Nursing Assignment - Dementia Care

Running head: NURSING ASSIGNMENT
Nursing Assignment
-Dementia Care
Name of the Student
Name of the University
Author Note

1NURSING ASSIGNMENT
Introduction:
The following case study is of an elderly patient, Mr Nyugen, aged 85 years who is
suffering from dementia and was presented to the emergency room for a fall related injury to
his head. He received a 1 cm cut to his forehead and was bleeding. The doctor recommended
a CT scan for the patient to check any signs of internal injury after cleaning and suturing the
wound. The aim of this report is to discuss the assessment performed on the patient
(including risk assessment), strategies that can help to empower the patient and support
independence, the psychological effects of the interventions identified, followed by a
reflection on the learning acquired from the case study.
Outline of the case scenario:
Using the clinical reasoning cycle, I was able to outline the patient condition to
identify the care priorities for the patient:
Patient Situation:
The patient is 85 years old, who was presented to the ED with a head injury that was
caused due to a fall and hitting with furniture. The patient has problems walking and uses a
walking stick. However due to his dementia, he keeps forgetting to use the walker, and also
forgets his medications. He currently lives alone, and his daughter lives next door with her
husband and family, and the patient is a widower. He also has a history of PTSD while he
was in the Army. He also is a heavy smoker and smoker about three packs of cigarettes every
week.
Important Cues/Information and its relation to patient condition:
The patient has advancing dementia that is causing problems with his memory as well
as has reduced his mobility (Kosse et al., 2015). The diagnosis of dementia can also be the

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reason for an improper gait and balance due to which his risks of falling has increased
(Kehinde et al., 2014). The patient served in the army, due to which he has a strong sense of
independence and prefers to take care of himself on his own. He had been diagnosed of
PTSD while he was in the army which could also be related to the onset of dementia
(Mawanda et al., 2017). Additionally his lifestyle of smoking can also place him in the risk
group of dementia (Zhong et al., 2015).
Main problems and Issues:
The main problems that can be identified for the patient includes the problem with
mobility and gait which increased his risks of falling and injuring himself as well as his
memory problems due to which he forgets his medication and can also cause problems of
malnutrition and further deterioration of his health (Hendriks et al., 2017).
Care Goals:
The care priority areas for Mr Nyugen includes improving his gait and balance to
prevent his risks of falling, helping his memory so that he does not forget his medication and
taking food on time, as well as performing an assessment of his home environment for fall
related hazards that can also increase his risks of falling (Brooker & Latham, 2015; Resnick
et al., 2018).
Discussion of the assessments performed:
Nursing diagnosis:
The main problems that was diagnosed for the patient was a problem with gait and
balance due to which he needs a walking stick/walker, problems with his memory as he
forgets to use his walker, take his medication. The patient was also found to be underweight,

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which might suggest he might be forgetting to take his food on a timely basis (Jayatilaka et
al., 2017; Cabrera et al., 2015).
The diagnosis performed for the patient included checking the vital signs of the
patient, checking the weight of the patient for weight loss, checking skin integrity for any
additional signs of injury, assessing the mobility and gait to assess his ability to move freely,
assessment of memory to understand the need for memory aids, checking the lifestyle and
diet of the patient to identify any lifestyle related risks as well as a routine physical
examination of the patient such as breathing rate, heart rate and oxygen saturation levels
(Gulanick & Myers, 2016).
Primary Diagnosis: The primary diagnosis for the patient was his reduced mobility and gait
which increased his risks of falling as well as his diagnosis for Dementia which also affected
his mobility and gait. The patient also has received a cut on his forehead due to a recent
episode of fall (Kehinde et al., 2014).
Secondary Diagnosis: The secondary diagnosis for the patient was a loss in his weight, due to
which he was underweight. Additionally, he also had a history of Hypertension and PTSD.
He is still taking medications for Hypertension, and forgetting the medication can increase
the risks of cardiac problems (Zhong et al., 2015).
Risks Identified:
The Australian Safety and Quality Framework for Healthcare provide guidelines for
safe and high quality in the healthcare delivery for patients. The framework incorporates
three important principles that help to provide safe and high quality care for the patients such
as patient centricity, information driven care, and focus on safety of care (Australian
Commission on Safety and Quality in Health Care, 2010).