1a
|
Number |
a. Nursing Action |
b. Rationale |
|
1 |
Cognitive testing includes any one of Genetic testing, neuroimaging, and biomarker testing. |
Cognitive impairment is a serious clinical condition. Timely diagnosis is critical for handling both the confused sufferer and the severe condition that was the cause. Strategies to avoid cognitive impairment may not always avoid it from occurring, therefore there is a requirement for alertness to every modification in a condition of the client (Wand et al., 2020). |
|
2 |
Taking interviews to find out the condition of their memory using Confusion Assessment Method (CAM) tool. |
Questions to measure remembering, behavior patterns, attitude, and cognitive condition are ideally performed with both the patient individually because then relatives people, or friends cannot provoke the individual. The individual’s conduct upon entrance at the physician’s clinic and contacts with personnel can often provide insight. The Confusion Assessment Method (CAM) is a standardised evidence-based technique which allows non-psychiatrically educated physicians to swiftly but also effectively diagnose and characterise hallucinations in medical and experimental contexts. It is founded on the DSM-IV clinical guidelines for hallucinations and has a specificity of more than 90%. A favourable or bad outcome is determined by four requirements: First, there is an abrupt start and a variable course, which would be identified by peripheral background or frequent diagnostic assessments. The second factor is lack of concentration. A basic testing for that is to number through 20-1. The third characteristic is confused thought, while the fourth is changing degrees of awareness. |
1b
|
Number |
a. Nursing Action |
b. Rationale |
|
1 |
Giving Alzheimer’s drugs |
Cholinesterase inhibitors, a kind of medicine authorized to treat Alzheimer’s mental illness as well as for persons with MCI whose major indication is impairment of remembering, are frequently prescribed by physicians (Weiss et al., 2019). Cholinesterase inhibitors, on the other hand, are not indicated for normal MCI therapy. Medications have not been shown to slow the course of Alzheimer’s and could have negative side consequences. The dose of the medicine is determined by the CAM test score. |
|
2 |
Giving Benzodiazepines |
Certain drugs can have adverse impacts on cerebral functionality. Such adverse symptoms are expected to disappear if the medicine is discontinued. It’s critical to address any adverse concerns immediately the physician, and the patient should never quit taking these drugs until the physician tells users to. Among these drugs the most important is Benzodiazepines. These are medications that are used to treat illnesses including stress, convulsions, and cognitive difficulties. If all characteristics 1 and 2 are observed, as well as at minimum one of characteristics 3 or 4 from the four requirements, the CAM is regarded favourable for the existence of hallucinations. Then this Benzodiazepines drugs are applied. |
|
Number |
a. Description of Mr. Goodwill’s score in a cognitive domain of the MMSE and the meaning or interpretation of this score |
b. Communication approaches or strategies that you could employ to effectively partner with Mr. Goodwill linked to each MMSE score |
|
1 |
Abnormal according to Single Cut-off |
Mr. Stuart Goodwill must be guided to stay active in smaller tasks to increase his senses. Also, his social connection must be increased to increase his self-confidence. |
|
2 |
Increased chances of dementia according to Range |
Healthy food must be given to him with proper medication to cure his dementia (Gidaro & Servais, 2019). |
|
3 |
Unusual for an eighth-grade education according to Education |
Mr. Stuart Goodwill must be taught about general awareness and basic knowledge to increase his general education level. |
|
4 |
Significant cognitive impairment according to Severity |
Benzodiazepines drugs must be given as per doctor’s prescription (Johnson et al., 2019). Based on the effect of this drug on him further, medication should be modified. |
The most important factor of giving proper medical care to older people is increasing their mental peace. That is why the importance of giving holistic care to older people has increased very much. Clinicians are focusing on anticipating and, if feasible, reducing the course of severe mental illness and losses in general health to assist older persons in remaining autonomous. Numerous initiatives had already been established to target a particular element of wellness; but, in order to encourage aging in residence, a holistic strategy to assess the health and wellness of aged persons is required (Fang et al., 2019). There are currently no approaches that handle the holistic and multifaceted evaluation of mental wellbeing and overall health. The issue in pursuing this method is assessing and integrating diverse data streams in order to offer a full evaluation of the healthcare of older persons. The next difficulty is to tailor such an evaluation to each patient’s medical requirements. The major reasons for using this care are as follows: This increases the mental peace of older people. The belief increases their confidence in the medication which increases its activity. Various physical activities in holistic care increase physical strengths (Fisher et al., 2020). Like this way to increase the mental peace and physical condition, it has become necessary to conduct holistic care for the older persons.
4a
In this case study Mrs. Connor, a 75-year-old lady who stays at the house alongside her spouse, comes to the office complaining of persistent hip discomfort which has not improved after medicine and physiotherapy. Mrs. Connor is worried that perhaps the discomfort has had a major impact on her regular routines and attitude during the last 3 months. Mrs. Connor stated that because her discomfort restricted her participation in hobbies and activity, she acquired weight as well as suffered regular bouts of incontinence. Mrs. Connor’s General physician advises her to undergo hip replacement surgery. As this is a major surgery so here taking consent from Mrs. Connor is very important. Therefore, to ensure that if she is capable to give concern about this huge surgery MMSE test must be done, and based on the results the registered nurse can determine her mental condition and if she is capable of giving the concern to do the hip surgery (Collins et al., 2018).
4b
The registered nurse makes certain that Mrs. Connor receives knowledge on constipation control and treatment. Mrs. Connor received an MMSE scoring rate of 26/30. She was docked two points for erroneously calculating reverse by sevens, and she has docked two points for recalling three things but only recalling one. Here both of the tests where Mrs. Connor docked her score was based on finding her memorizing ability. So here other than these two points deduction Mrs. Connor got a full score. Therefore, this implement is not abnormal and her mental condition is well enough to give concern on the hip injury (Astell-Burt & Feng, 2019). Therefore, in this case, the registered nurse must demonstrate the current medical condition of Mrs. Connor’s hip and why surgery is needed. Based on that she can decide on doing the surgery. After that based on Mrs. Connor’s decision the next to be taken and further instruction can be given to her to prevent and manage her constipation.
References
Astell-Burt, T., & Feng, X. (2019). Association of urban green space with mental health and general health among adults in Australia. JAMA network open, 2(7), e198209-e198209. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2739050
Collins, N. J., Barton, C. J., Van Middelkoop, M., Callaghan, M. J., Rathleff, M. S., Vicenzino, B. T., … & Crossley, K. M. (2018). 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. British journal of sports medicine, 52(18), 1170-1178. https://bjsm.bmj.com/content/52/18/1170?ct=
Fang, H., Tu, S., Sheng, J., & Shao, A. (2019). Depression in sleep disturbance: a review on a bidirectional relationship, mechanisms and treatment. Journal of cellular and molecular medicine, 23(4), 2324-2332. https://onlinelibrary.wiley.com/doi/abs/10.1111/jcmm.14170
Fisher, J. R., Tran, T. D., Hammarberg, K., Sastry, J., Nguyen, H., Rowe, H., … & Kirkman, M. (2020). Mental health of people in Australia in the first month of COVID?19 restrictions: a national survey. Medical journal of Australia, 213(10), 458-464. https://onlinelibrary.wiley.com/doi/abs/10.5694/mja2.50831
Gidaro, T., & Servais, L. (2019). Nusinersen treatment of spinal muscular atrophy: current knowledge and existing gaps. Developmental Medicine & Child Neurology, 61(1), 19-24. https://onlinelibrary.wiley.com/doi/abs/10.1111/dmcn.14027
Johnson, T. W., Räber, L., Di Mario, C., Bourantas, C., Jia, H., Mattesini, A., … & Guagliumi, G. (2019). Clinical use of intracoronary imaging. Part 2: Acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions: Endorsed by the Chinese Society of Cardiology, the Hong Kong Society of Transcatheter Endocardiovascular Therapeutics (HKSTENT) and the Cardiac Society of Australia and New Zealand. European heart journal, 40(31), 2566-2584. https://academic.oup.com/eurheartj/article-abstract/40/31/2566/5491794
Wand, A. P. F., Zhong, B. L., Chiu, H. F. K., Draper, B., & De Leo, D. (2020). COVID-19: the implications for suicide in older adults. International psychogeriatrics, 32(10), 1225-1230. https://www.cambridge.org/core/journals/international-psychogeriatrics/article/covid19-the-implications-forsuicide-in-older-adults/9890D02E0DA3021FCFE66B9A29F2684E
Weiss, A., Hussain, S., Ng, B., Sarma, S., Tiller, J., Waite, S., & Loo, C. (2019). Royal Australian and New Zealand College of Psychiatrists professional practice guidelines for the administration of electroconvulsive therapy. Australian & New Zealand Journal of Psychiatry, 53(7), 609-623. https://journals.sagepub.com/doi/abs/10.1177/0004867419839139
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