HLTENN013: Implement and Monitor Care of the Older Person - Mr. John Woods Case Study - Nursing Assignment Help

Assignment Task:

Task:
Using the case study and additional information provided, please complete PART A and PART B of the following assessment.

Background Information:

Mr John Woods is an eighty-five (85) years old male who resides at the Fellows residential aged care facility in metro Victoria. He has lived here for two (2) years and prior to this he used to live with his sister in their own family home. Once his sister died, he was finding himself becoming increasing socially isolated, anxious and finding it difficult to manage at home. He only had one brother left, who visited him once every three (3) months at the aged care facility.  

Mr Woods was never married and has no children. He used to work as a hairstylist and has always taken pride in his personal style and appearance. 

His past medical history includes

-    Myocardial infarct (MI) Diagnosed 8 years ago
-    Hypertension Diagnosed 13 years ago
-    Osteoarthritis and gout particularly in his left knee. 
-    Anxiety and depression Diagnosed 2 years ago

He has more recently been diagnosed with Alzheimer’s dementia and urinary incontinence (urgency incontinence <12 months) 

He ambulates with a 4 wheeled frame; however, staff often finds that he leaves the frame and is found walking in the hallways. Mr Woods requires one staff to assist with personal care, including dental care (full lower/ partial upper dentures).

Staff encourage him to attend social activities with other residents, however he tends to stay for only short periods and leaves the activity. John tends to wander around the facility and often forgets where his room is and requires staff to redirect and reorientate him often, several times a day. Staff have also noted that he is restless and wandering through the night, and spending time asleep during the day due to his night-time wandering. John complains that he has increasing pain in his left knee, however when asked about the pain he does not appear to be able to be to give accurate information to staff. His answers often seem quite confused and vague.

He has had two falls in last six (6) month, both resulting in nil injuries.

John can eat his meals with no staff assistance, however more recently the staff has noticed that he is eating less and at times forgets he is even there. Often his meals are returned completely uneaten. He has had a recent weight loss over the last 2 months) of more than two (2) kg, from 57.6 kg to 55.6 kg. 

He saw a dietician on admission; however, he has not had a follow-up review.
 

Medications:

• PRN Panadol 1gm TDS 
• Voltaren Emulgel daily to left knee
• Endone 5mg PRN
• Atenolol 100 mg mane

Current Situation (Morning Handover) 07:00 hrs:

You have been assigned to care for Mr John Woods on a morning shift.  Here is the handover you receive from the night staff:

Mr Woods, in room 19, has been awake for periods overnight. Staff checked on him at 01:00 hrs and they noticed his room light was on and he was sitting on his bed. Staff asked him what he was doing, and he replied that he was getting ready for lunch. Staff helped him to use the toilet and they noted that he was incontinent of urine. He was also noted to hold his left knee while ambulating. Staff re-applied an incontinence aid, he was administered analgesics by the nurse post pain assessment and he was assisted back to bed. He seemed quite confused and required reassurance that it was time for bed. 

Staff then noticed him up at 03:00 hrs and he required redirecting to his bed. At the time of report, he was having a shower with the night personal carer as he was up and at the nurses’ station requesting to go to the shops. He was quite upset this morning stating that he was looking for his sister. Staff offered reassurance and redirection.

Part A: Answering the questions (2000 words)

Medical diagnosis: Using the information you have been provided with describe the persons past medical history. Include the impact that this past medical history may/will have on the person.

Theory of ageing: Using the information you have been provided with and by doing further research determine which theory of ageing you believe is most appropriate for this person.  Provide justification for your response.

Physiology of ageing: Using the information you have been provided with, explain the physiology of ageing and how it relates to this person’s disease process.

Primary health services: Identify which primary health services you believe would be appropriate for this person. Justify your response. You must identify at least two (2) primary health services that are appropriate for this person.

Strategies and Interventions for dementia/challenging behaviours: Describe at least four (4) strategies or interventions that you may be able to utilise to assist to care for an individual with dementia.  Ensure that you have linked this back to the person in the case study (what behaviours have you identified in the case study that would need to be managed? and what could be some of the triggers that might contribute to challenging behaviours?).  Include physical pain as a trigger and communication strategies in your answer.

Oral hygiene: Using the information you have been provided with, identify why this person may be at risk for not having their oral hygiene needs met.  What strategies could be implemented to ensure that this person’s oral hygiene needs are met?

Pain: Using the information you have been provided with, identify how you would determine if this person was in pain. What may cause this person pain?  How would you manage this person’s pain?

Complementary therapies: Using the information provide identify any complementary therapies that you think this person may benefit from. Justify your response.

Part B: Create a nursing care plan based on the clinical reasoning cycle

Look, collect, process, decide, plan, act, evaluate and reflect.

Your nursing care plan must include:

A)    Two (2) actual problems/issues 
B)    Two (2) potential problems/issues

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