Nursing Strategies for Health Literacy Improvement in Elderly Patients: A Case Study of Mrs. Reynolds

This case study focuses on identifying health literacy issues in elderly patients and providing nursing strategies for improvement. The study uses Mrs. Reynolds as a case study to recommend health promotion programs and support specific to her needs. The study recommends strategies such as being aware of the patient's health issues, speaking clearly and using visual aids, and being patient and supportive. The study also recommends specific health promotion programs for Mrs. Reynolds, such as exercise programs and social activities.

Running head: NURSING STRATEGIES
NURSING STRATEGIES
Name of the Student:
Name of the University:
Author note:

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Assessment task- 1
Q1) Identify two health challenges facing Australian communities?
The two major health challenges faced by Australian communities are as follows
(Aihw.gov.au, 2019):
a) Equity issues and health inequality
b) Rapid urbanisation health issues
Q2) List and explain two environmental health issues facing Australian communities?
The two primary environmental health issues faced by Australian communities are as
follows (Australian Indigenous HealthInfoNet, 2019):
a) Ultraviolet radiation: sun exposure, Vitamin D and skin cancer- Compared with other
countries, Australia has a high level of solar ultraviolet (UV) radiation and the excessive
exposure has been linked to various types of skin cancer.
b) Extreme weather events- Extreme weather events often have substantial social and
economic impacts and may be hazardous to human life. Resulting health effects may be
immediate and physical (such as death and injury due to bushfires), short term (for example,
loss of shelter or access to clean water due to cyclone or floods) or long term.
Q3) A) Enlist principles of primary health care and write how you would apply principles of
primary health care in practice.
There are five major principles of primary health care, which are mentioned as
follows (Aihw.gov.au, 2019):
a) Accessibility- Making sure that primary care services are available, affordable and
provided equally to all individuals irrespective of their gender, age, ethnicity or location.

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b) Public or community participation- Involving all of community’s resources in promoting
health and addressing health problems at the grass roots level.
c) Health promotion- Helping a community to strengthen the socioeconomic conditions that
contribute to good health.
d) Appropriate use of technology- Using medical technologies that are affordable, feasible
and culturally acceptable to individuals and the community.
e) Inter-sectorial collaboration- Recognizing that any community’s health and well-being
does not depend solely on effective health care services.
B) State the philosophy of the primary health care model in Australia as defined by the
WHO.
Primary health care became a core policy for WHO in 1978, with the adoption of the
Declaration of Alma-Ata and the strategy of "Health for all by the year 2000" (Who.int,
2019). It is useful to understand primary health care as involving both core principles and a
variable set of basic activities.
Q4) List 4 reasons that can lead a person to become confused.
The reason that can lead a person to become confused are as follows (nhs.uk, 2019):
a) A stroke or Transient Ischemic Attack (TIA)
b) Head injury
c) Alcohol poisoning or alcohol withdrawal
d) Certain prescription medicines

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Q5) explain the pathophysiology of dementia and state two types of dementia.
Vascular disease is mainly caused by hardening of the arteries (atherosclerosis) due to
a thickening of the artery lining from fatty deposits or plaques (atheroma). Vascular disease
may manifest acutely when thrombi, emboli, or acute trauma compromises perfusion
(Alzheimer's Society, 2019).
Alzheimer's disease and vascular dementia are two types of dementia.
Q6) Give 2 nursing diagnosis that will apply to the person with dementia and identify for
each diagnosis two nursing interventions (care of a person with dementia)
The two nursing diagnosis with their interventions for dementia are as follows
(Bickford et al., 2019):
a) Enhancement of socialization and fulfilment of intimacy needs- The nursing intervention
are:
 Use touching to maintain contact with patient. Tactile stimulation is easiest to
interpret.
 Introduce the family members and friends using names which is familiar to the patient
b) Maintenance of a balance of sleep and activity- The nursing intervention are:
 Avoid use of restraints
 Design a balanced schedule of activity / sleep
Q7) what is the emergency and first aid management for the following conditions and injury:
The emergency and first aid management for the following conditions and injury are
(Ww2.health.wa.gov.au, 2019):

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A) Burn- Use bandage and an over-the-counter pain reliever, such as ibuprofen, naproxen
sodium or acetaminophen.
B) Penetrating injury to eye- Place thick pads above and below injured eye or cover object
with paper cup. Bandage the pads in place with no pressure on eyelids.
C) Cardiac arrest- An automated external defibrillator (AED) is used before attempting
cardiopulmonary resuscitation (CPR) because an AED save lives easily by detecting
ventricular fibrillation, hence providing an electrical shock.
D) Asthma attack- Sit the person upright comfortably and loosen tight clothing. If the person
has asthma medication, such as an inhaler, assist in using it.
E) Allergic reaction- Lay the person flat and do not allow them to stand or walk. Administer
adrenaline with an auto injector and an antihistamine pill.
F) Sprained ankle- Rest the injured part, wrap an icepack or cold compress in a towel and
place it immediately and Support the injured part with an elastic compression bandage for
few days.
G) Ingestion of non-corrosive poison- If the ingestion is in eye or skin immediately we
should rinse it with continuous fresh water and if inhaled move to a fresh air, away from all
toxic gases.
H) Spider bites and snake bites- Clean the area of the bite with soap and water. Encourage
them to remain calm and still to reduce the spread of venom.
I) Seizures- Provide general care, and comfort to keep the person safe and ease the person to
the floor. Place something soft under their head and loosen any tight clothing.

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Q8) State the emergency phone number for ambulance in Australia, both mobile and landline.
The emergency phone number for ambulance in Australia is (Triplezero.gov.au,
2019):
Mobile- 000
Landline- 112
Q9) Identify one specific health issue for-
a) Infants- Skin problems.
b) Children- Conjunctivitis
c) Adolescent- Depression
d) Adults- Overweight and Obesity
e) Older people- Dementia
Q10) for the following medical conditions state one community and one hospital resources
and service available to people:
Following medical conditions state one community and one hospital resources and
service available to people are (Swsphn.com.au, 2019):
a) Diabetes- TypeOneNation is the community developed for patient with type 1 diabetes and
Local chapters of the American Diabetes Association (ADA) is the community resource for
the people.
b) Rheumatoid arthritis- RA heath information and community and Rheumatologist are the
community and hospital resource for RA respectively.
c) Myocardial infractions- Myocardial Infraction and My Cardiac Coach™ are the
community and hospital resource for myocardial infractions respectively.

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d) Asthma- Asthma and Allergy Foundation of America and asthma community are
respective community and health resource for asthma.
e) Obesity-An One Health framework and obesity prevention community are respective
community and health resource for obesity.
f) Alzheimer’s disease- Alzheimer's Association national site is the community and the
Resources for Enhancing Alzheimer's Caregiver Health (REACH) is the health resource for
Alzheimer’s disease.
g) Depression/anxiety- Anxiety and Depression Association of America (ADAA) is the
community and health resource for people with Depression/anxiety.
h) Skin cancer- Skin cancer community and American Cancer Society is the respective
community and health resource for people with skin cancer.
i)Incontinence- The National Association for Continence is the community and health
resources for people with incontinence.
Q11) Give two nursing diagnosis that will apply to the person with confusion and identity for
each diagnosis two nursing interventions (care of a confused person)
Two nursing diagnosis and interventions for confused patients are as follows (nhs.uk,
2019):
a) Disturbed Thought Process- The nursing intervention are:
 Assess attention span and ability to make decisions.
 Check ability to send, receive, and interpret information.
b) Activity Intolerance- The nursing interventions are:
 Thoroughly assess the patient’s current physical activity and mobility.
 Determine the patient’s current medication intake.

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Q12) Identify two key components of the critical thinking and problem-solving approach
used in nursing practice.
The two key components of the critical thinking and problem-solving approach used
in nursing practice are (Ww2.health.wa.gov.au, 2019):
 Critical thinking requires logic
 Critical thinking requires flexibility
Q13) Describe what evidence-based practice is and give two examples of evidence based
practice that has contributed to contemporary nursing practices
Evidence based practice (EBP) is the conscientious use of current best evidence in
making decisions about patient care. The examples of evidence-based practice that has
contributed to contemporary nursing practices are infection control and Intravenous Catheter
Size and Blood Administration.
Q14) A) Explain health, including the illness continuum.
The Illness-Wellness Continuum is a graphical illustration of a wellbeing concept first
proposed by Travis in 1972. It proposes that wellbeing includes mental and emotional health,
as well as the presence or absence of illness.
B) Describe at least two (each) physical, psychological and social impacts of a health
problem on daily living activities you may need to discuss with the person and, with the
person’s consent, with family or carer. Explain how and why you would discuss it.
 Physical impact- A chronic physical illness is an enduring health problem that will not
go away – for example diabetes, asthma, arthritis or cancer.

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 Social impact- It includes Housing that is safe and affordable and access to education,
healthy foods and local health services for a better daily living activities and it would
be conducted by face-to-face interactions.
 Psychological impact- It includes highlight relevant literature evaluating the
relationship between cognitive functioning and discuss other bio psychosocial factors
affecting ADL performance.
Q15) List and explain two literature and professional bodies that are associated with primary
health care management.
The two literature and professional bodies that are associated with primary health care
management are (Ww2.health.wa.gov.au, 2019):
 APNA Education - APNA is the peak professional association for nurses working in
Primary Health Care including General Practice.
 Australian College of Nursing - ACN is a key national professional nursing
organisation open to nurses in all settings and at every stage of their careers.
Q16) A) Explain the service delivery models for-
A) Preventative- Advanced preventive services delivery model based on a health risk
appraisal-driven prioritization of tasks (Sarrah.org.au, 2019).
B) Curative- A guide to Curative Care Medical Treatment to improve or eliminate symptoms
that the patient is experiencing and to cure the patient's overall medical problems.
C) Rehabilitative- The NSW Rehabilitation Model of Care will improve patient outcomes
(Sarrah.org.au, 2019).
16B) Explain the roles and professional expertise of various members of the interdisciplinary
health care team.

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An interdisciplinary approach involves team members from different disciplines
working collaboratively, with a common purpose, to set goals, make decisions and share
resources and responsibilities (Www2.health.vic.gov.au, 2019). A team of clinicians from
different disciplines, together with the patient, undertakes assessment, diagnosis, intervention,
goal setting and the creation of a care plan.
Q17) List and explain at least two health literacy issues that potentially inhibit the person’s
capacity to access, understand, evaluate and communicate information to maintain and
improve their health.
The health literacy issues that potentially inhibit the person’s capacity to access,
understand, evaluate and communicate information to maintain and improve their health are
as follows (Cdc.gov, 2019):
 They are voting on an issue affecting the community’s health and relying on
unfamiliar technical information.
 They are not familiar with medical terms or how their bodies work.
 They have to interpret statistics and evaluate risks and benefits that affect their health
and safety.
 They are diagnosed with a serious illness and are scared and confused.

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Part 2
1. Identify health literacy issues that potentially inhibit the Mrs's Reynolds capacity to
access, understand, evaluate and communicate information to maintain and improve
her health.
Reynolds displays many of the normal characteristics of ageing. She faces issues while
remembering specific terms in English which makes it difficult for hr to express her concern.
2. What strategies could you use to support the Mrs's Reynolds capacity to gain and
understand information
The following strategies will to support the Mrs's Reynolds capacity to gain and understand
information
 Be aware of the person's health issues.
 Be attentive to the environment in which you are communicating.
 Speak clearly and articulately, and make eye contact.
 Adjust your volume appropriately.
 Use clear and precise questions and sentences.
 Employ visual aids, if possible.
 Take it slow, be patient, and smile.
3. What health promotion programs would you recommend for Mrs Reynolds and
identify the type of support you will provide to Mrs Reynolds as per her need
 . Maintaining a balanced diet. This is important for a healthy body and healthy brain.

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 Perform regular physical activity. This is essential for your body and mind.
 Actively participate socially and engage with others.
4. Complete a care plan for Mrs Reynolds addressing her needs in the hospital sector.
You will need to identify three nursing diagnosis, interventions, rationales, and
evaluations that you would use. In your care plan and interventions provided you are
to ensure that nursing interventions reflect Mrs's Reynold's needs and individuality
including considering cultural, religious, age and gender issues and theperson's
physical, psychological and social needs.
Risk Factors:
 Altered mobility
 Confusion
 Disorientation
 Malnutrition
 Skin breakdown
 Associated medical diagnoses (Alzheimer’s disease, blindness, cataracts, dementia,
osteoporosis, osteomyelitis)
 Hearing difficulties
 Neuropathy
 Impaired balance
 Sleeplessness

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 Environmental conditions
Desired Outcomes
 Doesn’t sustain fall
 Doesn’t experience any fall-related injuries
 Demonstrates preventive measures
 Implements strategies to prevent fall at home
Nursing Interventions Rationale
Assess conditions that can increase the patient’s level of
fall risk, such as history of falls, changes in mental
status, sensory deficits, balance, medications, and
symptoms related to diseases.
Proper assessment helps determine need
precautions.
Assess the patient’s environment for factors that can
increase fall risk.
Unfamiliar environment and improper place
furniture and equipment can increase patient’s
fall.
Orient to and stabilize the environment.
Elder patients may suffer from faulty sh
memory. Reorientation helps.
Provide for safety and keep lights on at night. Make sure
call bell is available all the time.
Allows patient to ask for assistance.
5. What will you need to consider in regard to culture, religion, age and gender issues
for Mrs Reynolds?

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 Demonstrating respect to her culture and religion
 Consider and take interventions keeping in mind her physical vulnerability due to age
 Should incorporate a female care taker keeping in mind hr gender
6. With the nursing interventions you have identified, identify how you would ensure
respectful practice that support Mrs Reynolds privacy and dignity
 Speak to the patient directly
 peak respectfully to and about the patient
 Ask how the patient would like to be cared for
 Protect the patient’s physical privacy
7. Explain what role or support Mrs Reynold's family can provide for her both in the
hospital setting and when discharged home. Explain how would you encourage Mrs
Reynold, family or carer to assist with the Mrs Ronald's self-care care as appropriate.
 Educating the family bout the needs of Mrs. Reynold
 Influencing the family members emotionally
8. How would you plan and adjust nursing interventions to assist Mrs Reynold to meet
her daily living activities?
 Regularly monitoring the activities of Mrs. Reynold
 Maintaining a detailed chart of her activities.
9. Identify and prioritise Mrs Reynold's nursing interventions according to her needs and
give a rationale for the priority rating given.

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Nursing Interventions Rationale
Assess conditions that can increase the patient’s level of
fall risk, such as history of falls, changes in mental
status, sensory deficits, balance, medications, and
symptoms related to diseases.
Proper assessment helps determine need
precautions.
Assess the patient’s environment for factors that can
increase fall risk.
Unfamiliar environment and improper place
furniture and equipment can increase patient’s
fall.
Orient to and stabilize the environment.
Elder patients may suffer from faulty sh
memory. Reorientation helps.
Provide for safety and keep lights on at night. Make sure
call bell is available all the time.
Allows patient to ask for assistance.
10. Monitor, evaluate and document the Mrs Reynold's response to nursing interventions
and their progress toward primary health goals in her case file. What members of the
interdisciplinary health care team would you need to report findings to?
Mrs Reynolds have shown improvement in effective communication. She has also orient to
and stabilize the environment.
11. Identify community resources and other resources (like resources required in hospital
setting) which you would provide to Mrs. Reynold, family or carer to match Mrs
Reynold's needs, also provide information on how to access them.
1. Midnight call bell

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2. Allow extra time for older patients.
3. Minimize visual and auditory distractions.
References:
Aihw.gov.au. (2019). Retrieved from https://www.aihw.gov.au/getmedia/cfd6abd4-32fb-
4995-835f-5e94dac7a827/aihw-aus-221-chapter-4-1.pdf.aspx
Alzheimer's Society. (2019). Types of dementia. Retrieved from
https://www.alzheimers.org.uk/about-dementia/types-dementia
Australian Indigenous HealthInfoNet. (2019). Environmental Health - Determinants of health
- Australian Indigenous HealthInfoNet. Retrieved from
https://healthinfonet.ecu.edu.au/learn/determinants-of-health/environmental-health/
Bickford, B., Daley, S., Sleater, G., Hebditch, M., & Banerjee, S. (2019). Understanding
compassion for people with dementia in medical and nursing students. BMC medical
education, 19(1), 35.
Cdc.gov. (2019). Understanding Health Literacy | Health Literacy | CDC. Retrieved from
https://www.cdc.gov/healthliteracy/learn/Understanding.html
nhs.uk. (2019). Sudden confusion (delirium). Retrieved from
https://www.nhs.uk/conditions/confusion/
Service Delivery. Retrieved from https://sarrah.org.au/book/export/html/397
Www2.health.vic.gov.au. (2019). Interdisciplinary approach to caring for older people

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in hospital fact sheet. Retrieved from https://www2.health.vic.gov.au/hospitals-and-
health-services/patient-care/older-people/resources/improving-access/ia-
interdisciplinary
Swsphn.com.au. (2019). Nurse Education and Professional Bodies. Retrieved from
https://www.swsphn.com.au/nurseeducationandprofessionalbodies
Triplezero.gov.au. (2019). Triple Zero (000). Retrieved from
https://www.triplezero.gov.au/Pages/Usingotheremergencynumbers.aspx
Who.int. (2019). WHO | Chapter 7: Health Systems: principled integrated care. Retrieved
from https://www.who.int/whr/2003/chapter7/en/index1.html
Ww2.health.wa.gov.au. (2019). WA Health, Government of Western Australia. Retrieved
from https://ww2.health.wa.gov.au/

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