Archive for category: My Nursing Writer

T.J. is a 76-year-old man that recently lost his wife.  He lives alone now in an ALF where he has some friends that he associates with.  They are “good for his overall well-being” claims the administrators of the facility who befriended T.J. when he lost his wife six months ago.  The facility that T.J. lives in is convenient for many aspects of his life, including entertainment and even some of the healthcare associates from neighboring clinics that have partnered with the facility to allow visits with the residents.

Over the years, the associates from the neighboring clinic have grown close to some residents and have followed them during some of their crisis, both emotional and physical.  Christine, a nurse practitioner from a neighboring clinic, has followed T.J. for many years and is now assessing his fall risk through a tool called the “Hendrick Fall Risk Tool II” a popular means of assessing the fall risk that may exist for an elderly person.

An entry by the ARNP recently on T.J. demonstrated that there was enough information, recognizing previous and present knowledge to utilize the tool to give T.J. a score representing his fall risk.  the entry reads: “T.J. is a 76-year-old that is evaluated today for his fall risk. He has a MedHx of BPH, COPD, seizures, eczema, and anxiety.  He has been seen monthly and he described some episodes of nocturia that still persists.  A list of his recent mediation includes Alprazolam, Phenytoin, Dutasteride, and ibuprofen prn.  By administering the Get Up and Go Test, we find that he only had a brief episode of not being able to rise but he performed well after that completing it in 12 seconds.  He demonstrates an improvement in his depression experienced in the past exhibited for several months after the loss of his spouse.  His friends at the facility keep him busy and he is much improved in his outlook for the future.”  C. Miller ARNP

Instructions:

1. Read the Fall Risk Assessment for Older Adults article.
2. Complete the Hendrich II Fall Risk Model tool form completely.
   • Assign the correct scores for the Fall Risk Tool.
   • Summarize the scores derived as per fall risk.
3. Develop a summary of the risks for T.J., so that the facility can respond to those risks and provide a safe environment.
4. Describe the level of safety that the facility should plan to give T.J.
5. Finally, explain whether you feel like the score from the Fall Risk Tool is accurate and if the tool is worth the effort to develop.
6. Your paper should be:
   • One (1) page or more.
   • Use factual information from the textbook and/or appropriate articles and websites.
   • Cite your sources – type references according to the APA Style Guide.
7. Upload your file by clicking “Browse My Computer” for Attach File.

Elder Abuse and Neglect
You are a charge nurse in the emergency department. An elderly woman arrives with bruises all over the upper torso of her body and down her left arm. She was brought in by her grandson who resides with her, and the grandson shares that he brought her in to be checked out because he thinks she may have fractured her wrist when she fell on the last step going down in the cellar to do laundry. He appears extremely stressed and states that his grandmother suffers from Alzheimer disease. When you put the patient’s name and demographic information into the electronic medical record it indicates that this patient was in 2 weeks prior with a concussion.

Instructions:

1. Read the scenario above and answer the following question:
   1. How would you assess the situation?
   2. What nursing interventions would you utilize to help both the elderly woman and the grandson?
2. Your paper should be:
   • One (1) page or more.
   • Use factual information from the textbook and/or appropriate articles and websites.
   • Cite your sources – type references according to the APA Style Guide.

Randy Adams is a 38-year-old male patient of Dr. Joseph Reynolds who was admitted yesterday morning for 24-hour observation for mild concussion following a motor vehicle accident. Randy lost consciousness during the accident and was very confused when he arrived in the ER after EMS transport. He is an Iraq war veteran and he seemed to think after the accident that this all happened in Iraq. Dr. Reynolds is concerned that Randy has some residual problems from a couple of explosive incidents that occurred while he was in Iraq. The physician is unsure whether Randy’s current symptoms are from the car accident or from prior injuries so he has referred him for consultations to both a neurologist and to a behavioral health specialist.

Based on the above please discuss the following.

Pathophysiology of concussive injuries and treatment

Neurological assessment tools used in your current practice setting (if not presently working, please describe one used during prior employment or schooling)

Current best practices associated with post-traumatic stress disorder (PTSD)

Nursing interventions you would include in this patient’s plan of care

How can changes in nervous system functioning affect an individual’s psychosocial health status?

What resources are available at the local, state, and federal levels to assist those suffering from PTSD?

While reviewing Randy’s discharge instructions with him, you notice that he is having difficulty holding the pen in his hand and appears to be unable to sign his name. You ask him if he is okay. He looks at you and attempts to smile but only the right side of his face appears to move—the left side is fixed. You fear he may be having a stroke. What would your next steps be?

Please, review the attached PowerPoint…

1.Why do many people seem to have negative feelings toward elders? What do you think that they fear when interacting with or touching older people? How can you as a nurse can overcome some of those fears or hesitations?

2. What types of rights do feel older adults should have when it comes to the end or prolong their life? If older adults with dementia or longtime chronic illnesses choose to withhold food/water or refuse treatment for an illness, do you feel that is within their rights? How would you counsel family members to deal with these types of issues?

3. Mention some strategies for assisting older adults in avoiding the problems of polypharmacy and organizing their medications in an easy to understand and use format. What are the different strategies that could be used? How would strategies change if the patient had hearing or vision deficits? What about if the patient were illiterate?

As stated in the syllabus the assignment must be presented in an APA format word document, Arial 12 font attached to the forum on the discussion board.

– A minimum of 3 evidenced-based references must be used, and one of them must be from a Geriatric Nursing Journal. References must be no older than 5 years.

– A minimum of 700 words is required.