Symptom cluster and symptom management

Running head: SYMPTOM MANAGEMENT
SYMPTOM MANAGEMENT
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SYMPTOM MANAGEMENT1
Symptom cluster and symptom management in advanced nursing practice
Identification and introduction of the symptoms
A symptom can be considered as a subjective experience of some alterations in the bio-
psychosocial functioning, cognition and sensation of an individual. It can only be perceived
by the patient Barsevick A., (2016).
One of the most common hospital acquired infection is the urinary tract infection that
accounts for about 40 % of all the nosocomial infections in Australia, especially in the long
term aged care settings. The management of UTI is challenging due to the barriers in
communication, chronic genitourinary symptoms and comorbidities. Most of the urinary
tract infections are related to urinary catheters that is a common device used in long term
aged care services (Melo et al., 2017). Delirium or confusion is being viewed widely as a
result of urinary tract infection. A UTI normally occurs as the bacteria enters the urinary tract
via urethra travelling to bladder and then to the ureters finally in the kidneys. Once bacteria
enters the kidneys they can enter the bloodstream, carrying the infection to the brain. With
the ageing the blood vessel stiffens over the years, allowing the brain to become susceptible
to infection. The bacteria in the blood stream can cause the blood brain barrier to cause
confusion and other cognitive difficulties. Delirium in adults can cause sudden confusion of
the time and place. They might become incoherent and their level of awareness can fluctuate.
Its relevance and importance to your nursing practice and impacts on the elderly’s
living in nursing home
Delirium and UTI are two common conditions in elderly people residing in aged care
homes. The incidence of both the conditions increases with age. Urinary tract infection
accounts for 25 % of all kinds of infection and delirium is found in almost 30 % of the total
number of elderly people. UTI is caused in older residents staying in the care homes are due

SYMPTOM MANAGEMENT2
to the fact, they are often do not receive appropriate care with respect to maintenance of
hydration. Furthermore, most of them don’t have safe swallowing mechanism making them
susceptible to less intake of fluids. Delirium might develop over one of two days (Cheung et
al., 2018) . While delirium can gave more than one aetiologies, but UTI is considered as one
of the predisposing factors. In my placement area, which is the geriatric ward, the presence of
delirium among the UTI patients is quite common. According to Balogun and Philbrick,
(2013), in subjects with Delirium, the UTI rates have ranged from 25.9 % to 32 % in
comparison to 13 % of the subjects that are without delirium.
UTI causes an altered mental status, then in surely affects the quality of life of elderly
people living experiencing this. The elderly people can display certain behaviour changes,
like hallucinating, restlessness, aggressive behaviour, rambling speeches, lethargy and slowed
movements, depression, sense of elated feeling or apathy. Elderly people living aged care are
taught about the self-management of their daily activities of living. Elderly people suffering
from delirium might find it difficult to cope up with their daily activities like grooming,
eating and cleaning. They might require some additional help from the aged care unit. An
extra nurses might have to be appointed, who could have been appointed to somebody having
more serious condition.
Apart from the patients, increased frequency of confusion, among the patients
suffering from dementia, also affects the organisation, due to increased stay, increased use of
the aged care resources including extra medicines and cost of for diagnosis. In case of
complications multidisciplinary teams are often employed to rule out the prevalence of any
neurodevelopment diseases (Rowe & Juthani-Mehta, 2013). Nurses have to invest more time
on elderly people suffering from the delirium, as they are more susceptible to slips, falls and
medication errors. Furthermore, being a nurse, I feel that aged care home is a place where
elderly people come to spend some of their last years of life. They have right to desire for a