I Had The Pleasure For Care For A Resident

For my seventh clinical shift at the Loma Linda Veterans Affairs Medical Center, my assigned preceptor Filipina Gumangan assigned me three patients on the 4NW unit. The unit where I precept is an intensive care step down unit. Filipina’s objective for giving me three patients this shift was to give me an opportunity to continue exercising my time management skills and to practice my reporting and charting skills, and wound care. This shift I was responsible for many clinical duties corresponding to the care of these patients. My patients this shift were Mr. B, a 72 year-old Vietnam War veteran newly diagnosed with colon cancer, Mr. S, a 65 year-old Vietnam War veteran in the hospital for complicated urinary tract infection, Mr. R, a 90 year-old Korean and Vietnam War veteran. Caring for these patients taught me more about the humanbecoming perspective of nursing and showed me about multidisciplinary coordination with peers, colleagues, and more.

There are a number of reasons a senior may need assistance with toileting or incontinence. While many seniors are embarrassed about these issues, Comfort Keepers care services personnel understand that these problems are just a part of life. The care is discreet and designed to preserve your loved ones' dignity and self-esteem. Often toileting assistance is linked to seniors who spend much of their time in the bed or in a wheelchair. In these cases, care services also involve pressure sore awareness and care.

There are some very practical considerations when someone with dementia is using the bathroom. There is the potential for the person to be scalded with hot water, to slip on the floor, or get locked in, or for the carer to strain their back.

Incontinence is one of the major problems faced by the elderly. Nurses can play a significant role in discovering continence problems (Lea R.et.al.2007). Urinary incontinence is the unintentional passing of urine. It is a very common problem and is thought to affect more than 50 million people in the developed world.(NHS.UK). To identify the problem and provide necessary treatment at the early stage, a thorough physical assessment is necessary.

The patient and their families must be aware of the infection, the source of infection, signs and symptoms, treatments, and measures to apply at home to decrease their risk of receiving an infection. Because geriatric patients are incontinent they may need a catheter in place to help remove their urine. Nurses must perform aseptic technique, wearing proper gloves when inserting or removing device. Another way to help reduce the risk of elderly urinary tract infections would be to avoid or remove catheter soon as possible. Once patients are cleared for discharge they must be aware of the steps to take to insure proper bladder

The nurse is challenged with the care of patients over a lifespan. Each stage of life brings its own physical and emotional changes which directs the care needs. The care needs of the pediatric patient will be much different from the needs of the geriatric population. The geriatric population has very specific needs which has prompted the government to establish the Quality Assurance & Performance Improvement (QAPI) program. The QAPI provides the framework for nursing facilities to develop and implement changes which address deficiencies the facility was found to have. Also, the QAPI program requires practices and policy be put in place to monitor care of the residents. The purpose of this paper is to list some of the changes the elderly go through as they age, and demonstrate these changes in a quality improvement project. After review of literature, I will discuss the challenges, barriers, and solutions as related to quality improvement. Lastly, I will discuss the quality of care for the geriatric in the future.

The resident is an 88-year-old Caucasian male who has been married for 63 years along with a long-term care living arrangement. He has medical diagnoses of generalized muscle weakness, cutaneous abscess of buttocks, and lack of coordination. The resident rated his health status as a score of “7” because he stated that he felt pretty energetic most of the time.

The clinical features Mrs Lee now 83 is displaying changes to health and cognition noted in the last three to four months, with two transient ischaemic attacks but no significant medical issues. Although currently taking three medications for high blood pressure. Changes in word finding, getting words mixed up and confusing identifying words. Insisting everything is fine showing a lack of insight into her changes or difficulties. Short term memory Mrs Lees has difficulty retaining recent memories, however long term memory appears reasonable. Although Mrs Lees home is reasonably well maintained, she is emaciated and personal hygiene is poor. There is also evidence of emotionally Liable being frequently teary with no reason. History includes

In NURS 279, I had the privilege of caring for a patient in his late 20’s who had newly been diagnosed with schizophreniform disorder, after having a “break down”. The main symptoms he had experienced over the few months pre-hospitalization included delusions of religious grandiosity and audio/visual hallucinations and the reason it took months before hospitalization is because he was living out of province, away from his family and mostly in social isolation, though his parents noticed a change in behaviour over the phone calls they shared. He became my patient 2 weeks after his admission, at a point where he had accepted his diagnosis and had control over his symptoms in a controlled environment, however, was med noncompliant, as he

Touhy, T. A., Jett, K. F., & Ebersole, P. (2013). Ebersole and Hess' Gerontological Nursing &

Introduction: Jessie Buchanan, an 80-year old female, was admitted to Bethany Care Society in room 3088-1 at the center unit. She is an extensive assist, requires 1 staff assistance and uses the transfer belt to transfer from bed to her wheelchair. She was admitted here because none of her family members can look after her because they are all busy with their own personal life. Jessie prefers to stay at Bethany because she receives full-time care from the health care providers. Jessie had a history of edema on her right ankle because she was experiencing hyponatremia. Currently, she is on fluid restriction and every morning I would put her compression stockings to prevent the occurrence of edema. Her condition worsens when she was diagnosed with osteoarthritis(OA), delirium, depression, type 2 diabetes mellitus, schizophrenia, hypertension, and urinary tract infections. Her recent urine culture shows that she is positive for urine nitrite and urine leukocyte which caused the UTI. Jessie is incontinent and she wears an indwelling catheter. Jessie said that sometimes her knees are painful. She takes an analgesic to relieve the pain that she feels. Jessie 's blood sugar level is within the range. She is not taking insulin or any oral medications like metformin because she knows how to control it, by following the proper diet. Jessie always have a good sleep and never complains about her sleeping pattern. She is taking medications for GERD, iron supplement, bone health,

One scholarly journal I found summarized the conclusion of various intervention studies for the management of incontinence and promotion of continence in care home residents. Once urinary training was implemented in a facility to analyze, incontinence rates, cost of supplies and efficiency ratios, random assignment, patterns of urinary incontinence, urological evaluations to reaffirm effectiveness and pre and post cost of hourly wet/dry checks were all documented to evaluate the program. The study ended with, “managing incontinence and promoting continence in care homes is complex, requiring time and cost-efficient management procedures to contain the problem and deliver quality, achievable care.”(Flanagan et al., 2014) The cost was a major issue that deterred many facilities from executing any sort of bladder training

It is essential for the nurse to have a proper and detailed assessment to determine the most likely cause or type of UI. One of the most basic and least invasive assessment a nurse can do is to obtain a complete history. A complete history must asked questions such as onset and duration, aggravating factors, characteristics, medical history (medical conditions and medications), associated symptoms, attempted treatments and severity (Testa, p. 83). There are also different tools that a nurse can use such as the Urogenital Inventory/ Incontinence Impact Questionnaire and Bladder Diary. Using questionnaires and bladder diary can be used in order to facilitate data gathering for people who have difficulty discussing incontinence face to face. Thorough history can provide insight and help identify potentially reversible causative factors and contributing risk factors related to UI (Mauk, p. 553). It is also important to have a detailed physical assessment, which focused on genitourinary system, abdominal, rectal and neurologic system, in order to determine the pathophysiology of voiding problems. If the nurse suspects any cognitive impairment from the initial assessment Mini Mental State Examination, Mini- Cog, and/or Confusion Assessment Method can be used to determine the severity of the cognitive impairment. It also alerts the healthcare provider for the patient’ increased risked for constant incontinence and it also determines the appropriate interventions. Having a comprehensive assessment will help the healthcare provider to diagnose and establish proper

A student, in the practical nursing program, giving the best care by using and applying skills, principles, and guidelines is the main concern. Seventy-five percent of patients in hospital are elderly simply because of their fragility and decrease in their immune system which would cause mature adult to develop a health problem. Every week is about meeting new patients with different type of diagnosis so skills can develop and one of the patients has caught a particular attention.

Visiting a nursing care facility while learning about gerontology they go hand and hand. While learning about aging the best way to fully understand the information is to make observations. There are numerous connections that can be made from observations and the class readings. Throughout this course, there have been many chapters in Social Gerontology that provide a lot of information to understand aging.