The purpose of this paper is to provide a nursing care plan for a geriatric client of a long-term care facility. This paper will discuss assessment of the client’s current health status. While her mental and social well-being are addressed, the most in-depth assessment of this client concerns her physical health. Nursing diagnoses will follow, based on the information collected during assessment. Then expected outcomes will be planned for the client, ideally resulting in improvement of her health status in various areas. This paper will then transition to theoretical implementation of nursing interventions, including any necessary teaching. While these nursing interventions will not be formally implemented, methods for evaluating the conjectured effectiveness of the interventions will be discussed.
Background Information
This nursing care plan is based on “Mrs. LaFrance” (not her real name), who is a resident of Life Care Center, a long-term care facility in Sierra Vista, Arizona. She is an English-speaking 89-year-old Caucasian female, born and raised in the Midwest to a father with German roots and a mother who immigrated from Sweden as a
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She wears glasses to correct her vision, but does not appear to suffer from poor corrected eyesight. She has a lapboard in her room on which she is assembling an intricate puzzle, with small pieces and a challenging Impressionist-style image. Her pupils are equal, round, react to light, and display accommodation (PERRLA). During the first assessment, her “corrected” hearing appeared fairly good, having little trouble understanding the normal-volume discussion. She had a bit more trouble hearing during the second assessment, asking for things to be repeated several times. Her ears appear symmetric and normal, with no discharge or anything else of note. Her speech is clear. Her oral mucous membranes are pink and moist, and lymph nodes did not appear to be swollen (they were not
Generally, in a LTC setting there is a director, assistant director, physician, pharmacist, nurses, medication aides, certified nursing assistants, case managers, social workers, and clergy. These individuals are tasked with providing a daily health plan for long-term care residents 24 hours a day, seven days a week. This group could consist of less or more healthcare associates which is conditional and determined by the goal plan; moreover, the intended outcome not solely geared towards physical rehabilitation. In modern society, rehabilitation is targeted to restore mind, body and soul thereby promoting the overall health of the patient, or
Another focus for change is that over the years the demand for home and community care over hospital care has continued to grow, as stated by the Queens nursing institute “Recent health policy points to the importance of improving and extending services to meet the health and care needs of an increasingly older population and provide services which may have previously been provided in hospital within community settings”.
Long-term care (LTC) covers a wide range of clinical and social services for those who need assistance due to functional limitations. These limitations usually result from complications associated with age related chronic conditions, from disabilities related to birth defects, brain damage, or mental retardation in children; or from major illnesses or injuries suffered by adults (Shi L. & Singh D.A., 2011). LTC encompasses a variety of services including traditional clinical services, social services and housing. Unlike acute care, long-term care is much more complicated and has objectives that are much harder to measure. Acute care mainly focuses on returning patients to their previous functional level and is primarily provided by specialty providers. However, LTC mainly focuses on preventing the physical and mental deterioration of an individual and promoting social adjustments to suit the different stages of decline. In addition the providers of LTC are more diverse than those in acute care and is offered in both formal and informal settings, which include: hospitals, physicians, home care, adult day care, nursing home care, assisted living and even informal caregivers such as friends and family members. Long-term care services have been dominated by community based services, which include informal care (86%, about 10 to 11 million) and formal institutional care delivered in nursing facilities (14%, 1.6 million) (McCall, 2001). Of more than the 10 million Americans estimated to require LTC services, 58% are elderly and 42% are under the age of 65 (Shi L. & Singh D.A., 2011). The users of LTC are either frail elderly or disabled and because of the specific care needs of this population, the care varies based on an indiv...
Nurse practitioners (NPs), one type of advanced practice nurses, are licensed by the states where they practice and certified by private boards. Nurse practitioners hold advanced degrees in clinical practice and function in a wide variety of settings and across the life span. They provide a broad array of healthcare services ranging from managing treatment plans, to prescribing medications, to implementing health promotion services. As of 2014, 205,000 NPs were licensed in the United States with 86% of those prepared to deliver care to patients in primary care settings (NP Facts, 2015). The progression of the Nurse Practitioner movement that occurred in the 1960 and 1970s emerged as a creative and
o Type of healthcare worker: Nurse practitioner o When this type of work entered the market: The medical profession of nurse practitioner was developed in the mid 1960s. The job of nurse practitioners grew from implementing work from primary care physicians into that of traditional nurses. o Reasons for creation and growth: In the late 1950s and early 1960s, increased specialization amongst physicians was taking place, which led to many doctors exploring other avenues of medicine, resulting in a large shortage of physicians practicing primary care. This left many rural and inner city areas with very limited access to medical care.
There are changes in the demographic as the population grows older, the number of older adult’s increases and thus, there is an increase of proportion of patients that are older adults for nurses to take care of (Wells, Y., Foreman, P., Gething, L., & Petralia, W., 2004). The nurses are there to assist and support the older adults in achieving wellness within their situation through empowering the clients (Touhy, et al (2012). Caring for older adults is important as there is an increase in population with deteriorating health. When caring for a client it is important to incorporate Jean Watson’s caring theories and Carative Factors to help influence and support the care. She encourages nurses to co-participate within the caring process by establishing unity and trust between the nurse and client. First, this paper will explain a situation in where I cared for an older adult and it will then introduce Jean Watson’s lower order needs, specifically the need for activity and how it relates to the older adult I cared for. Lastly, this paper will explain the nursing interventions I implemented to meet the lower order need, with a discussion of Carative Factor #4 relating to the client.
Licensed practical nurses (LPN 's) fill an important role in modern health care practices. Their primary job duty is to provide routine care, observe patients’ health, assist doctors and registered nurses, and communicate instructions to patients regarding medication, home-based care, and preventative lifestyle changes (Hill). A Licensed Practical Nurse has various of roles that they have to manage on a day to day basis, such as being an advocate for their patients, an educator, being a counselor, a consultant, researcher, collaborator, and even a manager depending on what kind of work exactly that you do and where. It is the nursing process and critical thinking that separate the LPN from the unlicensed assistive personnel. Judgments are based
Once upon a time, my best friend, Bryan Martinez, often heard his mother’s medical conversations with friends. One day at school, our teacher confronted Mrs. Martinez and told her that she was able tell that Bryan was a son from a nurse. Apparently there was an incident at school where a little boy was acting out and Bryan told our teacher that the little boy was agitated, and to give him some medication to calm him down. As demonstrated by Bryan, nursing is ongoing profession that promotes the health and well-being of individuals.
Nursing, a profession within the health care sector focused on the care of individuals, families, and communities. They attain, maintain, and recover optimal health and quality of life. Nursing is not about getting paid a lot annually, it is about the care that you have caring for others. If you are in the Nursing field and you do not like it and is doing it for the money it will show. If you care and love what you do it will show also. Nursing is a great occupation, and will take hard work, dedication, and patience. It can become exhausting as you tend to have sleepless nights due to what just happened in the Emergency Room just before you left. It also takes a strong-minded person, you should be able to go through and get through many things
Nursing assistants work in many types of settings including nursing homes, hospice, mental health centers, assisted living residences, home care agencies, hospitals, rehabilitation and restorative care facilities (Sorrentuino & Remmert, 2012). There are many types of Long-term care centers. For this paper, I will focus on the long-term care centers often referred to as nursing homes. These LTCs are "licensed facilities that provide extended care for individuals who do not require the acute care provided in a hospital but who need more care than can be given at home" (U.S Department of Health And Human...
A leader is described as a person who guides others and has authority and influence over others. They work to influence others into meeting certain goals. There is no right or wrong definition of a leader and there is no recipe that ensures effective leadership. Successful leaders have a good balance of vision, influence, and power. Leaders gain their authority from their ability to influence others to get the work done; because of this, anyone has the potential to be a leader. (Finkelman. 2012, p15)
Solutions for the nursing shortage beyond implementing safe nurse staffing ratios include: ongoing long-term workforce planning; institution of an education and practice system to promote more equitable compensation in the health care community based on a better understanding of the educational preparation required for different health care roles; implementation of specific strategies to retain experienced nurses in the provision of direct patient care, investigating the potential for using technological advances to enhance the capacity of a reduced nursing workforce; and advocate for increased nursing education funding under Title VIII of the Public Health Service Act and other publicly funded initiatives to improve
Saying that you are a registered nurse is a broad statement. Registered nursing is a job that has many aspects. Registered nurses work in many different settings and they carry out many different routines. As a registered nurse you could be exposed to many different opportunities. My goal is to be a registered nurse but, I need to learn a lot. Becoming a being a registered nurse requires a lot of hard work and effort but, if I focus on my goal I will be able to achieve it.
The career i chose is a branch of the medical field. I chose a career in nursing, more specifically the career path of a registered nurse. This career consists of providing care for people of all ages and helping them with managing their conditions. I chose this career because my mother is an rn and my family has a strong presence in the medical field. It is important to understand the education or training requirements, skills, or talents needed, salary, benefits offered, and the duties for a particular career when making this decision.
Geriatric nurses are to provide disease prevention, health promotion, and positive aging. The American Journal of Nursing, the American Nurses Association, and John A. Hartford Foundation Institute for geriatric nursing contributed to the development of gerontological nursing (Pierre, “Gerontological Nursing”). In 2001, the John A. Hartford Foundation awarded the American Association of Colleges of Nursing (AACN) a $3.99 million grant to launch a new initiative entitled “Enhancing Geriatric Nursing Education in Undergraduate Advanced Practice Nursing Programs” (AACN, “Caring for an Aging America”). In the early 1960’s, the ANA created a cabil of nurses to convened the first national geriatric nursing practice. Geriatric nursing gives an encompassing view of the care for older adults. Florence Nightingale and Doreen Norton provided insights on caring for the aged.