I Had The Pleasure For Care For A Resident

The clinical features Mrs Lee now 83 is displaying changes to health and cognition noted in the last three to four months, with two transient ischaemic attacks but no significant medical issues. Although currently taking three medications for high blood pressure. Changes in word finding, getting words mixed up and confusing identifying words. Insisting everything is fine showing a lack of insight into her changes or difficulties. Short term memory Mrs Lees has difficulty retaining recent memories, however long term memory appears reasonable. Although Mrs Lees home is reasonably well maintained, she is emaciated and personal hygiene is poor. There is also evidence of emotionally Liable being frequently teary with no reason. History includes

Urinary incontinence is very common following a stroke with 40-60% of hospitalised patients experiencing it in the acute phase, 25% on discharge and one third of survivors experiencing ongoing problems at one year (Barrett 2002, Kolominsky-Rabas et al.2003).Bladder and bowel problems are common following a stroke and can have a huge impact on physical and psychological aspects of quality of life, for both patients and carers. Health care professionals can do much to help improve and manage incontinence problems in stroke patients and this starts with a good understanding of key issues. Mobility and manual dexterity problems can compound bladder and bowel symptoms because they can make toileting access difficult, other problems such as visual disturbances, dysphagia and cognition also contribute indirectly to continence difficulties. There is evidence that professional input through structured assessment and management of care, together with the involvement of specialist continence nursing services, may reduce urinary incontinence and related symptoms after stroke. Bladder and bowel care requires active management –this includes a written personalised plan, taking into consideration required assistance, personal needs and goals. This essay is an overview on the importance of timely nursing assessment and management of urinary incontinence

The resident is an 88-year-old Caucasian male who has been married for 63 years along with a long-term care living arrangement. He has medical diagnoses of generalized muscle weakness, cutaneous abscess of buttocks, and lack of coordination. The resident rated his health status as a score of “7” because he stated that he felt pretty energetic most of the time.

In NURS 279, I had the privilege of caring for a patient in his late 20’s who had newly been diagnosed with schizophreniform disorder, after having a “break down”. The main symptoms he had experienced over the few months pre-hospitalization included delusions of religious grandiosity and audio/visual hallucinations and the reason it took months before hospitalization is because he was living out of province, away from his family and mostly in social isolation, though his parents noticed a change in behaviour over the phone calls they shared. He became my patient 2 weeks after his admission, at a point where he had accepted his diagnosis and had control over his symptoms in a controlled environment, however, was med noncompliant, as he

There are some very practical considerations when someone with dementia is using the bathroom. There is the potential for the person to be scalded with hot water, to slip on the floor, or get locked in, or for the carer to strain their back.

The nurse is challenged with the care of patients over a lifespan. Each stage of life brings its own physical and emotional changes which directs the care needs. The care needs of the pediatric patient will be much different from the needs of the geriatric population. The geriatric population has very specific needs which has prompted the government to establish the Quality Assurance & Performance Improvement (QAPI) program. The QAPI provides the framework for nursing facilities to develop and implement changes which address deficiencies the facility was found to have. Also, the QAPI program requires practices and policy be put in place to monitor care of the residents. The purpose of this paper is to list some of the changes the elderly go through as they age, and demonstrate these changes in a quality improvement project. After review of literature, I will discuss the challenges, barriers, and solutions as related to quality improvement. Lastly, I will discuss the quality of care for the geriatric in the future.

One scholarly journal I found summarized the conclusion of various intervention studies for the management of incontinence and promotion of continence in care home residents. Once urinary training was implemented in a facility to analyze, incontinence rates, cost of supplies and efficiency ratios, random assignment, patterns of urinary incontinence, urological evaluations to reaffirm effectiveness and pre and post cost of hourly wet/dry checks were all documented to evaluate the program. The study ended with, “managing incontinence and promoting continence in care homes is complex, requiring time and cost-efficient management procedures to contain the problem and deliver quality, achievable care.”(Flanagan et al., 2014) The cost was a major issue that deterred many facilities from executing any sort of bladder training

The patient and their families must be aware of the infection, the source of infection, signs and symptoms, treatments, and measures to apply at home to decrease their risk of receiving an infection. Because geriatric patients are incontinent they may need a catheter in place to help remove their urine. Nurses must perform aseptic technique, wearing proper gloves when inserting or removing device. Another way to help reduce the risk of elderly urinary tract infections would be to avoid or remove catheter soon as possible. Once patients are cleared for discharge they must be aware of the steps to take to insure proper bladder

A student, in the practical nursing program, giving the best care by using and applying skills, principles, and guidelines is the main concern. Seventy-five percent of patients in hospital are elderly simply because of their fragility and decrease in their immune system which would cause mature adult to develop a health problem. Every week is about meeting new patients with different type of diagnosis so skills can develop and one of the patients has caught a particular attention.

Incontinence is one of the major problems faced by the elderly. Nurses can play a significant role in discovering continence problems (Lea R.et.al.2007). Urinary incontinence is the unintentional passing of urine. It is a very common problem and is thought to affect more than 50 million people in the developed world.(NHS.UK). To identify the problem and provide necessary treatment at the early stage, a thorough physical assessment is necessary.

For my seventh clinical shift at the Loma Linda Veterans Affairs Medical Center, my assigned preceptor Filipina Gumangan assigned me three patients on the 4NW unit. The unit where I precept is an intensive care step down unit. Filipina’s objective for giving me three patients this shift was to give me an opportunity to continue exercising my time management skills and to practice my reporting and charting skills, and wound care. This shift I was responsible for many clinical duties corresponding to the care of these patients. My patients this shift were Mr. B, a 72 year-old Vietnam War veteran newly diagnosed with colon cancer, Mr. S, a 65 year-old Vietnam War veteran in the hospital for complicated urinary tract infection, Mr. R, a 90 year-old Korean and Vietnam War veteran. Caring for these patients taught me more about the humanbecoming perspective of nursing and showed me about multidisciplinary coordination with peers, colleagues, and more.

It is essential for the nurse to have a proper and detailed assessment to determine the most likely cause or type of UI. One of the most basic and least invasive assessment a nurse can do is to obtain a complete history. A complete history must asked questions such as onset and duration, aggravating factors, characteristics, medical history (medical conditions and medications), associated symptoms, attempted treatments and severity (Testa, p. 83). There are also different tools that a nurse can use such as the Urogenital Inventory/ Incontinence Impact Questionnaire and Bladder Diary. Using questionnaires and bladder diary can be used in order to facilitate data gathering for people who have difficulty discussing incontinence face to face. Thorough history can provide insight and help identify potentially reversible causative factors and contributing risk factors related to UI (Mauk, p. 553). It is also important to have a detailed physical assessment, which focused on genitourinary system, abdominal, rectal and neurologic system, in order to determine the pathophysiology of voiding problems. If the nurse suspects any cognitive impairment from the initial assessment Mini Mental State Examination, Mini- Cog, and/or Confusion Assessment Method can be used to determine the severity of the cognitive impairment. It also alerts the healthcare provider for the patient’ increased risked for constant incontinence and it also determines the appropriate interventions. Having a comprehensive assessment will help the healthcare provider to diagnose and establish proper

Approximately seventy percent of people experience urinary incontinence (UI) as a result of being admitted into the hospital. Urinary incontinence is more prevalent in elderly people, and predominantly affects women more often than men. Urinary incontinence can be is described as the uncontrolled loss of urine, and can be broken down into five different types. The first type of urinary incontinence is stress incontinence, which occurs when there is involuntary emission of urine due to coughing, sneezing, or applying any increased pressure to the abdominal region. The second type is urge incontinence, which is when a person has a strong need to void, the bladder then spasms, and the person experiences a spontaneous loss of urine. The third type of incontinence that a person may experience is referred to as mixed incontinence. A person may experience a combination of symptoms from any of the five types of incontinence. The fourth type of incontinence is overflow incontinence. Typically a person’s bladder fills completely, often without the urge to void, resulting in urinary dribbling. Lastly, there is functional incontinence. During this type of incontinence a person is generally aware of the urge to void, but due to some physical or mental deficit, a person has the inability to make it to the restroom. This poses many problems for both the patient and for the hospitals. As the numbers for UI continue to rise, the risk for falls will increase, as well as increasing the amount

This essay is a discussion about my experience during the first two weeks of my clinical placement in an older adult ward. My experiences will be demonstrated using the various nursing skills acquired thus far. The reflective account used is adopted from the work of Driscoll (2007) which splits the essay into three segments namely a) what happened, b) so what, (what were my feelings, what was good and what was wrong about the experience, c) now what, (if I find myself in that same situation what would I do differently).

Visiting a nursing care facility while learning about gerontology they go hand and hand. While learning about aging the best way to fully understand the information is to make observations. There are numerous connections that can be made from observations and the class readings. Throughout this course, there have been many chapters in Social Gerontology that provide a lot of information to understand aging.