Nursing Care Of The Older Adult Module 05 Assignment 559341

Nursing Care Of The Older Adultmodule 05 Assignment Case Study

Provide a comprehensive nursing care plan for an older adult based on a detailed case study. The plan should include the primary medical diagnosis, prioritized nursing diagnoses, specific goals for each diagnosis, and well-defined nursing interventions tailored to meet these goals effectively. Ensure the plan addresses the key health challenges faced by the elderly patient, emphasizing holistic and individualized care approaches rooted in current evidence-based practices.

Paper For Above instruction

The nursing care of older adults requires a multidimensional approach, recognizing their unique physiological, psychological, and social needs. As the population ages, nurses must develop comprehensive care plans rooted in a thorough understanding of prevalent health issues and the principles of geriatric nursing. This paper presents a detailed case study of an older adult, outlining the primary medical diagnosis, subsequent prioritized nursing diagnoses, specific goals, and strategic interventions.

Introduction

The demographic shift toward an aging population highlights the importance of specialized nursing care for the elderly. Aging is associated with increased vulnerability to acute and chronic diseases, functional decline, and psychosocial challenges. Effective nursing care hinges on accurate assessment, prioritization of health issues, and implementation of targeted interventions that promote independence, safety, and quality of life (American Geriatrics Society, 2010). This case study exemplifies these principles, illustrating a structured approach toward holistic nursing care.

Primary Medical Diagnosis

In this case, the patient’s primary medical diagnosis is congestive heart failure (CHF), a common condition among older adults characterized by the heart's inability to pump effectively, leading to fluid accumulation and reduced organ perfusion (Yancy et al., 2017). CHF can significantly impair mobility, breathing, and overall functional status, necessitating meticulous management.

Prioritized Nursing Diagnoses

The nursing diagnoses are prioritized based on the patient’s immediate health threats, potential complications, and long-term functional goals. The following are prioritized diagnoses in order:

  1. Impaired Gas Exchange related to pulmonary edema secondary to CHF
  2. Risk for Fall related to orthostatic hypotension and impaired balance
  4. Activity Intolerance related to fatigue and dyspnea
  5. Knowledge Deficit regarding disease management and medication adherence
  6. Impaired Physical Mobility related to muscle weakness and joint stiffness
  7. Risk for Skin Breakdown related to immobility and incontinence

Goals for Each Nursing Diagnosis

Goals are formulated to address each diagnosis, focusing on improving the patient's health status through achievable, measurable, and patient-centered outcomes:

  • Improve gas exchange to normal levels within 48 hours, evidenced by normal oxygen saturation and absence of dyspnea.
  • Prevent falls by maintaining safety measures, with no fall incidents during hospitalization or home care period.
  • Enhance tissue perfusion, with stabilized vital signs and reduced symptoms of CHF within 5 days.
  • Increase activity tolerance to perform ADLs independently within 1 week.
  • Improve patient knowledge about CHF management, including medication adherence and lifestyle modifications, by the time of discharge.
  • Restore mobility levels sufficient for independence in transfers and ambulation within 2 weeks.
  • Prevent skin breakdown through timely repositioning and skin care practices; skin integrity maintained during hospitalization.

Nursing Interventions

Interventions are directed at achieving the set goals and are supported by evidence-based practices:

  1. Impaired Gas Exchange
  • Administer supplemental oxygen as prescribed, titrating to maintain SpO2 >92%.
  • Monitor respiratory rate, oxygen saturation, and lung auscultation findings regularly.
  • Elevate the head of the bed to facilitate better lung expansion.
  • Assist with prescribed diuretics and monitor fluid intake and output.
  • Risk for Fall
    • Implement fall prevention protocols such as bed alarms, non-slip slippers, and clear pathways.
    • Assist with ambulation and transfers, using gait belts if necessary.
    • Evaluate medication side effects such as hypotension that increase fall risk.
  • Ineffective Tissue Perfusion
    • Monitor vital signs closely, especially blood pressure, heart rate, and respiratory status.
    • Administer prescribed cardiac medications, such as ACE inhibitors or beta-blockers.
    • Assess for signs of pulmonary congestion, including crackles, and manage accordingly.
  • Activity Intolerance
    • Encourage gradual activity with rest periods, adjusting according to tolerance.
    • Assist with mobility exercises to strengthen muscles and improve endurance.
    • Plan activities to avoid fatigue and monitor response to exertion.
  • Knowledge Deficit
    • Provide education on CHF pathology, symptom recognition, medication management, and lifestyle modifications.
    • Use teach-back methods to ensure understanding.
    • Coordinate with family members for ongoing support and education at home.
  • Impaired Physical Mobility
    • Implement physical therapy referrals to enhance mobility.
    • Use assistive devices such as walkers or canes as needed.
    • Encourage routine mobility exercises to promote strength and flexibility.
  • Risk for Skin Breakdown
    • Reposition the patient every 2 hours, using pressure-relieving devices.
    • Maintain skin hygiene and moisture management.
    • Inspect skin regularly, especially over bony prominences.

    Conclusion

    Effective nursing care for older adults with complex health conditions like CHF requires a comprehensive, patient-centered approach. Prioritizing diagnoses ensures that immediate threats are addressed while planning for long-term health and functional maintenance. Incorporating evidence-based interventions and patient education empowers older adults to participate actively in their care, promoting better health outcomes, safety, and quality of life. Nursing professionals must remain adaptable and sensitive to the unique needs of each patient, using holistic assessment and a collaborative approach to optimize care efficacy.

    References

    • American Geriatrics Society. (2010). Geriatric Nursing: A Guide to Care of Older Adults. New York: Springer.
    • Yancy, C. W., Jessup, M., Bozkurt, B., et al. (2017). 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure. Circulation, 136(6), e137-e161.
    • Riegel, B., Moser, D. K., Buck, H. G., et al. (2012). Self-Care of Heart Failure Patients. Circulation: Heart Failure, 5(3), 353-359.
    • Hirsch, G., & Anderson, J. (2016). Managing CHF in Older Adults. Journal of Geriatric Care, 22(4), 45-50.
    • Falk, A., & Walton, J. (2018). Hospital-based Heart Failure Program and Readmission Rates. Journal of Cardiology Nursing, 10(2), 27-35.
    • Lewis, S. L., et al. (2017). Medical-Surgical Nursing, 11th Edition. Elsevier.
    • McCance, K. L., & Huether, S. E. (2018). Pathophysiology: The Biological Basis for Disease in Adults and Children, 8th Edition. Elsevier.
    • Clark, N. M., et al. (2019). Patient Education and Self-management in Chronic Heart Failure. Nursing Clinics, 54(1), 79-90.
    • Jeon, Y., & Kim, S. (2020). Geriatric Nursing: Evidence-Based Practice. Journal of Geriatric Physical Therapy, 43(3), 124-131.
    • National Heart, Lung, and Blood Institute. (2019). Heart Failure. https://www.nhlbi.nih.gov/health-topics/heart-failure

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