The purpose of this essay is to use the Activities of Daily Living (ADL) assessment to identity the needs of a patient called Ernest (pseudonim). Ernest is a 74 years old man who was admitted in hospital with “off legs” due to infection. He has Chronic Kidney Disease (CKD) and haemodialyses three times a week. He has been diagnosed with dementia which makes him sometimes confused, although he has been able to live on his own at home with the assistance of his two daughters. After three weeks in hospital he was discarged to his home with a package of care. The assessment will be focus on three ADL: eating and drinking, mobilising and communication.
ADL evaluates the level of independence and coping mechanisms patients have when performing
As part of the ADL assessment, nurses need to know what Earnest is eating and drinking. As a CKD patient Earnest needs to follow a restricted diet to avoid other complications derived from CKD as high blood pressure or anaemia. He also must record his fluid intake to know how his kidneys are working and how much fluid he is retaining. Due to the CKD, Earnest’s kidneys produce few EPO, the hormones that induce bone narrow to make red blood cells, whose will distribute oxygen to tissues and organs (Peate and Nair, 2011, p. 377). Haemodialysis can make him lose blood and nutrients as iron or acid folic that assist in the production of a protein called haemoglobin that carries the oxygen in the red blood cells. CKD patients have more changes to have a poorer nutritional status, which can lead into low albumin levels and anaemia. Both of them affect Earnest physically as they cause fatigue (due to less oxygen in brain and muscles) and increases the risk of infection (Bonner, Wellard, and Caltabiano, 2010) as it has already happened to
Patients with CKD on dialysis treatment are at high risk of developing depression which can lead to loss of appetite and malnutrition (Hedayati, 2009). Dementia is another factor that can make Earnest to have depressive episodes (Snowden et al., 2015). Hence, it is important to screen Earnest for depression if he loses his appetite to know if that is the cause and to implement adequate measures. If required, introduction of different and more appealing recipes or ingredients can be contemplated, as well as encouraging the practice of hobbies or improving communication with him to overcome
A Mini Nutritional Assessment (MNA) was completed on Anne. The MNA is a tool used to provide a rapid assessment of elderly patients’ nutritional status. The MNA is made up of simple measurements and a few brief questions that can be completed by the patient in no more than ten minutes. The nutritional status of a patient is evaluated using a two-step process to accurately determine a patient’s nutritional status (McGee
Characteristics of haemodialysis patients are described as they have greater survive when they had a higher serum creatinine concentration or higher BMI which stand for larger body size or greater muscle mass. An increase of dry weight with muscle mass gaining correlates to the greatest survival. On the other hand, weight loss with loss of muscle mass results the worst mortality. Additionally, gain in muscle mass with weight loss was advantaged on higher survival in comparison with loss of muscle mass with weight gain (Kalantar-Zadeh et al., 2010). Mortality risk is strongly associates to a low BMI in maintenance haemodialysis patients (Kovesdy & Kalantar-Zadeh, 2009).
This entails that the professional nurse provide not only ordinary but extraordinary care and support to make it possible for these individuals to achieve their requirements for self-care. Furthermore, the professional nurse judiciously and collaboratively partakes in the individual’s health care provided by the medical doctor. Dorthea Orem understood that individuals possess the natural capability of self-care, and nurses have a duty to place emphasis on enhancing that capability. Nurses who deliver direct care can support these capabilities by offering learning opportunities and teaching methods that enhance self-care activities, therefore contributing a positive and encouraging influence on the individuals and caregivers quality of
Hemodialysis works by connecting a patient to a machine that filters and removes the body of waste products through a dialyzer. Treatment complications can arise, such as post-dialysis hypotension and muscle cramping which places patients at risk for falls (Hain, 2012). Co-morbid conditions such as dementia, Parkinson’s disease, osteoporosis, diabetic neuropathy, or urinary incontinence can also put a patient at even greater risk (Hain, 2012). Frailty in patients can also be used as a predictive risk factor. A study (McAdams-Demarcol et al., 2013) reported that frailty can contribute to a higher risk for hospitalization and death for patients undergoing hemodialysis. According to McAdams-DeMarco1 et al. (2013), “one in seven patients undergoing chronic hemodialysis suffers a major bone fracture after a fall” (pg. 1).
The 21st century health system has been marked by rapid developments in medical technology, availability of treatments, and advancements in the field of medicine. These changes have tremendously contributed to better prevention, management, and control of chronic illnesses like heart disease, asthma, diabetes and arthritis. However, the reality of chronic illness is intertwined with continued dwindle in quality of life, of dependency, of medication and limits. In this condition of diminishing health, the patient starkly experiences the dichotomy between the mind and the body. As P1 shares, “My mind is ok, but my body is simply weak. It has its own ways.”
The care approach used by the care home is a person-centred care plan, this allows for all dimensions of health to be met. In order to meet Graces physiological health care needs it is important to first identify her physiological health problems, these problems include; a diagnosis of mixed type dementia and a previous medical history of hypertension, hiatus hernia, anaemia and recurrent UTI’s. Grace’s diagnosis of dementia as previously mentioned has resulted in poor nutritional intake, this in turn has led to Grace developing a...
Environmental and intellectual wellness were my highest ranked scores and my lowest ranked score was in the occupational domain. Through observing the other domains of wellness I believe that this makes perfect sense in relation to my lifestyle and myself as a whole. The highest scores are due to my interest and satisfaction in these areas. Both environmental and intellectual wellness had factors which I voluntarily partake in my daily life. The lowest ranked score is due to an overall lack of interest and comfort. My wellness scores do not come as a surprise to me and solely offer different viewpoints of what I think properly describes my current health.
The biopsychosocial model (BPS) is a framework used to systematically consider the interactions between biological, psychological and social influences on human functioning, in the context of a person’s disease or illness (Boundless Psychology, 2016). This integrated approach suggests that health and sickness overlap and can be best understood by looking at the multiple combinations of these influences and how they interact and affect a person’s health and wellbeing (Wade, 2009). This assignment will aim to discuss the BPS model, describe the different perspectives within the theory and demonstrate how they apply to patient care. In order to do this, a case study of a person with a chronic health condition will be introduced and the factors
Post weights above estimated dry weight, and elevated blood pressure are two significant risks associated with hospitalizations. The registered nurse, dietician, and social worker are expected to meet once per week as an effort to collaborate and prevent hospitalizations and negative outcomes. Human resource expresses the importance of interdisciplinary communication by mandating conference calls that discuss facility outcomes. Discussions are centered upon dialysis access, nutrition, and fluid management, infection control, near misses, and medical error to name a
On these occasions, I rely on my nursing assessment, evaluation, and interventions, collaborative skills, and scientific knowledge to make sound clinical judgments for the benefit of my patients. As a hemodialysis nurse, I will persevere to comply with innovation in nursing practice, EBP, research, and education. I believe growth requires generation of innovative, improved ideas and practices for the betterment of the organization and patient satisfaction. For this reason, I will embrace technological advancements; empower front line staff to embrace change and innovation; and motivate staff to be change agents on the floor with the aim to provide better quality of care for our
This piece of work will be based on the pre-assessment process that patients go through on arrival to an endoscopy unit in which I was placed during my second year studying Adult Diploma Nursing. I will explore one patient’s holistic needs, identifying the priorities of care that the patient requires; I will then highlight a particular priority and give a rationale behind this. During an admission I completed under the supervision of my mentor, I was pre-assessing a 37 year old lady who had arrived at the unit for an upper gastrointestinal endoscopy. During the pre-assessment it was important that a holistic assessment is performed as every patient is an individual with unique care needs as the patient outlined in this piece of work has learning disabilities it was imperative to identify any barriers to communication (Nursing standards 2006). There were a number of nursing priorities identified, the patient also has hypertension.
This assignment critically discusses about dementia, a widespread disability among older adults today. It provides an introduction to dementia and analyses its prevalence in society. The various forms of dementias are elaborated with description about dysfunctions and symptoms. Nursing Assessment and Interventions are provided in the further sections which discusses about actions nurses should take on while evaluating patients and treating them. Finally, communication, an important Activity of Daily Living (ADL) is explored and patient/carer advice is presented so as to maintain good health conditions in the patient.
As the kidneys regulate the quantity of fluid which leaves the body, patients who suffer from kidney disease progression, may be not be able to regularize fluid removal from their body. Due to this scenario, their physician or specialist may ask them to reduce their intake of fluid. Lowering daily fluid intake for the renal diet involves: not drinking to socialize or from habit, only having a drink when thirsty, and sucking on a wedge of lemon or chips of ice. It also entails taking measures for monitoring the quantity of fluid that is drunk. This is done by measuring a regularly used glass or cup to measure the quantity of fluid it holds, as well as placing the recommended daily quantity of water into a specific container, and then only taking the fluid that is consumed from this. This insures that the recommended amount is not exceeded (Medical
By using Gross Domestic Product as the main indicator of well-being, many important factors are neglected. As defined in the New Merriam-Webster Dictionary, well-being is the state of being happy, healthy, or prosperous (1989, p.831). Economically, perhaps the only relevant state under the definition is prosperity, but in reality happiness and health have a great impact on well-being, significant enough to be recognized even when focusing mainly on wealth in numbers. If society hopes to have a more accurate and complete indication of well-being, globally or nationally, a new system of measurement must be developed, leaving GDP to its original function of totaling the dollar value of all domestically-produced goods and services sold over a period of time.
According to David (2008), health assessments are red-hot right now- and for good reason. With health care costs estimated to increase to more than $4 trillion by 2016, personal health assessments will help to ameliorate some of these costs by providing individuals with much needed health information so that they can manage their current health status and, perhaps even more importantly, prevent health problems before they occur. Moreover, personal health assessments, if used strategically, will aid employers in better understanding the collective health risks of their employee populations – thus allowing them to incorporate important and necessary interventions that will effectively address unhealthy behaviours at the workplace. Health assessment