Nursing Care

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Introduction P.R. is a 34 year-old male from Guatemala who went to a lake for cliff diving. He dove off of a cliff 20 feet from the water, hitting a rock, and fractured his neck at C6. This left P.R. as an incomplete quadriplegic, with partial gross movement of his upper arms. P.R. is able to move his shoulders to slightly lift his arms, but has no movements in his legs or the trunk. P.R. requires total assistance for all activities of daily living, and is incontinent of both bowel and bladder function. He speaks primarily Spanish and cannot communicate in English. He is verbally abusive and becomes combative with care givers. He does not have family support in America and is having difficulty adapting to American foods. P.R. has…show more content…
is not receiving enough nutrients such as protein and vitamins that are crucial to wound healing, which impedes healing of the pressure ulcers (Myers, 2012). Last but not least, he has sexual dysfunction that can be detrimental to his psychosocial well-being. He is physically unable to achieve erection and orgasm. Appendix A is provided at the end of the paper to show an example of nursing care plan for physiological issues. Psychosocial Issues Spinal cord injury is a sudden and devastating event for patients. The injury can be extremely debilitating and it may require a significant alteration in lifestyle post injury. P.R. has sustained a relatively high level (C6) spinal cord injury, which makes him very limited functional capacity. He will go through grieving process followed by anger for the loss of function and independence. This may be especially difficult for P.R. because he is a young man in his thirties who sustained a debilitating injury in a foreign country without any support from family and friends. Spinal cord injury has left P.R. unable to move his entire lower extremities and trunk muscles. He is unable to do the most basic activities, such as feeding and bowel movement without the help of a caregiver. For a young man who was active and completely independent, it is very difficult to accept this reality. It should also be noted that most of the nursing staff are females, which further damages his male ego for having total dependence.
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