Alcohol Withdrawal Risk Assessment Case Study - Medical Science Assignment Help

Assignment Task

Part 1

Alcohol withdrawal risk assessment

This case study is going to discuss about Alcohol withdrawal risk assessment (AWRA)for
Mr.Jungala 71,years old with comorbidities. He consumes alcohol 2-3 times a week andcurrently restricted to take alcohol in the hospital especially when he is on medical management for his other medical illness, which interrupt the effectiveness of his medications. Quick stopover of alcohol in the hospital end up with many withdrawal symptoms like anxiety, tremors, depression, sweating, tachycardia, agitations, aggressive behaviour, fear etc. which may affect his physical and mental health. This alcohol withdrawal risk assessment is used to find out the exact diagnosis of level of alcohol consumption, symptoms, patient safety, and implement the appropriate treatment plan and motivate patient to engage in long term alcohol withdrawal (Eloma et al., 2018). The frequency, quantity, and type of standard drinks consumed by Mr.Jungala is assessed in the last 24 hours and over last week, months and year, besides, other drinking consequences is also evaluated. His assessment result shows he comes under very mild withdrawal risk level which could cause complication during his withdrawal. Early treatment of benzodiazepine 300 mg is given orally to prevent severe withdrawal symptoms, thiamine (50-100gm/daily)and multivitamins is provided to prevent vitamin B1 deficiency which help in prevent him return to drinking and control severe symptoms. (Airagnes et al.,2019).

Cognitive assessment

The goal of the cognitive assessment is used to determine the individual cognitive abilities by measuring important aspects of his brain functioning through numerical reasoning and verbal reasoning. Correspondingly, identifying the signs of cognitive function in order to provide care and treatment for Mr.Jungala. Cognitive assessment is taken to Mr.Jungala is because he is 71 years old with history of fall may lead to cognitive impairment, moreover drinking alcohol may be a contributing factor to affect his cognitive function. Also, in terms of aging factor this assessment is done to rule out Dementia and Alzheimer’s disease. Montreal cognitive assessment tool is used to Mr.Jungala by asking him short list of words, by asking him to identify animal pictures, objects and also ask him to identify person, place and time to check his cognitive ability. Mini mental state examination tool is used to assess the physical and mental health status, medication side effects, psychosocial factors, undetected pain and discomfort which influences cognitive abilities(Korsnes, M. S. 2020). Based on intellectual functioning test Mr.Jungala is able to follow commands and he is oriented to place and person but not time as it could be because of medication side effects but not to be concern currently (Dautzenberg, 2019)

Falls assessment

The purpose of falls assessment in health care is to identify risk patient aged 65 and above to reduce risk of falling by identifying and addressing the underlying risk factors and implement falls prevention care plan on Mr.Jungala. Falls risk assessment tool (FRAT)is used to evaluate the patient recent falls, medications, nutritional status, psychological, cognitive, mobility status, transfers, behaviours and record the outcome for multidisciplinaryapproach. Moreover, this assessment tool helps to test strength, balance and gait then improve it with regular exercise. Also, fall prevention strategies is used in the hospital by providing walking aids, easy access to his personal items like eye glasses, call bell, easy and safety access to toilet, implementing falls mat,reduce clutters around bed sideis highly essential. Besides, exercise program, vitamin D supplementation, appropriate footwear advice, proper clothing, cataract surgery recommendations, hazard reduction training and education program is advised to perform his activities of daily living and reduce the risk of falling. Providing low bed close to the wall but there should be space between wall and bed which decrease the fall risk. Additionally, non-slip socks prevent fall in hospital setting. Observing for the body weight, level of appetite, urine frequency is observed and encourage appropriate prevention strategies, thus helps him fast recovery and reduce pain(Bhangu,2017).

Functional Assessment

A functional assessment is an interdisciplinary and multidimensional diagnostic process which assess functional, medical and psychosocial status of elderly people. It’s a review of individual mobility,transfer skills, activities of daily living, self-care, sphincter control, communication across multiple settings is performed by the functional assessment test(Means, K. M., &Kortebein P. M, 2013).  The goal of this assessment is to improve the health status of the patient, identify the limitations of patient ability to function in daily life, allow the medical health team to develop the interventions to improve the function, physical therapist helps in teaching exercises to  restore mobility and improve the range of motion and the occupational therapist aids in providing walking aids for walking and weight bearing, nurses helps in wound care, assisting and supporting in his activities of daily living such as bathing, dressing and undressing, personal hygiene and grooming, preparing food , delivering ,feeding, toileting, walking, incontinence, and assist him with medications to improve the quality of life. As Mr.Jungala has soft tissue injury in right hip as a result of fall with pain score 6 and movement limitations the goals isto provide mobility aids like four-wheel support walker for his pain and movement restraints, also he needs help for bathing, dressing and other activities of daily living. This assessment focus Mr Jungalaon holistic approach, ensure that we are culturally sensitive to their needs and requirements(Talarska,2016)

Nutritional Assessment

Nutrition is essential key componentof health in elderly people which disruptsaging process. Nutrition assessment goal is to find out patient risk at malnutrition, improving the decline of functional status and improving the nutritional health, restore mobility, boost immune level and develop the disease management caused by inadequate nutrition (Abd Aziz et al., 2017). Furthermore, assessingclinical history, physical examination, dietary outline of Mr Jungalaevaluated by dietician and ask set of questioners about his diet change and weight loss in the last 6 months.  This assessment shows Mr Jungala has less appetite and decreased energy expenditure which might deterioratehis physiological and mental functions. Therefore, the dietician recommendssupplements of vitamin c, vitamin D and vitamin 12 to protect against deficiency in ageing immune system. Subsequently, in terms of Jungala blood glucose levelappears to be 3.9 mm mol/l which is very lowdue to poor nutrition and taking various medication. Along with, the dietician recommends to drink plenty of water for his constipation andsuggesting soluble fibre supplements to relieve his discomfort. In the long run, he has unstable angina, hypertension and chronic renal failure, which has major impact on his nutritional status therefore,dietary recommendations to Mr.jungalais advised to avoid salty, sugary,fatty and potassium rich foods, with fluid restriction and concentrate more on low carbohydrates diet to improve nutritional status to improve his medical condition(sharma, 2017)

Part 2

Aging is a process of slow change over time evident in older people. In this case, Jungala’s age related changes commonly seen are vision changes, anxiety, depression, skin bruise, prone to fractures and falls as a result of decreased bone mass, reduction in muscle strength due to loss of muscle tissue, loss of teeth, decrease in weight, difficulty in reading, driving  which of these changes demand assistance in ageing. Eating healthy and balanced diet helps Jungala to maintain quality of life in older age

Comorbidities is defined as a person who have two or more significant clinical condition at the age of 70s. This case reported of hypertension, unstable angina, Diabetes mellitus, chronic renal failure, which influences his health and some of these conditions could be the contributing factor for Mr.Jungala’s fall. Furthermore, loss of confidence, anxiety increased by long term illness, muscle weakness, poor visionmay lead to risk of fall(Arukala., 2016). However, Perindopril is the medication to treat high blood pressure in Mr.Jungala, prescribing NSAID with perindopril increase the risk of high potassium level in the blood called hyperkalaemia end with dehydration with a symptom of light-headedness might increase the risk of fall. Similarly,poor nutrition intake along with the diabetic medication metformin decreases the blood glucose level in the blood results with hypoglycaemia and cataract caused by diabetic neuropathy which could be another contributing factor for his fall. Besides, his vital shows high blood pressure for Mr Jungala is because aspirin might decrease the effect of hypertensive drugs so the blood pressure is not in control which leads to dizziness and this could be prone to his fall. Medications that contribute to fall is more when compare to his illness so medication should be considered for people over 65 years of age where no contraindication exist(Saitz, 2018).
The factor which is highly influenced for Mr jungala illness is the cardio vascular disease such as hypertension, unstable angina which is associated with other system. The nursing interventions for his hypertension includes monitoring and recording B.P, at sitting and standing position for initial evaluation, is because comparison of pressure provides clear view of vascular involvement, also, checking for skin colour, moisture, temperature and capillary refill time, the presence of cool foot and delayed capillary time which may be due to peripheral vasoconstriction or decreased cardiac output.Similarly, monitoring  response to medications to control blood pressure, is to determines the effectiveness, responseand side effects of medications (Bhangu et al., 2017). Patient with three or more medications  withblood pressure over 140/90 referred to the appropriate specialist like cardiologist, endocrinologist for further treatment. Likewise, physical therapist help him in teaching exercise program to restore his mobility in the home environment and referred Mr.Jungala to services and support for daily living to assist his challenges in health inabilities, they cover wide range of options to manage the life independently and the support servicesentertainclinical and personal care services delivered in the aboriginal  community by maintaining socially interconnected relationship and provides him the quality of care(Mattei da Silva,2019)

Part 3

Healthy aging encompasses physical, social, mental, spiritual well-being which is an essential determinant to maintain a high-quality life in elderly people. Active emotional energy helps in promoting mental well-being and independent in older age. Likewise, social life relationship contributes emotional wellbeing by involving in high level of social activities and positive emotions which influence cognitive functioning and lower risk for morbidity and mortality. Considering Jungala’s psychosocial vital signs he is in acute confusion state accompanied by acute illness, disorientated to time, distressed and fearful. He might be experiencing depression with low moods, loss of interest in the activities of daily living, lethargic appearance, low concentration level, difficult in decision making, restless sleep, loss of appetite and fear of death(Forman, 2016). As per psychosocial health of Mr.Jungala the positive side shows he is very much supportive and living happy with his family members, friends and independent in his daily activities plus very concerned about his children’s and grandkids. 

According to this case study he is not socially isolated but his anxiety level is just because his daughter two children are diagnosed with cancers which is unbearable for Mr.Jungala also, he was very upset and worried that his urinary tract infection, diabetes and  unstable angina will make him visiting hospitals frequently which lay more pressure to his family members.

Considering the psychological factor of Mr.Jungala, the health and support services giving him an opportunity to engage with social interaction activities and make him socially connected. Family mental health support services, eye care services, will support Mr.Jungala and help them to overcome social isolation through recovery and strength focused approach and achieve workforce participation (Beverly et al., 2016). Local community health well-being services offers wide range of health services who have long standing mental and functional illness that includes treatment, rehabilitation and case management for elderly people (Agarval et al., 2017).

Following hospital discharge, the complete goal is to develop strong multidisciplinary team that ensure patient outcome thus, the health care professionals prepares structured discharge planning, medication management, referrals, long term follow up services, self-care health education and monitoring with the involvement of patient and family members. Furthermore, succeeding Jungala’s discharge he will be referred to the aboriginal community rehabilitation centre services provided either in home or centre through multidisciplinary approach which includes medical services by aboriginal practitioner whom they provides culturally appropriate safe care, and the nursing community role aids in monitoring the patient, assist in wound care, medications and support his activities of daily living , physiotherapy to encourage mobility and independence, occupational therapy to provide mobility aids, besides assessing home environment and safety before going home(Soteriou, 2016). Similarly, podiatry for his foot care and dietician for his nutritional advice, also Indigenous health liaison officer supports the patient in hospital and connect the services for discharge planning by ensuring he is on appropriate care and culturally safe, pharmacist plays important role in drug safety. Referrals onto conventional services for ongoing management to support Mr.Jungala to maintain the person cantered integrated care delivery through holistic approach empowering health and psychosocial wellbeing of the patient.
1. Aged care services and interdisciplinary care 
a. Identify and discuss aged care services and interdisciplinary referrals that you  would make as a registered nurse to promote Alex and Sarah independence.  Provide a rationale for the services you have selected and link this to the case  study. 
2. Age related changes and Patient assessments 
a. Identify five body systems you would like to assess with specific linkage to the  case study. Provide a description of the assessment and possible age-related  changes (specific to the body system) that the patient may be experiencing  and how this is impacting on the patient’s quality of life. 
b. Identify five different assessments (not body systems) you would perform on  Alex and link these assessments to the case study. With each assessment  provide a rationale as to why you would perform this assessment. 
3. Medication management 
Examining the patient’s medication history answer the following questions: 
a. Identify and describe the age-related changes that impact on  pharmacokinetics (Absorption, Distribution, Metabolism & Excretion) b. The older person is vulnerable to adverse drug events. Identify and describe  what factors in the case study increase the risk of an adverse drug event. c. For each medication describe what the medication is used for and any  potential complications that Alex may experience while taking this medication. 
4. Reflection 
a. Reflecting on the case study evaluate the impact of your own personal  experiences and beliefs on how you would feel in this situation.

This Medical Science Assignment has been solved by our Medical Science Experts at My Uni Paper. Our Assignment Writing Experts are efficient to provide a fresh solution to this question. We are serving more than 10000+ Students in Australia, UK & US by helping them to score HD in their academics. Our Experts are well trained to follow all marking rubrics & referencing style.

Be it a used or new solution, the quality of the work submitted by our assignment experts remains unhampered. You may continue to expect the same or even better quality with the used and new assignment solution files respectively. There’s one thing to be noticed that you could choose one between the two and acquire an HD either way. You could choose a new assignment solution file to get yourself an exclusive, plagiarism (with free Turnitin file), expert quality assignment or order an old solution file that was considered worthy of the highest distinction.