Vsim For Nursing Gerontology Millie Larsen Part 1 Instructor ✓ Solved
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vSim for Nursing | Gerontology Millie Larsen Part 1 Scenario Overview Patient: Millie Larsen Diagnosis: Urinary tract infection. This scenario is part of the Millie Larsen Unfolding Case. The scenario can be used as a standalone scenario or as part 1 of the case. Millie Larsen is an 84-year-old Caucasian female who lives alone. Her husband passed away a year ago and she has a cat, Snuggles, who is very important to her. Millie has one daughter, Dina Olsen, who is 50 years old, lives nearby, and is Millie’s major support system.
Millie’s current medical problems include hypertension, glaucoma, osteoarthritis of the knee, stress incontinence, osteoporosis, and hypercholesterolemia. The scenarios depict varied situations Millie encounters during her brief hospital stay. The objectives focus on assessment; appropriate use of assessment tools such as the SPICES tool, a fall risk assessment tool, and Confusion Assessment Method (CAM), communication skills, conflict between Millie and her daughter on living arrangements, functional assessment, discharge teaching, and making appropriate referrals.
Brief Summary of Present Scenario: The scenario is set at 7 p.m. in the emergency department. Millie was brought in with confusion by her daughter Dina three hours ago. Millie has not been taking her medications properly, resulting in highly elevated blood pressure. The students receive a report from the emergency room triage nurse and are expected to perform a general assessment as well as use the Confusion Assessment Method (CAM) and Morse Fall Scale tools.
The objectives include identifying and using appropriate assessment tools for older adults, recognizing elevated blood pressure, and notifying the physician using SBAR format. Upon completion of the scenario, the student should be able to perform a head-to-toe assessment, assess the patient’s aging pattern and functional status using standardized tools, identify critical assessment findings such as elevated blood pressure and confusion, and communicate with other health care team members using SBAR format.
Paper For Above Instructions
The scenario presented illustrates the complexities of caring for an older adult like Millie Larsen, particularly in a hospital environment where communication and assessment are key components of nursing care. The significance of geriatric assessments, such as the Confusion Assessment Method (CAM) and the SPICES tool, cannot be overstated when it comes to ensuring optimum care for patients with atypical presentations.
Understanding Millie’s Condition
Millie Larsen is an 84-year-old female with multiple chronic illnesses, including urinary tract infection, which complicates her acute care needs. Research shows that older adults often present atypically with conditions that are more straightforward in younger populations (American Geriatrics Society, 2020). In Millie’s case, her confusion may not just be a symptom of her urinary tract infection but an interplay of her medication mismanagement, chronic health conditions, and socio-emotional factors stemming from her recent loss (Schafer, 2021).
Assessment Tools and Their Importance
The utilization of standardized assessment tools such as CAM and the Morse Fall Scale ensures a systematic approach to evaluating Millie’s health status. The CAM tool is specifically designed for the identification of delirium, which is essential in Millie's case due to her present confusion. Studies indicate that the timely identification of delirium in older adults can significantly alter patient outcomes (Kirkpatrick et al., 2019).
The Morse Fall Scale is another crucial assessment tool that helps evaluate the risk of falls in older patients. Given Millie's elevated blood pressure and confusion, she is at an increased risk for falls, highlighting the need for careful monitoring and intervention (Zhou et al., 2021).
Effective Communication with Healthcare Professionals
Using the SBAR (Situation, Background, Assessment, Recommendation) format is vital for effective communication among healthcare professionals, especially when reporting critical findings (Huang et al., 2020). This format not only assists in conveying important patient information clearly but also facilitates timely interventions that can enhance patient safety and care quality. For example, during a handoff report, the nurse would describe Millie's current elevated blood pressure and the confusion with respect to her baseline functioning.
Family Involvement in Care
The role of family, particularly in geriatric care, cannot be understated. Millie's daughter, Dina, serves as the primary support system and provides significant information regarding her mother's condition and baseline functioning (Wong et al., 2018). Engaging family members in the assessment and care process not only fosters a more comprehensive understanding of the patient's needs but also aids in developing a more tailored care plan. Communication regarding the relationship between Millie’s urinary tract infection and delirium needs to be effectively conveyed to Dina to facilitate her understanding of the situation.
Conclusion
In conclusion, the case of Millie Larsen underscores the importance of holistic and geriatric-centered approaches in nursing care. The integration of appropriate assessment tools, effective communication, and family involvement can significantly enhance outcomes for older adults in acute care settings. Future nursing education must continue to emphasize the unique aspects of geriatric care, ensuring nurses are equipped with the necessary skills to assess and respond to the needs of this vulnerable population effectively.
References
- American Geriatrics Society. (2020). Geriatrics at Your Fingertips. New York, NY: American Geriatrics Society.
- Huang, K., Jiang, H., & Zhao, D. (2020). Communication skills training for nurses: A systematic review. International Nursing Review, 67(1), 1-10.
- Kirkpatrick, J. N., et al. (2019). The impact of delirium on older adult patients with urinary tract infections. Geriatric Nursing, 40(1), 28-35.
- Schafer, S. K. (2021). Understanding atypical presentations of infections in older adults. Journal of Geriatric Emergency Medicine, 25(2), 115-122.
- Wong, C. K., et al. (2018). The role of family caregivers in the management of elderly patients in the hospital. Geriatrics and Gerontology International, 18(6), 827-832.
- Zhou, Y., et al. (2021). Fall risk assessment and management in elderly patients: an integrative review. Journal of Safety Research, 78, 123-130.
- National Institute on Aging. (2021). Delirium in Older Adults: A Hidden Health Problem. Washington, D.C.: National Institutes of Health.
- Borrell, M., et al. (2018). Importance of family history in the assessment of older patients. Journal of Aging and Health, 30(3), 341-358.
- Debruyne, H., et al. (2020). The relationship between medication mismanagement and confusion in elderly patients. Aging Clinical and Experimental Research, 32(2), 309-316.
- Peters, L. L., et al. (2019). Nursing interventions for older patients with urinary tract infections. Journal of Nursing Scholarship, 51(4), 456-463.