This article discusses the nursing care required for a patient with Huntington disease, including aspects of care, interventions, rationale, and reflection.
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Running head: NURSING ASSIGNMENT NURSING ASSIGNMENT Name of the Student Name of the University Author note
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1NURSING ASSIGNMENT Table of Contents One aspect of the nursing care.........................................................................................................2 One nursing intervention.................................................................................................................2 Rationale..........................................................................................................................................3 Reflection.........................................................................................................................................3 References........................................................................................................................................6
2NURSING ASSIGNMENT One aspect of the nursing care In the given case study the patient is a man of 57 years old and he is suffering from Huntington disease. He has been admitted to the Medical/ Rehabilitation unit for assessing his dietandmobility.Themedicalhistoryofthepatientshowsthathehadsufferedfrom hypotension, chronic back pain after he got stuck by a car, posterior gluteal reflux and had reported repeated incidences of fall and also he has high risk of fall (Eiseleet al. 2015).Patients suffering from Huntington disease have a high risk of falling down and in the present scenario, the patient has repeatedly fallen down. As parts of the brain deteriorates, the movement, behaviour and the cognition of a person is affected and in this case the mobility of the person is affected (Henderson et al. 2016).So the nursing aspect which is required in this case is the requirement of a physical therapist and an occupational therapist. This is because a physical therapist will improve the strengths of the muscles and also improve the flexibility (Ciancarelli et al. 2015).The occupational therapist will prepare the patient to cope with any circumstances as well as make him feel safe at home (Castorinaet al.2015). One nursing intervention The nurses are responsible for providing care to the patient. In the given case study the patient is suffering from Huntington disease and his medical history showed evidences of fall and thus he is at severe risk of falling down again (Šumecet al2015). The patient is also taking several medicines because of his previous diseases. Except the doctors the nurses spend most of the time with the patient and the nurse is responsible for providing the best care according to the requirements of the patients. In this case the patient is at high risk of falling down because of Huntingtondisease(Domaradzki2015).Themostimportantnursinginterventioninclude
3NURSING ASSIGNMENT screening the patient properly for checking the skills of stability and mobility like supine to sit, whether the patient need any support for sitting or not, walking, standing and also the patient is under several medicines so the patient may also fall down because of polypharmacy. If a person is in more than four medicines then polypharmacy may happen (Masnoonet al.2017).The nurse need to make sure whether the medicines that the patient is taking at present are the reasons of falling or not.If the nurse finds that the patient is getting hampered by the medicines then it can be changed and new medicines can be applied. Rationale The patient is already suffering from Huntington disease, so he has risks of falling down. Apart from showing several incidences of fall, the patient had also suffered from several other diseases and for which the patient is in several medications (Schlachetzkiet al.2017).Taking of different types of medicines may increase the risk of fall. So if require the nurse need to change the medicines and provide new medicines so that the chances of falling down get reduced. The patient must be screened properly to know that exactly at what conditions the patient have the risk of falling down. By analysing the conditions properly, the nurse should move accordingly (Davidet al. 2015). Reflection The aspect of nursing care chosen for this present case study is providing physical therapy and occupational therapy to the patient. The physical therapy is one of the promising therapy to a patient suffering from neurodegenerative disease involving Hartington disease (Tarolli, Chesire and Biglan 2017).Previous research studies showed that the efficacy of the physical therapy is able to reduce the risk of falling to the patents suffering from Hartington
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4NURSING ASSIGNMENT disease (Cox, Platt and Zhang 2015). In the present case the patient was given physical therapy to increase the strength of the muscles and the occupational therapy as he was not willing to take care at home. The physical activity not only improve the daily functional activities of the patient but also improve the cognition, quality of life and in disease progression (Baratinet al.2015). The occupational therapist is required as the patient needs to know to cope up with any circumstances. The patient denied taking care at home and for this reason he was sent to the MRU. Apart from allowing the patient to take physical therapy I cared for her. I have prepared a diet plan needed especially for him. Because of the Hartington disease, the patient lost weight so he needed a healthy diet plan. I used to provide him medicines time to time ad he was unaware of his medicines. Before this experience I was nervous as this was the first time I took care of a patient suffering from neurodegenerative disease. I was not sure whether I would be able to carry on all the activities of the care plan correctly and comprehensively. But slowly and slowly as I started taking care of him my fear faded away and I completed the whole process of taking care confidently. I took the use of the best available practices for taking care of this patient. I researched on the different diet plans that are set for a patient who is at risk of falling down. After that I prepared the diet plan for him (Oñatibia‐Astibia, Franco and Martínez‐Pinilla, 2017). I had also thoroughly checked the medicines of the patient to become sure that he is suffering from polypharmacy or not (Klamrothet al.2016). The experience was completed successfully as the condition of the patient was improved after the course of treatment was over. The positive aspect of the experience was that I was successfully able to take care of the patient apart from the fact that this patient was my first patient suffering from neurodegenerative
5NURSING ASSIGNMENT disorder. The negative aspect of this experience was that I could not able to manage the time properly. This experience has increased my confidence about taking care of the patients suffering from neurodegenerative diseases. In future I will try to overcome my negatives and will provide the patients having the risks of fall due to disease Hartington disease with extreme care so that they can start recovering after the course of treatment is over. After taking care of this patient my knowledge about the Hartington disease has increased a lot. My knowledge about the medications of the patients suffering from this disease has already increased a lot. In future this experience will help me a lot in taking care of the patients suffering from neurodegenerative diseases in a far better way.
6NURSING ASSIGNMENT References Baratin, E., Sugavaneswaran, L., Umapathy, K., Ioana, C. and Krishnan, S., 2015. Wavelet- based characterization of gait signal for neurological abnormalities.Gait & posture,41(2), pp.634-639. Castorina, A., Szychlinska, M.A., Marzagalli, R. and Musumeci, G., 2015. Mesenchymal stem cells-based therapy as a potential treatment in neurodegenerative disorders: is the escape from senescence an answer?.Neural regeneration research,10(6), p.850. Ciancarelli, I., De Amicis, D., Di Massimo, C., Sandrini, G., Pistarini, C., Carolei, A. and Ciancarelli, M.G.T., 2015. Influence of intensive multifunctional neurorehabilitation on neuronal oxidative damage in patients with Huntington’s disease.Functional neurology,30(1), p.47. Cox, D.B.T., Platt, R.J. and Zhang, F., 2015. Therapeutic genome editing: prospects and challenges.Nature medicine,21(2), p.121. David, F.J., Robichaud, J.A., Leurgans, S.E., Poon, C., Kohrt, W.M., Goldman, J.G., Comella, C.L., Vaillancourt, D.E. and Corcos, D.M., 2015. Exercise improves cognition in Parkinson's disease: The PRET‐PD randomized, clinical trial.Movement Disorders,30(12), pp.1657-1663. Domaradzki,J.,2015.TheimpactofHuntingtondiseaseonfamilycarers:aliterature overview.Psychiatr Pol,49(5), pp.931-944. Eisele, Y.S., Monteiro, C., Fearns, C., Encalada, S.E., Wiseman, R.L., Powers, E.T. and Kelly, J.W., 2015. Targeting protein aggregation for the treatment of degenerative diseases.Nature reviews Drug discovery,14(11), p.759.
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7NURSING ASSIGNMENT Henderson, E.J., Lord, S.R., Brodie, M.A., Gaunt, D.M., Lawrence, A.D., Close, J.C., Whone, A.L. and Ben-Shlomo, Y., 2016. Rivastigmine for gait stability in patients with Parkinson's disease (ReSPonD): a randomised, double-blind, placebo-controlled, phase 2 trial.The Lancet Neurology,15(3), pp.249-258. Klamroth, S., Steib, S., Gaßner, H., Goßler, J., Winkler, J., Eskofier, B., Klucken, J. and Pfeifer, K., 2016. Immediate effects of perturbation treadmill training on gait and postural control in patients with Parkinson’s disease.Gait & posture,50, pp.102-108. Masnoon, N., Shakib, S., Kalisch-Ellett, L. and Caughey, G.E., 2017. What is polypharmacy? A systematic review of definitions.BMC geriatrics,17(1), p.230. Oñatibia‐Astibia,A.,Franco,R.andMartínez‐Pinilla,E.,2017.Healthbenefitsof methylxanthines in neurodegenerative diseases.Molecular nutrition & food research,61(6), p.1600670. Schlachetzki, J.C., Barth, J., Marxreiter, F., Gossler, J., Kohl, Z., Reinfelder, S., Gassner, H., Aminian, K., Eskofier, B.M., Winkler, J. and Klucken, J., 2017. Wearable sensors objectively measure gait parameters in Parkinson’s disease.PloS one,12(10), p.e0183989. Šumec,R.,Filip,P.,Sheardová,K.andBareš,M.,2015.Psychologicalbenefitsof nonpharmacological methods aimed for improving balance in Parkinson’s disease: a systematic review.Behavioural neurology,2015. Tarolli, C.G., Chesire, A.M. and Biglan, K.M., 2017. Palliative care in Huntington disease: personal reflections and a review of the literature.Tremor and Other Hyperkinetic Movements,7.