Identification of Leonards Health Risk Factors †Free Samples

Question: Discuss about the Identification of Leonards Health Risk Factors. Answer: Identification of Leonards three health risk factors using Clinical Reasoning CyclePatient situation and collecting information In the provided case study, Leonard is a 73 years old male living alone without any family in the community. His wife died a few years back and he has no children. He had left his job few years back and is not working right now. He has a medical history of mild cognitive impairment, anaemia, industrial deafness, decubitus ulcer on left leg shin, and arthritis in lower back, mild hypotension and urinary incontinence. He was diagnosed with mild cognitive impairment around 3 years ago but his Mini-Mental State Examination (MMSE) score was 25/30 12 months ago, which is a normal cognitive score. However, from last 6 months, Leonard is getting socially isolated spending most of the time at home. He is showing lack of interest in his usual activities, feeling tired and sleeping most of the day. Further, in these last 6 months, his daily functioning is also deteriorated and he had two falls incidence with this duration. In the present situation, Leonard is admitted to the emergency department after third fall incidence. He is having bruising on face and hip, mild confusion, low body weight and anxiety. He is unable to walk and stand properly in hospital observations. Leonard also needs help with transfers and self-care activities. He is also facing difficulty in planning personal tasks. Collecting and processing information As per provided information, Leonard was a victim of mild cognitive impairment that risk to Alzheimers disease. His MMSE was normal around 1 year ago as per his MMSE score of 25/30 but his recent symptoms from past 6 months are not proper that involves mild confusion, social isolation, problem planning task, improper self-management (Dong et al. 2012). Further, he had two major fall incidence in past that involves fall from stairs and fall from bed in the night. His recent fall incidence was also a serious one where he falls at a local shop and admitted to the emergency department. This fall incidence increases his risk of serious injury (Robinson et al. 2014). Leonard was anaemic as per his past medical history. In recent symptom at the hospital he is considered underweight. Further, Leonard requires help in work like shopping and cleaning because he took help from his Home and Community Care (HACC) services. This indicates a risk of severe anaemia that can cause complication with g rowing age. Identification of issues As per provided information analysis, the three risk factors or issues in Leonard case involves risk to Alzheimers disease, serious fall injuries and severe anaemia as per his growing age. Establishing goals For the identified risk factors thenursing goals involve: - Minimizing the complication of Alzheimers disease Providing support services to control fall incidence Provide proper fluid and food intake to enhance better health and overcome low body weight condition. Taking action The fulfilment of these goals would require propernursing interventions that should be performed by the healthcare professional to overcome risk conditions in Mr. Leonards case. These nursing interventions are discussed in the below-provided section of this essay. Evaluating outcomes The fulfilment of mentionednursing goals could be evaluated using specific evaluation tools and monitoring strategies. For detecting betterment in weight and health, a proper monitoring chart (weight management chart) should be developed where the weight of every week should be noted till 6 months to achieve targeted goal. Further, control over fall incidence can be determined using an observation chart for 6 months time duration where the number of fall incidence should be noted and this observation should continue till the fall incidence stop completely. Lastly, the MMSE scale is perfect to evaluate control over cognitive condition minimising the risk of Alzheimers disease. Evaluating three best-practice assessment tools for Leonard case The first identified issue in Leonard case is the risk to Alzheimers disease as his medical history states mild cognition impairment with risk to Alzheimers disease. His present social and medical conditions from last 6 months indicate a risk to Alzheimers disease. As per Dong et al. (2012) study, the best assessment tool for Alzheimers disease is Mini-Mental State Examination (MMSE). This test was previously performed for Leonard 12 months ago but his condition from last 6 months indicate towards the consequences of mild cognition impairment risking Alzheimers disease. According to Paillard et al. (2015), early diagnosis of Alzheimers disease can help to support and medicate reversing the effect of the disease. However, there is no single assessment tool to detect cognitive impairment yet MMSE is most widely used tool that is used to detect cognitive situation within 10-15 minutes of duration with detailed analysis using 30 questions. The second tool appropriate to assess and prevent fall incidence in case of Leonard is Falls Risk Assessment Tool (FRAT) (Hempel et al. 2013). This tool was developed in 1999 and is considered the most reliable tool for fall incidence management and prevention till date (Moorhead et al. 2014). According to Hnizdo et al. (2013) study, FRAT involves a three-part assessment where Part -1 determined falls risk status, Part-2 detects risk factor checklist and Part-3 is the action plan for recovery. Lastly, a review chart is constructed to revise the care plan as per detected risk status each time FRAT assessment is performed for the patient. Lastly, the third risk issue involves low body weight and risk of anaemia in Leonards case. For this issue, the most suitable assessment tool is Body Mass Index ratio (BMI) because this tool determines body weight as well as estimate health risk related to body weight (Moorhead et al. 2014). The BMI tool measure as analyses body weight as per height and mass (muscle or fat) that help to detect health risk if there is extra fat in the body. Any patient can perform BMI using machine available that automatically determines the health condition (Herdman, 2011). In case of Leonard, BMI tool will work to maintain a healthy body weight assuring no risk of anaemia. Identification and discussion of interventions that will support Leonard and analyse the relation of these interventions with duties of health professional The below-provided list in thenursing intervention to be adopted in case of Mr. Leonard linked with specific duties as a health professional for each identified intervention. The below provided nursing interventions are developed for the most noticeable symptoms in Leonardos case of Alzheimers disease. These symptoms are the self-care deficit (dressing and grooming), social isolation, impaired physical mobility and mild confusion. Further, interventions related to weight and fall management are also included in this section. For Alzheimers disease Nursing intervention Nursing obligation Allow patient to perform his daily activities by himself with giving instructions and further assist patient in activities if needed. In this intervention professional shall help the patient to develop self-confidence and boost motor skills, sequencing ability, balancing and consciousness (Andrieu et al. 2015). Determine social environment and participation where the patient is comfortable. The professional needs to develop psychological functioning, socializing and prevent violent reactions (Montine et al. 2012). Provide rest/sleep short periods Through this intervention, patient will get stimuli for social interaction and activities minimizing frustration, sensory overload and agitation (Paillard et al. 2015). Allow patient to learn mild motion exercise and short periodic movements. Further, provide assistance and education regarding similar. In this intervention, professional needs to provide repetitive instructions and assistance until patient learns to perform a complete task. This will help the patient to overcome muscular atrophy and joint contractions (Paillard et al. 2015). Avoid the utilization of walking frame to avoid potential injury. The professional shall work to assist the patient in walking as well as avoiding chances of injuries because patients having cognitive impairment can harm themselves using a walker. AD patients cannot use walkers properly due to psychological disturbance (Sindi et al. 2015). Schedule patients activities and needs as per timings This intervention provided professional a strategy that can help the patient in planning task (Stern, 2012.). Fall Management Detect the risk objects, regions and situations where the patient can fall and try to remove these hurdles. The professional needs to acknowledge these conditions promoting patient safety and fall prevention (Delbaere et al. 2013). Provide call light and response immediately This will help to prevent falls at bedtime where the professional need to be careful regarding the indications by the patient (Habib et al. 2014). Provide physical and occupational therapy with gait strategies and assistive devices. The professional needs to let patient learn using the gait belt and assistive aids like canes, wheelchairs that help in safety and stability (Gallion, 2015). Weight management Plan nutrition based healthy diet for Leonard based on his age and bodily requirements. Professional needs to detect the daily nutrition requirement of the patient and promote sufficient nutritions implementation in the diet (Anderson et al. 2012). Set short-term and long-term food/fluid intake goals. This intervention will help a sporty way of nutritional balance. Professional would need to set these goals creating encouragement in the patient to take food and fluid in a manner of play (Landi et al. 2012). Consider companionship as a part of mealtime Eating with the patient will help to improve both socialization as well as patient interest in eating (Anderson et al. 2012). Provide liquid energy supplements The energy supplements can work to help in weight gain and avoid falls being a direct source of energy. The professional needs to balance these supplements and provide them to the patient (Moorhead et al. 2014). References Herdman, T.H. ed., 2011.Nursing diagnoses 2012-14: definitions and classification. John Wiley Sons. Moorhead, S., Johnson, M., Maas, M.L. and Swanson, E., 2014.Nursing Outcomes Classification (NOC)-E-Book: Measurement of Health Outcomes. Elsevier Health Sciences. Anderson, G.H., Foreyt, J., Sigman-Grant, M. and Allison, D.B., 2012. The Use of Low-Calorie Sweeteners by Adults: Impact on Weight Management3.The Journal of nutrition,142(6), pp.1163s-1169s. Andrieu, S., Coley, N., Lovestone, S., Aisen, P.S. and Vellas, B., 2015. Prevention of sporadic Alzheimer's disease: lessons learned from clinical trials and future directions.The Lancet Neurology,14(9), pp.926-944. Delbaere, K., Sherrington, C. and Lord, S.R., 2013. Falls prevention interventions. InOsteoporosis (Fourth Edition)(pp. 1649-1666). Dong, Y., Lee, W.Y., Basri, N.A., Collinson, S.L., Merchant, R.A., Venketasubramanian, N. and Chen, C.L.H., 2012. The Montreal Cognitive Assessment is superior to the MiniMental State Examination in detecting patients at higher risk of dementia.International Psychogeriatrics,24(11), pp.1749-1755. Gallion, A.D., 2015. Improving a Fall Prevention and Management Program in an Acute Care Setting. Habib, M.A., Mohktar, M.S., Kamaruzzaman, S.B., Lim, K.S., Pin, T.M. and Ibrahim, F., 2014. Smartphone-based solutions for fall detection and prevention: challenges and open issues.Sensors,14(4), pp.7181-7208. Hempel, S., Newberry, S., Wang, Z., Booth, M., Shanman, R., Johnsen, B., Shier, V., Saliba, D., Spector, W.D. and Ganz, D.A., 2013. Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness.Journal of the American Geriatrics Society,61(4), pp.483-494. Hnizdo, S., Archuleta, R.A., Taylor, B. and Kim, S.C., 2013. Validity and reliability of the modified John Hopkins Fall Risk Assessment Tool for elderly patients in home health care.Geriatric nursing,34(5), pp.423-427. Landi, F., Liperoti, R., Fusco, D., Mastropaolo, S., Quattrociocchi, D., Proia, A., Tosato, M., Bernabei, R. and Onder, G., 2012. Sarcopenia and mortality among older nursing home residents.Journal of the American Medical Directors Association,13(2), pp.121-126. Montine, T.J., Phelps, C.H., Beach, T.G., Bigio, E.H., Cairns, N.J., Dickson, D.W., Duyckaerts, C., Frosch, M.P., Masliah, E., Mirra, S.S. and Nelson, P.T., 2012. National Institute on AgingAlzheimers Association guidelines for the neuropathologic assessment of Alzheimers disease: a practical approach.Acta neuropathologica,123(1), pp.1-11. Paillard, T., Rolland, Y. and de Souto Barreto, P., 2015. Protective effects of physical exercise in Alzheimer's disease and Parkinson's disease: a narrative review.Journal of clinical neurology,11(3), pp.212-219. Robinson, L., Newton, J.L., Jones, D. and Dawson, P., 2014. Self-management and adherence with exercise-based falls prevention programmes: a qualitative study to explore the views and experiences of older people and physiotherapists.Disability and rehabilitation,36(5), pp.379-386. Sindi, S., Mangialasche, F. and Kivipelto, M., 2015. Advances in the prevention of Alzheimer's Disease.F1000prime reports,7. Stern, Y., 2012. Cognitive reserve in ageing and Alzheimer's disease.The Lancet Neurology,11(11), pp.1006-1012.