Nursing Care And Rationale For Ms Marley: Using Roper-Logan-Tierney Model

Maintaining a secure environment

The following care discussion utilizes the Roper-Logan-Tierney model to evaluate a specific patient, Ms Marley, who has several health concerns. They include osteoporosis, hearing deficit and hypertension. The paper analyses three particular activities: sleeping, mobilizing and maintaining a secure environment.

Tierney, Logan and Roper developed a very crucial model for the health practice. It aids in implementing clinical procedures in relation to various activities of livings (AOL) (Alligood, 2017). Additionally, utilization of this model makes it possible for healthcare professionals to discover AOL, activities of living, which can be mitigated so as to establish relevant care plans which are patient-specific to enhance well-being and health.

Information is fundamental in the health profession. Obtaining appropriate information is key in availing relevant support to probable patients. Information acquired is related to psychological, economic, environmental, socio-cultural, political and biological factors (Greene, 2015). The most appropriate primary information entails a person’s health history, age and vital signs. The second information I would require to develop Ms Marley’s care plan includes her responsibilities, beliefs and values.

Vital signs reveal the measurements of fundamental body functions. I would conduct a physical examination to obtain my patient’s vital signs. These comprise of blood pressure, body temperature as well as pulse and respiration rates (Dibona, 2013). The patient’s age information would be obtained by asking Ms Marley or her daughter. It is important in prescribing the appropriate medication for her (Cosman et al., 2014). Knowing a patient’s past medical history is paramount as it makes a nurse conscious of the person’s medical conditions. Such information can be obtained from nursing notes or patient records. Precisely, it is essential to know Ms Marley’s other medical conditions like hypertension, hearing deficit and osteoporosis.

It is important that various actions are undertaken to sustain a secure environment when carrying out activities of living. The actions may comprise activities like washing hands. Specifically, in Ms Marley’s case, such actions include driving carefully and preventing accidents while at home. Traditionally, the environment affects human beings. It is the responsibility of every person to take care of the environment because people also affect the environment (Millis and Levine, 2014). Secondary information like responsibilities, beliefs and values of Ms Marley will help in influencing various decisions as regards to developing her care plan.

Maintaining a safe environment is imperative in achieving patient care. In the case study, it is vital that both the external and internal environment be considered. Marley has a considerable hearing deficit. Therefore, it is important that the nurse taking care of her ensures that there is minimal noise as this makes her fail to sleep. It is vital that the environment in which a patient is in be maintained. In the same vein, this ensures that there is a reduction in the risk of further infections. A patient’s psychological, mental and physical wellbeing are also maintained. Therefore, the Roper-Logan-Tierney model assists in making sure that diverse patient requirements are considered (Williams, 2015). The model also comprises of significant care especially for the internal or interior environment that is on a cellular level. Therefore, this element forms an essential component of the entire recovery process precisely for Ms Marley’s case study.

Mobilizing

There are various assessments which are vital and have to be done to maintain a secure environment.  First, conducting a falls evaluation would be important. It is paramount to find out from Ms Marley if she experiences frequent falls. Additionally, this would be important in steering clear further fractures since she has osteoporosis. Osteoporosis is a medical condition that is characterized by reduced bone density and reduction in strength (Hernlund et al., 2013). It is vital to perform tissue viability assessment as well as hearing, vision, immobility and mobility evaluation. Physiological data has to be assessed. In this case, it is necessary that Ms Marley’s blood pressure is evaluated.

Mobilization entails movement produced by muscles which enable people to sit, run, walk and stand. Other movements include non-verbal communication, for instance, mannerisms, hand gesticulations as well as facial expressions. Conventionally, mobility is usually affected by various factors. Health practitioners’ intervention can greatly aid in improving body function and subsequent capability to recover. The surgical health professionals conducted the CRIF (closed reduction and internal fixation) on Ms Marley (Mitchell, 2014). Additionally, the patient was to be relocated to a Sub-Acute Rehabilitation Unit. She would be discharged soon if she recovers swiftly. Conversely, failure to fully recover would necessitate the consideration of other reconstruction techniques which are even suited to such elderly patients, for instance, hemiarthroplasty.

More importantly, it is imperative to conduct different assessments during this mobilization activity. Normal gait or posture has to be evaluated. Consequently, in Ms Marley’s scenario, it is helpful in determining the likelihood of falls. On account of the patient having osteoporosis, the assessment to determine normal gait is necessary because any fall might lead to a fracture in one of her bones since they are generally weak (Basu and Millett, 2013). After keenly assessing Ms Marley, mobility barriers were observed. Other vital evaluations include aids utilized for mobilization and handling and moving assessment.

Utilizing communication skills to develop a therapeutic connection as an appropriate intervention, Ms Marley disclosed that she was concerned about various issues. She needed to get home soon to continue taking care of her garden and pets, that is, two dogs. Consequently, she stated that she experienced pain after the surgery. On the other hand, she also stated that she was afraid of falling again. She was optimistic that she would get better. Ms Marley further revealed that she wanted to get back to her busy lifestyle. She desires to continue being active and consequently drive around. She raised concerns that the room where she was admitted was noisy. The healthcare providers promised to handle the issue. Later on, Ms Marley agreed to put on the bi-lateral hearing equipment to assist in her listening ability. Consequently, an alternative nursing intervention utilized to help Ms Marley in mobilization was to administer recommended or prescribed analgesics. The prescribed analgesics were specifically for pain reduction. Therefore, this minimized the consequences that the surgical wounds would present.

There are various effective interventions to mobility barrier observed in the patient, Ms Marley. As a health professional, it is necessary to encourage the patient to seek assistance from her daughter if she has difficulty walking. Furthermore, this would aid in steering clear falls that can cause bone fractures. Another helpful intervention is to consider lifestyle transformation. For example, develop an exercise routine and consume a diet that contains adequate vitamin D and calcium to strengthen her bones (Melse-Boonstra and Mackenzie, 2013). Similarly, providing medication particularly for stopping bone loss, increasing bone formation and strength is also a relevant intervention.

Adequate sleep makes the human body to completely relax from the stress of daily living. During sleep, repair of cells and growth takes place. During this activity, various assessments can be conducted. First, it is significant to evaluate a patient’s pattern of sleep. In Ms Marley’s scenario, she did not experience a normal sleep pattern after her surgery. In addition, medication as well as activities to enhance or promote sleep need to be assessed.

There are diverse interventions for Ms Marley’s sleeping problem. First, the health practitioner taking care of her ought to ensure that the room where she sleeps is free from noise. The nurse can also consider the influence of the prescribed medication. Some medicines occasionally lead to sleep disorders. Moreover, behavioral interventions occasionally mitigate lack of sleep. These include cognitive restructuring, sleep hygiene and relaxation training. Therapies such as sleep restriction, paradoxical intention and stimulus control are also fundamental behavioral interventions.

These interventions will improve Ms Marley’s health status. They will make her sleep for more than six hours. Customarily, persons who have few bedtime hours, for example, less than five hours are at a greater risk of getting hypertension. Adequate sleep will help Ms Marley’s blood control various blood hormones. It will also make her nervous system healthy. Therefore, this will help in controlling her hypertension (Dibona, 2013). Furthermore, enough sleep facilitates bone metabolism or bone remodeling. Bone remodeling maintains the density, flexibility, and strength as well as repairs bones. Furthermore, bone remodeling is accountable for replacing or reshaping damaged bone structures. Therefore, adequate sleep will help Ms Marley in healing the fractured Femur and mitigating her osteoporosis.

The Roper-Logan-Tierney prototype or model is significant to the healthcare practice in relation to the various activities of living. It makes it possible for clinical experts to recognize AOL (activities of living) which are achievable especially when developing care plans (Barrett, Wilson and Woodlands, 2014). The model gives people an opportunity to conduct diverse activities which are necessary for maintaining well-being as well as health. It is important to note that the model entails phases of intervention, planning, assessment and evaluation.

Notably, it is imperative to evaluate a patient’s nursing care. Evaluation encompasses the provision of a basis to conduct both assessment and planning. The phase includes problems associated with the patient’s transformation. In light of this, the evaluation stage provides the nurse or doctor with the opportunity to evaluate the care provided (Green, McGwin and Odwsley, 2013). The care must be analyzed to determine whether it was effective in attaining the objectives previous set. Objectives include striving to attain improved health condition of the patient.

Evaluation is vital as it aids nurses to discover probable challenges which arise during an intervention. For instance, for the scenario of the old lady aforementioned, the health practitioner can analyze whether the prescribed analgesics were efficient. Moreover, the intervention is prosperous if the analgesics reduced Ms Marley’s pain after surgery. It is critical to examine if the various techniques used to improve Ms Marley’s sleep actually work effectively. An investigation has to be done to disclose whether the diverse behavioral interventions to reduce lack of sleep worked. In addition, this will be observed in Ms Marley’s faster recovery from the surgical wound. The observation is made because enough sleep makes bone remodeling to swiftly repair fractured bones (Kanis et al., 2013). Therefore, evaluation makes it possible to improve healthcare service delivery to Ms Marley. Through the evaluation, the nurse is able to enhance or improve the various intervention techniques for similar patients in the future. In conclusion, the reflective process establishes crucial thinking skills to aid develop the capability to provide clear rationales, especially when making health-related decisions.

References

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