Healthcare Plan For A Patient With Alzheimer’s Disease ✓ Solved

Healthcare Plan for a Patient with Alzheimer’s Disease and Hypertension

Develop a comprehensive healthcare plan for a 74-year-old male patient named Victor Woods, who has Alzheimer's disease and hypertension. The plan should include an overview of his medical background, current physical and cognitive status, and a detailed nursing care plan with specific interventions and rationales aimed at managing his conditions, maintaining safety, and improving quality of life. Incorporate evidence-based practices, monitor relevant health parameters, address potential complications, and provide guidance for both healthcare providers and family members to support optimal patient care.

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Introduction

Providing specialized healthcare management for elderly patients with chronic conditions such as Alzheimer’s disease and hypertension requires a multidisciplinary approach that emphasizes safety, comfort, and functional preservation. Victor Woods, a 74-year-old patient diagnosed with Alzheimer’s disease and hypertension, exemplifies the complexities involved in caring for geriatric patients with cognitive decline and cardiovascular risks. Developing an effective healthcare plan involves understanding his medical history, current status, and implementing tailored interventions that address his unique needs.

Medical Background and Current Status

Victor Woods was diagnosed with Alzheimer’s disease in 2016, with symptoms including memory impairment, behavioral changes, and progressive cognitive decline substantiated by brain imaging studies indicating brain tissue loss. He also has a five-year history of managed hypertension, with recent blood pressure readings of 160/90 mmHg despite medication. His physical assessment shows impaired mobility, skin laxity, and a BMI of 21.2 kg/m². Vital signs reveal a pulse of 94–110 bpm, respiration rate of 18 per minute, and no signs of retinopathy or limb swelling, indicating an absence of overt vascular or pulmonary complications at present.

Challenges and Risks

Older age, cognitive impairments, immobility, and comorbid hypertension predispose Victor to a range of complications including pressure ulcers, infections, behavioral issues, and cardiovascular events. His impaired mobility increases risk of pressure injuries and deep vein thrombosis, while skin laxity heightens susceptibility to skin breakdown. Cognitive deficits contribute to safety concerns such as wandering, poor medication adherence, and inability to communicate discomfort or warning signs.

Goals of Care

The primary goals include maintaining optimal blood pressure to prevent cardiovascular events, preserving cognitive function and behavioral stability, preventing skin breakdown, and enhancing safety and comfort. The plan aims to enable Victor to maintain as much independence as possible, minimize agitation, and support his emotional and psychological well-being. Family involvement is essential to ensure continuity of care and effective communication.

Nursing Interventions and Rationales

1. Monitor Blood Pressure Regularly: Assess blood pressure using appropriately sized cuffs, with recordings taken while sitting, standing, and at rest. Precise monitoring facilitates timely adjustments in antihypertensive therapy and reduces risk of hypertensive emergencies (Cheryl et al., 2016).
2. Assess Skin Integrity: Regularly inspect skin, particularly over bony prominences, noting any signs of breakdown or early pressure injury. Elderly skin’s diminished elasticity and moisture make vigilant monitoring vital to prevent ulcers (Alderden et al., 2017).
3. Evaluate Mobility and Activity Levels: Monitor mobility status daily to prevent deconditioning. Encourage supervised activity as tolerated, and assist with positioning to relieve pressure points. Physical activity promotes circulation and reduces skin breakdown risks.
4. Monitor Cognitive and Behavioral Status: Conduct routine neuropsychological assessments and observe for changes in cognition, confusion, or agitation. These insights guide modifications in care strategies to maintain safety and reduce distress (Kennison & Long, 2018).
5. Ensure Communication and Orientation Aids: Use calendars, labels, and visual cues to support orientation. Engaging Victor with familiar stimuli maintains a sense of stability and reduces confusion, aiding in behavioral management (Alzheimer’s Association, 2020).
6. Maintain Hydration and Nutrition: Regularly assess intake and hydration status, offering nutrient-rich foods and fluids. Proper nutrition supports skin integrity, cognitive function, and overall health.
7. Implement Environmental Safety Measures: Create a safe environment by securing hazards, using bed and chair alarms if necessary, and providing controlled wandering areas. Safety modifications minimize fall and injury risks (Livingston et al., 2020).
8. Provide Family Education and Support: Educate family members about disease progression, behavioral management, and safety precautions. Support groups and counseling can help families cope with emotional stress (Alzheimer’s Association, 2020).
9. Use Comfort and Behavior Management Techniques: Employ soothing communication, positive reinforcement, and distraction techniques to manage agitation or aggression. Avoid restraints unless absolutely necessary to preserve dignity.
10. Medication Management: Review medications for CNS effects, interactions, and adherence. Educate caregivers on proper administration and potential side effects to ensure efficacy and safety.

Conclusion

Developing and implementing a comprehensive healthcare plan for Victor Woods requires careful assessment, evidence-based nursing interventions, and active family participation. By focusing on meticulous monitoring, preventive strategies, safety measures, and psychological support, caregivers can optimize his quality of life and mitigate complications associated with Alzheimer's disease and hypertension. Ongoing evaluation and adaptability of the care plan are essential as his clinical status evolves.

References

• Alderden, J., Rondinelli, J., Pepper, G., Cummins, M., & Whitney, J. (2017). Risk factors for pressure injuries among critical care patients: A Systematic Review. International Journal of Nursing Studies.
• Alzheimer’s Association. (2020). 2020 Alzheimer’s disease facts and figures. The Journal of the Alzheimer’s Association.
• Cheryl, R., Himmelfarb, D., Commodore-Mensah, Y., & Martha, N. (2016). Expanding the role of nurses to improve hypertension care and control globally. ScienceDirect.
• Fazio, S., Pace, D., Maslow, K., Zimmerman, S., & Kallmyer, B. (2018). Alzheimer’s Association dementia care practice recommendations. The Gerontologists.
• Kennison, M., & Long, E. (2018). The long journey of Alzheimer’s disease. Journal of Christian Nursing.
• Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., & Banerjee, S. (2020). Dementia prevention, intervention, and care: 2020 Report of the Lancet Commission. The Lancet.