Comprehensive Nursing Case Study: Managing Mrs. M.T.'s Complex Health

This nursing case study details the care of Mrs. M.T., an 82-year-old patient admitted to the emergency department with respiratory problems. Bedbound due to an old CVA and cared for by her granddaughter, Mrs. M.T. presented with low blood pressure, urinary tract infection, dehydration, anemia, decreased renal function, and pneumonia. Physical examination revealed infected stage IV pressure ulcers, and the caregiver reported a recent change in mental status and decreased appetite. The case study identifies frailty signs such as weakness, weight loss, and fatigue, as well as geriatric syndromes including inability to perform ADLs and IADLs, mental disorientation, pressure ulcers, and hearing impairments. The analysis addresses the causes of pressure ulcers, preventative actions, and strategies to prevent geriatric cascade spiraling. Key discharge issues include fall risk, disturbed mental status, and activity intolerance, highlighting the potential need for a caregiver to provide consistent support. This document is available on Desklib, a platform offering a range of study tools and resources for students.

Running head: NURSING CASE STUDY OF MRS M.T.
NURSING CASE STUDY OF MRS M.T.
Name of the Student
Name of the University
Author’s Note:

1NURSING CASE STUDY OF MRS M.T.
Answer to the question number 1:
The patient has right sided paralysis which is secondary to old stroke. Also, patient is
bedbound and unable to perform ADLs and IADLs. Therefore, it can be stated that the patient
is a fall risk.
Answer to the question number 2:
The patient had a decrease in 50 per cent renal function and was also suffering from
dehydration. If the patient had maintained normal renal function and hydration level, it might
have prevented her from being hospitalized.
Answer to the question number 3:
The signs of the patient’s frailty are:
 Weakness
 Weight loss
 Fatigue
 Malnutrition (Shao et al., 2016)
Answer to the question number 4:
The geriatric syndromes of this patient are:
 Inability to perform ADLs and IADLs
 Mental disorientation
 Pressure ulcers
 Hearing impairments
 No dentures (Bell et al., 2016)

2NURSING CASE STUDY OF MRS M.T.
Answer to the question number 5:
The patient is bedbound for the whole duration while her caregiver is away with work. The
patient cannot reposition herself or get up from her bed. Hence, the patient had to stay in a
same position for long duration. This is one of the causes of pressure ulcers. Therefore, this is
one of the contributing factor to the patient’s pressure ulcers.
Following actions can be taken for the prevention of pressure ulcers:
 Changing of position frequently
 Maintenance of general hygiene
 Movement and exercise (Demarré et al., 2015)
Answer to the question number 6:
Following actions can be taken to prevent the patient from spiralling into geriatric cascade:
 Assessment of fall risk and necessary actions need to be taken accordingly.
 Maintain the patient’s hygienic needs.
 Proper immediate actions need to be taken for the patient’s medical needs.
 Provision of caregiver for her daily needs
Answer to the question number 7:
Following issues needs to be addressed while the patient is discharging:
 Risk of fall and fall prevention.
 Disturbed mental status.
 Intolerance to daily activity.
Answer to the question number 8:
The patient might need the service of a caregiver upon discharging as her current caregiver
cannot present all the time.

3NURSING CASE STUDY OF MRS M.T.
References:
Bell, S. P., Vasilevskis, E. E., Saraf, A. A., Jacobsen, J. M. L., Kripalani, S., Mixon, A. S., ...
& Simmons, S. F. (2016). Geriatric syndromes in hospitalized older adults discharged
to skilled nursing facilities. Journal of the American Geriatrics Society, 64(4), 715-
722.
Demarré, L., Van Lancker, A., Van Hecke, A., Verhaeghe, S., Grypdonck, M., Lemey, J., ...
& Beeckman, D. (2015). The cost of prevention and treatment of pressure ulcers: a
systematic review. International journal of nursing studies, 52(11), 1754-1774.
Shao, Y., Mohanty, A. F., Ahmed, A., Weir, C. R., Bray, B. E., Shah, R. U., ... & Zeng-
Treitler, Q. (2016). Identification and use of frailty indicators from text to examine
associations with clinical outcomes among patients with heart failure. In AMIA
Annual Symposium Proceedings (Vol. 2016, p. 1110). American Medical Informatics
Association.