Assignment on Nursing: Long Term Care Placement

   

Added on  2020-05-11

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Running head: NURSINGNursingName of the StudentName of the UniversityAuthor note
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2NURSINGIntroduction The assignment is the outcome of the long term care placement. The assignment is theassessment of the Mrs X an 88 year old patient currently residing in the long term care placementdue to left sided cerebrovascular accident which caused right sided hemiplegia. The elderlypatient will be evaluated using the “Gordon’s Functional Health pattern framework” (Gordon,2016). The rationale for choosing this framework is the facility to conduct comprehensivenursing assessment of the patient (Gordon, 2016). The patient data will be collected for focusedassessment using two evidence based tools. The first one is the Hendrich II fall risk model as thehospitalized patient is at risk of fall (Campanini et al., 2018). The second tool is the Bradenpressure ulcer risk assessment, to determine the risk of pressure ulcer (Carreau et al., 2015). Theaim of the assessment is to prepare the care plan including interventions relevant to the clinicalcondition of the patient. The care plan also includes nursing care strategies based on existingliterature. The compliance of the care plan to the registered nurses competencies especiallyDomain 1 (1.2 and 1.5) as mentioned by the Nursing Council of New Zealand (2016) isdiscussed. The patient under care is the 88 year old lady admitted to hospital with right sidedhemiplegia caused by the cerebrovascular accident. She has the medical history of hypertensionthat increases the risk of heart failure. She lives after her husband’s death with her children andgrandchildren. She has concerning issues with oedema lower extremities of her body such as herright feet. She complains of limited dependence after hemiplegia and pain on rights side due tostrike. She has also concerns related to the deprived sleep, bladder and bowel continence. Thepatient is however active, conscious and responds during interaction.
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3NURSINGAssessment The following has been identified with Mrs X on completing the Gordon’s FunctionalHealth patterns framework assessment and compiled as below-1.Health perception- Health ManagementThe patient demonstrated frustration due to limited dependence caused by hemiplegia.She described her need for help with activities of daily living. She highlighted her medicationintake for sleep, bowel and blood pressure. Mrs admitted of her history of smoking and have quitafter stroke in 2016. The patient demonstrates low pain tolerance as it is adding to her tress. She demonstratesinterest in gaining back her independence. The patient can well verbalise her concernsHer current vital signs were noted as followsRespirations- 22 breaths Temperature: 36.8 degrees CelsiusBlood Pressure- 140/90 maintained with Amlodipine (as it lowers high blood pressure) (Fares et al., 2016)Oxygen Saturation- 98%Heart Rate- 81 beats per minute Weight - 92 kgs, Height: 175 cms- indicating BMI of 30.04, which means, the patient is having obesity (Mandviwala, Khalid, & Deswal, 2016). 2.Nutrition-Metabolic pattern
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4NURSINGThe patient takes rich diet and eats meals three times daily. She fails to adhere to thedietary recommendations. She is recommended to have the puree diet. However, sheconsumed the normal food taking care of the quantity and consistency of the food. She ismindful of chewing food on left side of mouth. Mrs X feed herself and uses lower andupper dentures and does not complain of difficulty in eating mashed food. The usual food intake of patient is as follows- 1.Breakfast- Porridge with milk, with sugar toast, and one fruit. She takes high calorie food evident from morning tea with hot chocolate, Biscuits, crackers or pikelets with jam and cream2.Lunch- Takes vegetables and chicken soup alternately, toast with spaghetti and sausages and a fruit 3.Dinner- Toast with scramble eggs, and Steamed fish in sauce. The patient has high intake of fluid as recommended by professional and is evident fromthe water bottle beside her and pitcher of water and a cup within her reach. The patient needs to reduce weight as she is obese and is risk factor for heart failure(Mandviwala, Khalid & Deswal, 2016). The skin condition that is pale colour and warm body indicates of low fever. Thepressure assessment was conducted for patient using the Braden’s scale and the score of 18indicates high risk of ulcer (Carreau et al., 2015). The same is also evident from her inflamed andred around groin, vulva and inner thighs. However, she prefers Kawakawa Maori remedy thanany other remedy.
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