Paper Example on Nursing Care for Older Adults: Mrs. Leung's Case Study

Introduction

From the acute care case study, various nursing problems should get addressed. Any registered nurse should have the capability to handle them with ease. Caring for older people should not be ignored since it is a critical issue in society. These old residents have minimal mobility hence require a lot of aid to survive by competent individuals.

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Nursing Care Plan

Assessment Nursing Diagnosis Intervention Outcome

Mrs. Leung can hardly move without a wheelchair aid due to a femur fracture that occurred after she fell.

The patient has difficulties hearing.

Mrs. Leung goes for a short call through the aid of the urinary catheter.

Mrs. Leung has osteoporosis

The patient suffers from hearing impairment

She has urinary incontinence As a nurse, I could ensure that she uses a wheelchair, which will help her resume motion even though she has been bedridden most of the time. I will also engage her in muscle-strengthening exercises to facilitate balance when moving.

With her hearing problem, I will teach her to read lips for more natural communication. I will also give her hearing gadgets to amplify sounds in her ears.

I would ensure she has a urinary catheter all the time to help ensure control in urine passage. The use of walking aid and muscle exercise will make movement easier for Mrs. Leung in the short and long-run, respectively.

Learning to read lips will help this patient communicate more effectively as well as the use of hearing aids. Hearing aids.

Urinary catheter helps prevent unnecessary passing of urine by the patient hence better hygiene and care.

Nursing Priorities and Care Plan

Risk of fall

In the elder individual's settlement, one of the major priorities is ensuring minimal risk of falls. These people are fragile, and their muscles lack adequate balance. In case of an incident, they could get hurt like in the case of Mrs. Leung, who ended up suffering a neck injury. Elderly persons can fall due to dizziness, poor sensory perception, common illnesses, use of medication, and impaired mobility. Those under this risk are above 65 years, and it gets worse as the age advances. The desired outcomes of registered nursing care in older adults are to ensure their patients are free from such accidents. Caregivers also work hard towards implementing measures that provide high safety at settlement homes. To reduce these falls, nurses usually identify any risk factor in the association, assess every patient's environment for related harm, and then secure them at all costs. In most cases, they ensure their beds are low, install assistive devices in every room, ensure proper lighting for patients' spaces, and answer calls immediately, among other interventions. For a patient like Mrs. Leung, she probably did not have anyone watching over her, and that why no one witnessed her fall (Park, De Gagne, So & Palmer, 2015). Such occurrences should get avoided at all costs.

Risk of infection

In elder persons, their integumentary and immune systems go through a lot of changes over the years, making them weak. They also have ineffective suppressed inflammatory response due to the continuous use of medication and, in some cases, harmful substances or poor nutrition and slowed ciliary response. Infections can be hazardous for these older adults since their antibodies are not adequate or strong enough to fight germs. Therefore, it is upon the nurses to ensure that these patients stay healthy without infections. These medical experts have ways of observing this phenomenon like vitals monitoring for every patient daily, skin assessment for tears, redness or breaks, keep measuring temperature, limiting urinary catheter use where possible, and taking periodic blood samples. All these measures taken are meant to ensure that there are limited chances of contacting infections since they could be deadly. Since these individuals cannot take care of themselves, it is upon the nurses to do it. Some diseases can lead to loss of hearing, which could be what happened to Mrs. Leung. Poor health might have been the reason for her fall, which led to a fracture (Choy, Chen, Yau, Hsu, Chik & Wong, 2016). Nurses should ensure that these older adults get accommodated in the hygienic environment due to their delicate body systems.

Hypothermia

Old persons have a high possibility of experiencing body temperatures that are below average. Environmental exposure and changes in thermoregulation due to advanced age are the main factors of this risk. Registered nurses have the responsibility of ensuring that these individuals are warm all the time to prevent respiratory complications, which can be fatal. When old individuals are experiencing hypothermia, they often shiver, have cold skin, become pallor and tachycardia. These nurses aim at ensuring that their patient's temperature and mental state remain stable or go back to normal after the intervention. Nurses should intervene in this dynamic by constantly measuring their patient's temperatures with low range thermometer to ensure it's normal. The mental records of each patient should be available for assessing and reviewing. Nurses should use muscle relaxers and sedatives carefully to avoid increasing the risk of hypothermia. Those undergoing x-rays should get covered with blankets, and slow re-warming of hypothermic individuals is always of importance. It is essential to ensure that patents like Mrs. Leung are in full capacity. When incapacitated, they could end up not conveying essential details of their wellbeing hence affecting care giving (Norful, Martsolf, de Jacq & Poghosyan, 2017). It is also crucial to keep these mental status records for deciding which person requires more attention than the others.

Evaluation of Registered Nurses Role

Registered nurses working in elderly persons' homes get specialized in geriatrics medication. It is the sort of care giving that does not only concentrate on physical prosperity but also that of mental status. Most of the conditions dealt with include aging, dementia, and Alzheimer's disease. Most of those who work in these place standard nursing expertise while few have advanced certificates and degrees. There are a lot of duties in these homes. These roles get categorized according to the individual's qualifications. All employees at retirement homes or assisted living facilities who deal with patients must possess a degree certificate in nursing. For supervision positions, a degree in geriatric or nursing management is required, but those who have pursued master's certification also qualify. However, those without these advanced learning certificates can acquire them quickly while still in practice (Abrams, Nathanson, Silver, Ramirez, Toner & Teresi, 2017). The America Nursing Credentialing Center offers opportunities for such career development. Registered nursing duties vary from one facility to another, although there are common ones like:

Helping patients bathe: These older adults are not flexible as usual hence they need help conducting daily duties. Due to fractures and injuries that they sustain in their bodies, they cannot be able to shower correctly. They also do not know how to use some bathing gadgets and can easily slip, thus falling if left alone in bathrooms (Backhaus, Verbeek, van Rossum, Capezuti & Hamers, 2018). Therefore, RN's help these individuals to clean up.

Dressing Older adults: Individuals age and they lose their correlation of performing tasks like wearing clothes. These patients on assisted living care cannot get themselves dressed, and that is why their families think it's best to stay at homes where they can receive such services. Registered nurses help improve these individuals' lifestyles by ensuring they are well dressed.

Help them get up and down: Due to muscle issues, older adults have a hard time getting up and down. Their joints are weak and worn out; hence every attempt to adjust them when standing or sitting is usually painful and stressing (Kiljunen, Valimaki, Kankkunen & Partanen, 2017). RN's, therefore, take up the role of giving them a hand when rising or lying down.

Motion help: These individuals must walk daily to keep their bodies active. However, doing this is usually hard for older adults since they lack balance and energy. Registered nurses typically hold their hands to facilitate movement in and out of rooms or for leisure activities (Lovink, Persoon, van Vught, Schoonhoven, Koopmans & Laurant, 2017). They also provide them with walking pieces of equipment like walkers and wheelchair.

Monitoring conditions and vital signs: Preventing a risk from occurring requires a lot of monitoring for control purposes. RN's are used to taking relevant necessary tests to ensure their patient's conditions do not deteriorate. These checkups include temperatures and urine tests. They provide that old individuals are healthy each day.

Physical and mental status reporting: The doctors who work in these institutions do not mingle with patients unless there is a condition that needs attention. Therefore, registered nurses have the responsibility to check on these people's physical and mental health and then give the doctor their complete analysis of each individual (Gransjon Craftman, Grape, Ringnell & Westerbotn, 2016). That helps reduce the need for many doctors since these assisted living facilities are homes and not hospitals.

Medication administration: Since they are trained and registered nurses, they know how to administer medication. Older adults cannot read instructions and know the required medicines for age-related illnesses. Some conditions like incontinence, loss of mobility, and sleep disturbance are very adamant in old age and need to get resolved to ensure the quality of life (Tiew, Koh, Creedy, & Tam, 2017). Such duties are performed by RN's since doctors cannot manage to attend all patients every day.

Literature Review

Dellefield, Castle, McGilton, and Spilsbury investigated the relationship between nursing homes and registered nurses. From their findings, it was clear that these practitioners added value to these facilities by ensuring NH quality. However, they also led to the increased cost of running these homes since their services are not cheap. There are concerns about expenses incurred in hiring these individuals, although the skill mix they provide diminish such cost-related fears. For the benefit of society at large, individuals are challenged to show how employing RN's helps enhance efficiency, cost-effectiveness, and nursing home quality (Dellefield, Castle, McGilton & Spilsbury, 2015). Therefore, according to these authors, having RN's in this practice is essential.

According to the study on the professional development of RN's by Emily Cooper, Karen Spilsbury, Dorothy McCaughan, Carl Thompson, Tony Butterworth, and Barbara Hanratty, they established the care needs these individuals required. They found out that for these individuals to have successful careers, they had to possess knowledge, skills, experience, and competence for quality services to older residents. In these facilities, the most important responsibility is ensuring the quality of life by promoting dignity and safety for residents. To assure professional development, individuals should provide personal care, short and long-term conditions management, and also dementia care (Cooper, Spilsbury, McCaughan, Thompson, Butterworth & Hanratty, 2017). There is, however, a shortage in labor supply, which is the most significant barrier in nursing homes.

Researchers like Ramona Backhaus and Hilde Verbeek, among others, investigated the future competencies that will emerge to distinguish the need for RN's in nursing homes. In their perspective, this field is flooding with many individuals gr...