Health History Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and […]
Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.
Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and frequently becomes lost, needing help to get back to his room. Mr. M has become dependent on many ADLs, whereas a few months ago, he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.
Critical Thinking Essay: In 750-1,000 words, critically evaluate Mr. M.'s situation. Include the following:
You must cite a minimum of two sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Clinical manifestations present in Mr. M include confusion, forgetfulness, fear, and aggression. The patient has trouble recalling the names of his family members and room number and repeating what he has just read. He is also experiencing emotional challenges, becoming agitated and aggressive quickly. Mr. M appears to be afraid and fearful, especially when he becomes aggressive, which indicates that he could have an emotional health complication. He is also reported to be caught in confusion and has been found wandering at night, especially when he experiences difficulty getting back to his room. He also experiences difficulties performing various activities of daily living, which necessitates urgent care.
Based on the clinical manifestations present in Mr. M, Alzheimer’s disease ought to be considered a primary diagnosis, while dementia could be considered a secondary diagnosis. Alzheimer’s disease is often characterized by memory impairment, in which patients report difficulties remembering events, rapid mood changes, and confusion (Anor et al., 2017, p. 127). Patients also report difficulties concentrating, problem-solving, and planning, making it hard to finish their daily tasks. Since Mr. M has reported such challenges, Alzheimer’s disease could be considered a primary diagnosis for his condition. Dementia could be considered the secondary diagnosis for Mr. M since the condition causes patients to experience behavioral, emotional, and psychological irregularities. Although dementia may present similar symptoms as Alzheimer, it may cause lasting implications on the patient’s behavioral and psychological health, necessitating treatment and monitoring from skilled clinicians. Therefore, dementia ought to be considered as the secondary diagnosis for Mr. M.
When performing my nursing assessment, some abnormalities I would expect to see include impaired judgment, irregularity in abstract thinking, and personality challenges. Since the patient is experiencing memory loss and confusion, it would be likely that the patient cannot make a rightful judgment on elements such as distance, duration, and depth. I would also expect the patient to experience difficulties completing tasks that require abstract thinking. Due to the rapid deterioration of his condition, the patient is likely to be experiencing personality challenges, such as a decline in self-esteem. I would, therefore, expect to seek such abnormalities when assessing Mr. M’s health condition.
Mr. M.’s current health status may have multiple physical, psychological, and emotional health implications. The patient may feel overwhelmed by waves of difficult emotions due to extreme fear and worry about the risk of disease progression. As a result, Mr. M may develop anxiety due to the rapid deterioration of his health, which may attract serious psychological health challenges such as depression. Since Mr. M is experiencing difficulties performing his daily tasks, he is likely to develop guilt and resentment due to demands made on family and friends to support him socially and financially. The patient’s condition may also present severe symptoms affecting memory decisions, judgment, and social abilities to interfere with his daily life. It may also result in cognitive impairment and mental incapacitation, such as total memory loss, language problems, and loss his sense of direction. To avoid such health complications, Mr. M requires urgent intervention.
Some interventions that can be implemented to support Mr. M. and his family include cognitive Stimulation Therapy, pharmacological treatment, and home-based reality orientation. Cognitive stimulation therapy is a non-pharmacological intervention used to support people with dementia by involving them in themed activities designed to engage and stimulate cognitive stability (Lobbia et al., 2018). The patient needs to be involved in cognitive stimulation therapy sessions with a trained practitioner, skilled in interpersonal communication or a dementia care specialist to restore his cognitive function and stimulate healing. Mr. M could also be administered disease-modifying drugs, such as anti-dementia drugs, to stimulate the production of brain chemicals required to facilitate communication between nerve cells in the brain to restore the normal functioning of the patient’s neuro system. Moreover, the patient’s family could remind him about the present through home-based reality orientation, reinforce his self-identity, and enhance his interaction with the environment. Such interventions ought to be adopted in the strive to restore the patient’s cognitive and psychological health.
Anor, C. J., O’Connor, S., Saund, A., Tang-Wai, D. F., Keren, R., & Tartaglia, M. C. (2017). Neuropsychiatric symptoms in Alzheimer’s disease, vascular dementia, and mixed dementia. Neurodegenerative Diseases, 17(4-5), 127-134. https://www.karger.com/Article/Abstract/455127
Lobbia, A., Carbone, E., Faggian, S., Gardini, S., Piras, F., Spector, A., & Borella, E. (2018). Cognitive stimulation therapy (CST) is effective for people with mild-to-moderate dementia. European Psychologist. https://econtent.hogrefe.com/doi/full/10.1027/1016-9040/a000342
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Published On: 01-01-1970
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