CLINICAL COURSE OF CONDITION There are five stages from 1 to 5, but people experience these stages differently, and it is common that a stage is missed. Stage 1 and 2 are early-stages that accompany mild motor symptoms, 2 and 3 mid-stages, and 4 and 5 advanced-stages that accompany immobility, dependence and cognitive decline (Hunter & Miller 2016). PD affects all aspects of health including physical, mental, psychological and social well-being, and thus the patients with PD, especially in advanced-stages require assistance with all aspects of living. PD can be a risk factor of chronic disability, higher mortality and lower quality of life (Hunter & Miller 2016). Richard is in the early-mid stage of PD. In this stage movement and gait …show more content…
Surgery may be considered if Richard suffers from severe levodopa-induced dyskinesia (Farrell et al. 2016). In order to improve Richard’s functional mobility, nursing care focuses on independence in ADLs. Richard has been referred to physiotherapist, and the physiotherapist has visited Richard’s home and provided daily exercise education to increase muscle strength and improve coordination and dexterity, and relieve his back pain (Farrell et al. 2016). The physiotherapist has been visiting Richard’s home once a month to see how Richard progresses, and providing a progressive exercise program. An Occupational therapist has visited Richard’s home three times to examine any falls risks. The occupational therapist installed rails in Richard’s bathroom and hallway around the house. A wheelie walker has been prescribed, but according to his family members, rarely uses it at home. Special utensils with built-up handles have been provided to help his mealtime (Farrell et al. 2016). Recently, a speech pathologist has been referred by his GP, since the GP has been concerned about Richard’s tongue tremor and its effect on communication, swallowing and possible dysphasia. The speech pathologist examined Richard and provided education such as exaggerating the pronunciation of words, speaking in short sentences, chewing on one side and then the other, controlling the build-up saliva, holding head upright,
He wants to become independent in ADLs such as bathing, toileting, dressing, transfers and IADLs such as caring for his grandchildren and home management. CP is successful in communication, feeding, grooming, hygiene, and bowel/bladder management. He is contact guard for transfers, mobility and bathing. CP currently struggles to shower and dress his lower body, transfer from bed to wheel chair and wheelchair to toilet/shower bench.
Anyone with limited mobility should be assisted to change positions by the care providers on a regular schedule to help
7. Generally, PD causes anorexia, decreased sense of smell, constipation, dry mouth, difficulties chewing and swallowing. What interventions are used to address these issues?
Within my work setting of the nursing home, we have several ways we help develop skills for every day life. Within the home we have a physiotherapist, who works with residents to help them get better mobility by helping them move their arms and legs better as an example and encouraging them to attempt the exercises when alone also.
This case study is about a patient, T.C., who I treated while a physical therapy assistant at an acute rehabilitation hospital. T.C. had terminal spinal cancer and at the time of admission had a fair prognosis to maintain function and strength enough to be discharged to his daughter’s home with home health care and family support, and he wanted to eventually go back to his own apartment. He was using a wheelchair as he was partially paralyzed from the waist down, and was able to use a transfer board to transfer from his wheelchair to bed and back.
The efficacy of these interventions must constantly remain under scrutiny by maintaining surveillance of statistical evaluations. In addition, as a profession nursing must take into account practices that are working and those that are not based on evidence based practices and continue learning from past mistakes. It is also important not to overlook or take for granted even the slightest possible interventions for fall prevention. For example, although the CDC has ambiguously concluded that exercise programs can improve physical functioning but does not appear to reduce falls in nursing home patients, there is ongoing research that may conclude differently. The changes to current nursing practice are two-fold: 1) be open to change, 2) accept the challenge to analyze the data, learn from successes and failures, and seek to do away with unsustainable ineffective practices to reduce patient
Balance, strength, and mobility are used in day to day for activity of daily living that are used by both independent and dependent adults. Mobility is defined as “the
At rest and during speech, X showed symmetry in her lips and face. She was a nose breather and showed adequate range of motion for lips and jaw during speech. X demonstrated adequate tongue-jaw and lip-jaw dissociation. She demonstrated sufficient lip strength and was able to produce a tight labial seal. X presented with adequate range of motion of her tongue as noted by her ability to protrude and retract the tongue, create lateral tongue wags, and elevate the tongue tip. She presented with difficulty when fully encircling her lips with her tongue. The client’s dentition was unremarkable.
Additionally, there are many simple tasks that can be completed during everyday patient care, which can lead to a decrease in patient’s falls. Some interventions include maintaining a clutter-free space in patient rooms, non-skid footwear, placing the bed in the lowest position, and keeping the call light in reach at all times (Hempel, Newberry, Wang, Booth, Shanman, Johnsen, & Ganz, 2013). All of which, promote safety by preventing mechanical falls caused by an overcrowded, cluttered room, and offering the patient the ability call for help when needed for tasks such as toileting; as many falls occur during the process of ambulating and transferring to and from the commode.
Activities of Daily Living/Instrumental ADL –self-care activities due to lack of interest or pleasure, home-making, driving, dressing, and eating Addressing functional use of her right hand will optimize independence with ADLS
Ms.D. is independent and lives alone in her home, however, she reports difficulty remembering to carry out or terminate activities. She reports that she has forgotten to turn off the sink twice this year and flooded her apartment both times. The Functional Activities Questionnaire was chosen to inquire about her safety and the other activities in her life. Next, the Berg Balance Scale was used to highlight Ms. D.’s risk of falling noted by her “furniture-walking”, foot drop, and failed hip replacement. She carries a cane with her but often walks in the senior center without using it. Also, Ms. D. reports difficulty walking in the community and states that she needs a break every five steps due to fatigue. Lastly, the Modified Mini-Mental State Exam was chosen to determine Ms. D.’s cognitive impairment level, if any, and to rule-out Alzheimer’s Disease. As her chief complaint, Ms. D. reports often forgetting the names of people, places, and things. As mentioned before, she has forgotten to turn off her sink and flooded her apartment
The multidisciplinary team (MDT) meeting that the author attended was regarding Laura 's case, a 62 year old lady that lives alone and had a fall followed by knee surgery on her right leg which now needed rehabilitation. Laura also has Hypertension, arthritis and was recently diagnosed with Parkinsons Disease, which is managed with medication.
The opening scene sets the atmosphere of physical conflict because when the second witch says that the witches will meet next “when the battle’s lost and won.”, it implies that there is some kind of war/battle going on as the witches speak. This is proven true in Act 1, Scene 2, when Macbeth, Duncan, Malcolm and other characters talk about Scotland winning a battle to Norway. As for moral conflict, the last line “Fair is foul, foul is fair, hover through the fog and filthy air.” represents the internal confusion between right and wrong they will try to instill in Macbeth in Act 1, Scene 3.
Edgar Allan Poe was born in Massachusetts in 1809 and was orphaned by the time by the age of 2 (Fisher ix).
A literature review was conducted in order to locate an article reporting the results of a primary nursing research study published within the last year. A literature search was performed using the databases PubMed and CINAHL to identify relevant evidence from the nursing literature supporting the lack of palliative care being provided to heart failure patients, and the barriers impeding these services. PubMed was used to locate the primary nursing research article on September 25, 2015. This database contains archives of medical and life sciences journal literature for the U.S. National Institutes of Health. “Heart failure” and “palliative care” were the initial search terms used, yielding 5,958 search results.