care
for Mr. Jackson. Henceforth, with the help of an effective care plan the patient can become self-
confident and capable of being facing the critical health problems in the future.
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REFERENCES
Books and Journals:
Lee, C.M.Y., and et.al., 2013. The cost of diabetes in adults in Australia. Diabetes research and
clinical practice. 99(3). pp.385-390.
Doenges, M. E., Moorhouse, M. F., and Murr, A. C. 2016. Nurse’s pocket guide: Diagnoses,
prioritized interventions, and rationales. FA Davis.
Foretz, M., and et.al., 2014. Metformin: from mechanisms of action to therapies. Cell
metabolism. 20(6). pp.953-966.
Huang, W., Castelino, R.L. and Peterson, G.M., 2015. Adverse event notifications implicating
metformin with lactic acidosis in Australia. Journal of Diabetes and its
Complications. 29(8). pp.1261-1265.
Jha, M.K., Pakhira, D. and Chakraborty, B., 2013. Diabetes detection and care applying CBR
techniques. IJSCE. 6(2). pp.132-137.
Kirk, J.K., and et.al., 2012. Performance of health literacy tests among older adults with
diabetes. Journal of General Internal Medicine. 27(5). pp.534-540.
Knight, A.W., and et.al., 2012. The Australian primary care collaboratives program: improving
diabetes care. BMJ Qual Saf. 21(11). pp.956-963.
Lipska, K.J., and et.al., 2015. Potential overtreatment of diabetes mellitus in older adults with
tight glycemic control. JAMA internal medicine. 175(3). pp.356-362.
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Morgan, M.A., Coates, M.J. and Dunbar, J.A., 2015. Using care plans to better manage
multimorbidity. The Australasian medical journal. 8(6). p.208.
Westbrook, J.I., and et.al., 2015. What are incident reports telling us? A comparative study at
two Australian hospitals of medication errors identified at audit, detected by staff and
reported to an incident system. International Journal for Quality in Health Care. 27(1).
pp.1-9.
Online
Metoprolol, 2015.[Online]. Available through :< https://www.webmd.com/drugs/2/drug-
11207/metoprolol-tartrate-oral/details>.
Nursing diagnosis, 2016.[Online]. Available through :<
https://www.aimu.us/2017/02/15/diabetic-retinopathy-symptoms-diagnosis-and-
management/>.
Nursing roles, 2014.[Online]. Available through :< https://www.nursingworld.org/practice-
policy/workforce/what-is-nursing/>.
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