Nursing Informatics
The scenario described herein is in grounded in geriatric medicine, and utilizes the NANDA, NIC, and NOC elements to link the various components in standardized language to the data, information, knowledge, and wisdom associated with this exercise. The key parts of the paper are as follows: 1) Introduction; 2) nursing diagnosis (NANDA), including actual diagnosis, risk diagnosis, and wellness diagnosis; 3) nursing outcomes classification (NOC); 4) nursing interventions classification (NIC); 5) conclusions.
Case Presentation
The patient is an elderly woman with early stage dementia, who reports her age as 87 years. The patient's family brought her to the clinic because she has been complaining of malaise and refuses to receive help with dressing, both of which are unusual for the patient. Vitals were taken and all are within normal range, except that the patient had a temperature just above 37.9C. Examination revealed that the patient was experiencing suprapubic pain and costovertebral…...
Beveridge, L.A., Davey, P.G., Philliops, G. & McMurdo, M.E.T. (2011, June). Optimal management of urinary tract infections in older people. Clinical Interventions of Aging, 6, 173 -- 180. . doi: 10.2147/CIA.S13423. PMCID: PMC3131987
Mellen, C.K., Ford, M., & Rindone, J.P. (2010, July). Effect of high-dose cranberry juice on the pharmacodynamics of warfarin in patients. British Journal of Clinical Pharmacology, 70(1), 139-142. doi: 10.1111/j.1365-2125.2010.03674.x.
Nicolle, L.E. (2000). Asymptomatic bacteriuria in institutionalized elderly people: evidence and practice. Canadian Medical Association Journal (CMAJ),163(3), 285 -- 286.
Client Evaluation
The client is a 78-year-old female. She has been divorced for 30 years. She is retired. Her social class is upper middle class. Her medical history is free from significant trauma. She had six hospitalizations, all for childbirth, and one surgery; a cesarean section combined with a tubal ligation. She has two chronic health conditions: high blood pressure and chronic obstructive pulmonary disease (COPD). She is a former smoker. She lives with an adult son and her other children live nearby. She was a domestic violence victim for the 20 years of her marriage and has some lingering physical problems (an improperly healed broken rib) and emotional problems from that period of abuse. Her parents, a younger brother, and two of her children predeceased her.
Medical Issues
The patient is not currently suffering from any acute medical issues. She does have two significant chronic medical issues: high blood pressure and COPD.…...
Antihypertensive drugs and lip cancer in non-Hispanic whites. Arch Intern Med, 172(16): 1246-51. doi:10.1001/archinternmed.2012.2754.
Goren, A., Annunziata, K., Schnoll, R.A., & Suaya, J.A. (2014). Smoking cessation and attempted cessation among adults in the United States. PlosOne, 9(3): e93014. doi: 10.371/journal.pone.0093014
Hoonhorts, S.J., Ten Hacken, N.H., Lo Tam Loi, A.T., Koenderman, L., Lammers, J.W.,
Geriatric Population
hat is the best way to assure that older people are well cared for in an acute healthcare setting? hat are the roles that nurses should play when it comes to providing the best possible care to older, frail people? These questions will be addressed in this paper using scholarly research from the available literature.
Advanced nursing skills for frail older people
Sarah Goldberg is a senior clinical academic nurse at the University of Nottingham's University Hospitals, and she writes in the journal Nursing Older People that an "innovative solution" in terms of providing the necessary skilled care to older people is to train experienced nurses to become "advanced nurse practitioners (ANPs) (Goldberg, 2014). An advanced nurse practitioner will be able to conduct comprehensive geriatric assessments, which will be important given that many very old and frail patients have "cognitive impairment, depression and anxiety," which can lead to a sense…...
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Works Cited
Goldman, S. (2014). Developing Advanced Nursing Skills for Frail Older People. Nursing Older People, 26(4). 20-24.
Krail, E., Close, J., Parker, J., Sudak, M., Lampart, S., and Colonnelli, K. (2012). Innovation
Pilot Study: Acute Care for Elderly (ACE) Unit -- Promoting Patient-Centric Care. Herd Journal, 5(3), 90-98.
Pulled from http://micmrc.org/system/files/11.2-ADL.pdf
Vitals fairly in line what is expected a normal for patient of this age, family/patient history of type II diabetes but fairly well controlled, mild arthritis but decently controlled, no sign of heart disease despite family history
4) Patient is putting on a little weight, lives a mostly sedentary lifestyle (but not abnormally so for age bracket), diet a bit substandard based on what is self-reported
5) See goals below where abnormal challenges are listed
Essay Topic Examples
1. The Impact of Social Isolation on the Health of Elderly atients:
This essay would explore the psychological and physical effects of social isolation on elderly patients. The focus can be on how lack of social interaction contributes to the decline in mental health, such as the onset of depression and anxiety, and how it may exacerbate existing health conditions or lead to the development of new ones, such as dementia and heart disease.
2. Geriatric harmacology: The Challenges of Medication Management in Elderly atients:
The essay would address the complexities involved in managing medications for elderly patients. With age, the body's response to drugs can change, leading to different therapeutic outcomes and increased risks of adverse effects. The discussion would include factors like polypharmacy, drug interactions, and the importance of personalized medical care in geriatric pharmacology.
3. Technology and Innovation in Elderly Care: Enhancing Quality of Life for Aging…...
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Primary Sources
U.S. Department of Health and Human Services, Administration on Aging. \"A Profile of Older Americans: 2021.\" Administration for Community Living, 2021.
World Health Organization. \"World Report on Ageing and Health.\" World Health Organization, 2015.National Institutes of Health, National Institute on Aging. \"Global Health and Aging.\" NIH Publication no. 11-7737, October 2011.Social Security Administration. \"Annual Statistical Supplement to the Social Security Bulletin, 2020.\" Social Security Administration, 2020.Centers for Medicare & Medicaid Services. \"Medicare and You: National Medicare Handbook.\" Centers for Medicare & Medicaid Services, 2022.
Patients that are sixty-five years or older account for an average of more than fifty percent of the visitors to the Intensive Care Unit (ICU) and there are a host of known risk factors that are associated with individuals who are among this demographic and many elderly patients are discharged directly to long-term living facilities due to the fact that they are unable to continue to function independently and maintain daily activities (Tang, Tang, Hu, & Chen, 2016). It is further estimated that approximately one quarter of all of the elderly patients that are admitted to the emergency department display some form of metal impairment related to delirium, dementia, or both, and many hospital departments have made mental assessments for these demographics part of their routine operations (Soryal & al., 2014). Therefore, not only does the prevalence of mental impairments serve as a serious concern for…...
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Works Cited
Barr, J., & al., e. (2013). Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit. Critical Care Medicine, 263-306.
Malone, M., & al., e. (2014). Acute Care for Elders: A Model for Interdisciplinary Care. Aging Medicine, 233-244.
Soryal, S., & al., e. (2014). Best Practice Models of Emergency Department. Aging Medicine, 220-231.
Tang, H., Tang, H., Hu, F., & Chen, C. (2016). Changes of geriatric syndromes in older adults survived from Intensive Care Units. Geriatric Nursing, 1-6.
Monitoring Home Medication AdministrationIntroductionMonitoring home medication administration for the elderly is essential because this population is at higher risk for medication-related problems due to several factors, including age-related changes in pharmacokinetics and pharmacodynamics, the presence of multiple chronic conditions, and the use of multiple medications. In addition, elderly patients may have cognitive impairments, functional limitations, and social isolation, which can further increase their vulnerability to medication errors and adverse drug events. Monitoring home medication administration for the elderly is essential because this population is at higher risk for medication-related problems due to several factors, including age-related changes in pharmacokinetics and pharmacodynamics, the presence of multiple chronic conditions, and the use of multiple medications. In addition, elderly patients may have cognitive impairments, functional limitations, and social isolation, which can further increase their vulnerability to medication errors and adverse drug events.The MCIOne tool that is used for monitoring home medication administration for…...
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ReferencesHirsch, J. D., Metz, K. R., Hosokawa, P. W., & Libby, A. M. (2014). Validation of a patient?level medication regimen complexity index as a possible tool to identify patients for medication therapy management intervention. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 34(8), 826-835.Onder, G., Lattanzio, F., Battaglia, M., Cerullo, F., Sportiello, R., Bernabei, R., & Landi, F. (2011). The risk of adverse drug reactions in older patients: beyond drug metabolism. Current Drug Metabolism, 12(7), 647-651.Wimmer, B. C., Bell, J. S., Fastbom, J., Wiese, M. D., & Johnell, K. (2016). Medication regimen complexity and polypharmacy as factors associated with all-cause mortality in older people: a population-based cohort study. Annals of pharmacotherapy, 50(2), 89-95.
I could not find a prohibition against liver transplants for those 70 or over, but there is a good deal of information in the literature supporting transplants for older people. In the PubMed section of the National Institutes of Health a study of 1,446 "consecutive liver transplant recipients was conducted" and 241 elderly patients (over 60) in that group were compared with younger counterparts. The conclusion: "Low-risk elderly patients fare as well as younger patients after liver transplantation" (Levy, et. al, 2001).
Meanwhile, Dr. Gerald S. Lipshutz, assistant professor of surgery at the David Geffen School of Medicine at the University of California reports the results of the findings at the orld Transplant Congress in 2006. In a study of 62 patients (Group I) between the ages of 70-79 that had received liver transplants -- compared with a group of 864 patients getting…...
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Works Cited
Flaman, Paul. "Organ and Tissue Transplants: Some Ethical Issues." St. Joseph's College, the University of Alberta. Retrieved June 23, 2011, from (2001): 1-14.http://www.ualberta.ca/-pflaman/organtr.htm .
Kahn, Katherine. "Age Alone Does Not Affect Outcome of Liver Transplant in Elderly."
hospitals profits come from the cardiology department. One key strategy the hospital should adopt is specializing for growth. Not only has the rise in specialty hospitals increased in the last few years, but it has also enabled hospitals facing stiff competition to maintain or gain new patients. A specialized care strategy must be adopted for proper implementation of strategy. Hospital administrators in this role have to take the time to examine potential or existing specialty healthcare providers within the community. By identifying an area of opportunity, it becomes much easier put into effect a strategic plan that will gain the hospital national and even worldwide recognition.
Specialty hospitals satisfy the needs of a specific population. In the case of the hospital, those are elderly patients with cardiac problems. By examining if the local demographics match this population group, hospital administrators can then focus their attention on recruitment of specialized personnel…...
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References
Freeze, R., Vinze, A., Santanam, R., & Furukawa, M. (2012). IT Adoption: Healthcare Metrics Tracking. 2012 45th Hawaii International Conference On System Sciences. http://dx.doi.org/10.1109/hicss.2012.392
Girotra, S., Lu, X., Vaughan-Sarrazin, M., Popescu, J., Horwitz, P., & Cram, P. (2011). Abstract P314: The Impact of Hospital Cardiac Specialization on Outcomes After Coronary Artery Bypass Graft Surgery: Analysis of Medicare Claims Data. Circulation: Cardiovascular Quality And Outcomes,4(Suppl 1), AP314-AP314. Retrieved from http://circoutcomes.ahajournals.org/content/4/Suppl_1/AP314.abstract
Elderly Falls
With the help of a thorough clinical evaluation, the risk factors, risks associated with falling and working out adequate intervention methods to curb the rate of elderly falls can be achieved. As per the 2011 AGS / BGS guidelines, (Panel on Fall, 2011) certain particulars need to be incorporated in a particular clinical evaluation: 1: Patient history, physical examination, mental and physical functionality; 2: Number of falls occurring, number of medications taken; issues regarding mobility, balance and gait; blurred eyesight; various mental disabilities; weak muscular strength; uneven heartbeat and rhythm; postural hypotension; problems in feet and risks related to environment (Shubert, 2014).
Strategies to Prevent Elderly Falls and Health elated Consequences
Assistive Devices and Other Protective Equipment: Appropriate footwear is required for particular conditions, for instance, wintery weather necessitates anti-slip shoes whilst warmer weather requires cleated footwear, facilitating decreased falls (Panel on Fall, 2011).
Clinical Disease Management (Acute and Chronic Illness): Using…...
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References
Clemson, L., Mackenzie, L., Ballinger, C. & Close, J.C.T. (2008). Cumming RG. Environmental interventions to prevent falls in community-dwelling older people: A meta-analysis of randomized trials. J Aging Health. 20(8):954-971.
Gillespie, L.D., Robertson, M.C., Gillespie, W.J., Lamb, S.E., Gates, S., and Cumming, R.G. (2009). Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. (2), Art.No.: CD007146
Panel on Fall prevention in Older Persons, American Geriatrics Society and British Geriatrics Society, (2011). Summary of the Updated American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons. J Am Geriatr Soc.;59(1):148-157.
Scott V, Gallagher E, Higginson A, Metcalfe S, & Rajabali F. (2011). Evaluation of an evidence-based education program for health professionals: The Canadian Falls Prevention Curriculum (CFPC). Journal of Safety Research. 42(6):501-507.
Quality Improvement ScenarioSubject: Identifying Performance Gaps and Proposing Quality Improvement InitiativesDear [Nursing Managers Name],As requested, I have identified two critical performance gaps in our skilled nursing facility and have outlined potential quality improvement initiatives to address these issues.Performance Gap A: Inadequate Orientation and Training for New StaffThe expedited orientation process for new staff has resulted in insufficient training. This deficiency is likely contributing to the increased incidence and severity of patient falls.Details for Decision-Making include comparing current versus recommended orientation durations, the number of new staff and their shift distribution, and fall rates before and after orientation changes. Quality Improvement Initiative: Data Collection involves tracking fall rates by staff experience and surveying new staffs confidence. Ideas for Change include comprehensive orientation with simulation training and mentoring new staff (oncallo et al., 2020).Performance Gap B: Misallocation and Insufficient Supply of Fall Prevention EquipmentFall mats that were designated for high-risk patients are…...
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ReferencesBhasin, S., Gill, T. M., Reuben, D. B., Latham, N. K., Ganz, D. A., Greene, E. J., ... & Peduzzi, P. (2020). A randomized trial of a multifactorial strategy to prevent serious fall injuries. New England journal of medicine, 383(2), 129-140.Johnson, K., Scholar, H., Stinson, K., & Razo, M. L. S. (2020). Patient fall risk and prevention strategies among acute care hospitals. Applied Nursing Research, 51, 151188.Roncallo, H. R., Ray, J. M., Kulacz, R. C., Yang, T. J., Chmura, C., Evans, L. V., & Wong, A. H. (2020). An interprofessional simulation-based orientation program for transitioning novice nurses to critical care roles in the emergency department: pilot implementation and evaluation. The Joint Commission Journal on Quality and Patient Safety, 46(11), 640-649.
Patient Access to Experimental Drugs
Experimental drugs are being used in treating cancer and other life-threatening diseases in the hopes that effective cures and treatments can be identified. There are however, ethical questions relating to the use of experimental drugs and this work seeks to answer the question that asks whether patients should have access to experimental drugs and to answer why or why they should not have this access.
Experimental Drugs
Experimental drugs have carved inroads to treating cancer patients and most recently; this has been reported in the form of a drug that serves to "neutralize two mechanisms cancers need to survive." (Coghlan, 2012) The new drug is Cabozantinib. This drug is reported by one individual interviewed in this study to have been used by a family member who died while taking the drug for non-small cell carcinoma in the form of lung cancer. When asked the question of how this…...
Using an appropriate patient assessment form (Sample Forms, 2013), D.M. has been found to have uncontrolled Type 2 diabetes, hypercholesterolemia, uncontrolled hypertension, chronic anemia, and probable hypothyroidism (Sample Forms).
Diabetes Type 2
is most probably on a poorly controlled diet of high cholesterol and high simple sugars. Diabetes mellitus type 2 is a metabolic disease wherein the body is not able to properly use ingested food because of insulin resistance. If more simple or refined sugars are consumed, the less the body is able to process them as nutrients. These tend to stay and float in the blood stream, un-used, and in this condition, they cause trouble in the different parts of the body. These include the end organs, such as the brain, the eyes, the kidneys, the heart, and even the feet. A poorly controlled diet and the lack of physical activities in many…...
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BIBLIOGRAPHY
Glasgow, R.E., et al. (2005). Development and validation of the patient assessment of chronic illness care. Vol. 43 # 5, Medical Care: PuMed. Retrieved on October 15,
The results of this analysis highlight the need for hospitals to fine-tune their discharge process to reduce readmissions, and support the expenditure of additional resources for this purpose as a cost-effective intervention; as an example, author cites a hospital in Iowa that implemented a rigorous post-discharge planning process for patients with heart failure and 30-day readmission rates were reduced by 3-9% during the 3-month period following implementation.
Conclusion
The research showed that many elderly patients who suffer from congestive heart failure also suffer from a wide range of comorbid conditions, including diabetes and hypertension. These patients can be reasonably expected to require periodic or even frequent treatment in emergency departments and/or hospitalizations for these conditions, making the need for effective and seamless post-discharge planning especially important. In this regard, the research also showed that there are some valuable evidence-based practice guidelines available, though, that can help clinicians better coordinate post-discharge care,…...
Providing adequate care for an individual suffering from dementia presents many difficulties for nurses. Patients with dementia often have debilitating conditions such as Alzheimer's or similar neurologic diseases which are progressive, thereby making it challenging for them to remember, think lucidly, communicate effectively or complete activities of daily living. Furthermore, dementia can cause rapid variations in mood or even modify personality and behavior. With the tremendous number of elderly in society more and more nurses are required to care for patients with progressive dementias. It is imperative that a diagnosis be reached early in the course of the cognitive impairment and that the patient is closely monitored for coexisting morbidities. Nurses have a central role in assessment and management of individuals with progressive dementia. This essay provides some evidence-based practical strategies for managing the behavioral problems and communication difficulties often encountered in this population.
I currently…...
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Reference List
Aud, M.A., Oliver, D., Bostick, J. And Schwarz, B. 2011. Effectiveness of Social Model Care Units for Dementia. International Nursing Research Congress 2005.
Care, N.D. 2010. Teaching and Learning. Pulse. Winter Edition.
Fletcher, S. And Zimmerman, S. 2010. Trainee and trainer reactions to a scripted dementia care training program in residential care/assisted living settings and nursing homes. Alzheimer's Care. 11(1): 61-70.
Goodman, C. 2011. The organizational culture of nursing staff providing long-term dementia care is related to quality of care. Evidence-Based Nursing. 47:1274-1282.
1. The impact of technology on the nursing profession 2. The role of emotional intelligence in nursing practice 3. The importance of evidence-based practice in nursing 4. The ethical dilemmas faced by nurses in healthcare settings 5. The challenges of caring for elderly patients in nursing homes 6. The role of cultural competency in providing nursing care 7. The impact of nursing shortages on patient care 8. The importance of effective communication in nursing practice 9. The role of nursing leadership in improving patient outcomes 10. The benefits of interdisciplinary collaboration in healthcare settings.
11. The role of nursing education in shaping the future of....
Key Factors Contributing to Surgical Site Infections in Obstetrics and Gynecology Patients Surgical site infections (SSIs) are a significant complication in obstetric and gynecological (OB/GYN) surgery, leading to increased morbidity, prolonged hospital stays, and healthcare costs. Understanding the key factors contributing to SSIs is crucial for implementing effective prevention strategies. 1. Preoperative Factors: Diabetes and obesity: Impaired wound healing and immune function increase the risk of infection. Smoking: Nicotine constricts blood vessels, reducing oxygen and nutrient delivery to the wound. Malnutrition: Inadequate nutrition compromises immune function and wound healing. Vaginal infections: Preoperative colonization of the vagina with pathogens can increase the risk....
Of course! Here are some potential essay topics related to health nursing:
1. The role of nurses in promoting health and preventing illness 2. The impact of technology on health nursing practices 3. Cultural competence in health nursing 4. The importance of collaboration and teamwork among healthcare professionals 5. Mental health nursing: addressing the stigma and promoting awareness 6. The ethical considerations in health nursing practice 7. The challenges and opportunities in gerontological nursing 8. Evidence-based practice in health nursing 9. The role of nursing in managing chronic diseases 10. The impact of the COVID-19 pandemic on health nursing practices and patient care
I hope these topics help you deepen your....
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