Nursing Care Plan Assignment on Dementia

Added on - 28 May 2020

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1CASE STUDY AND NURSING CARE PLAN ON DEMENTIACASE STUDYThis is the case study of a Patient A who is 75 years old, who is living withdementia, and has been under the live in support of a residential care. Dementia hasaffected the life of patient A, as he was suffering from memory loss of recent events.The patient was already suffering some mild cognitive impairment, which has worsenedover time and the person is having difficulties in performing even the simplest tasks.The patient was having several episodes of depression and schizophrenia, which haveled to his hospital admission. Patient A was having low to moderated tremors. He hadalso been suffering from some incontinence issue which has further deteriorated his selfconfidence. Patient has also got a past history of substance abuse and alcohol.Incontinence is common is patients with dementia as cognitive deficits in patient causesloss of visuospatial abilities and frontal lobe dysfunction that interferes with the patient'sability to recognizes the needs to go to the toilet, to recognize the toilet, to disrobe oruse the toilet properly. The brain fails to control the sphincter muscles of the bladder(Orme et al., 2015). He is unable to move on his own which signifies an end stagedementia. The patient has also reported that he is having difficulties in swallowing. Brainimaging and blood tests have confirmed the occurrence of dementia (Selmen et al.,2012). Mood testing IQ examination has also indicated towards the occurrence ofdementia. Subjective data reveals that the patient had been suffering from tremors.Tremors, confusion and shuffling can be associated with Lewy body dementia(Reijnders et al., 2013). It is the most misdiagnosed and the second most commoncause of progressive dementia. Occurrence of lewy bodies is linked with ageing. Thepatient was also suffering from age related incontinence issues. The patient had beenreported to be suffering from Vitamin B 12 and folate deficiencies have also taken a tollon the life of the patient, which can be one of the perpetuating factors behind dementia(Moor et al., 2012). Vitamin D is known for its ability to utilise phosphorus and calcium ofthe body. The results of the ‘mini-mental state examination’ result were compared to theVitamin D status of the patient and were found to be quite low than the normal value(Moor et al., 2012). vitamin D have numerous functions in the nervous system ofanimals, such as regulation of the neuro-trophic factors, calcium homeostasis, release
2CASE STUDY AND NURSING CARE PLAN ON DEMENTIAof the neurotransmitters, oxidative stress mechanisms, and modulation of theinflammatory process and immune system (Moor et al., 2012)..Cognitive impairment is one of the common symptoms of the dementia.Dementia is a disease related to brain and such a disorder might disrupt the problemsolving capacity and judgement function of the brain, which has led to behavioural andmetal problems in the patient A (Reijnders et al., 2013).Although the world has advanced in the fields of molecular biology, the mysteriescontrolling the lifespan of the human is still to be unravelled. Many theories that fall inthe two broad categories ‘programmed and error theories’ have found to beunsuccessful explaining the process of ageing. Yet one of the modern theories that gowell with this case study is the 'free radicals theory (Liochev, 2013)'. This theory wasintroduced by Dr. Denham Harman, who has proposed that free oxidative radicals andsuper oxides damages the macromolecular cell components, such as lipids, sugars,nucleic acids and proteins, causing the cell to stop functioning (Kirkwood & Kowald,2012). The body poses some natural antioxidants that curb the ill effects of the oxidativeradicals.Reactive oxygen species (ROS) are the by-product of the mitochondrial electrontransport chain during aerobic respiration. If the ROS are produced in excess then itoverwhelms the natural antioxidants of the body and due to which cells such as theneuronal microglia gets damaged. ROS are produced in abundance in the centralnervous system (Kirkwood & Kowald, 2012). The brain is vulnerable to oxidativedamage as it is rich in peroxidizable fatty acids, responsible for the 20% of the totaloxygen consumption of the body. The oxidative species causes nitration of the lipids,leakage of the DNA strands and the nitration of the proteins of the neuronal cells(Liochev, 2013). Free radicals are also found to be responsible for the extrinsic skinageing by the damaging the skin DNA (Zuluaga et al., 2012).The case study reveals that the patient had a past history of alcohol addiction. Itshould be noted that the environmental sources of oxidative radicals includes smoke,
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