Elderly Care Case Study: Diarrhoea, Nausea and Vomiting

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12th Feb 2020 Nursing Case Study Reference this

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This essay will discuss the case study of Mrs Bowling, who is 80-year-old female admitted to hospital with prolonged diarrhoea, nausea, vomiting and decreased mobility. Mrs Bowling is retired teacher and leaves home with her husband. This paper will use the case of Mrs Bowling to discuss about the factors that are taken into account when obtaining health assessment data. Furthermore, risk assessment will be prepared relating to Mrs Bowling case including rationale for the particular assessments. Finally, hospitalisation impact on the patient and her family will be reviewed, providing strategies for adaptation to the new circumstances.

A health assessment is detailed and organised examination of an individual used to determine potential health concerns. The main goal of the assessment is to prevent potential health issues or establish appropriate interventions that can lead to enhanced quality of life (Department of Health Australian Government, 2014). There are several factors that need to be considered when collecting health assessment data. Initial step is obtaining consent from the patient in order to undertake the assessment and collect the necessary data. Determine the cognitive status of the patient and their ability to provide factual data. If cognition is declined, guardian should be involved in the process (Office of the Australian Information Commissioner, 2015). As per Koutoukidis, Stainton and Hughson (2012), data collection includes both subjective and objective data. Where possible primary information need to be obtained through the patient or immediate family member. On the other hand, objective data is gathered by physical assessment according to the present signs and symptoms. Any potential barriers in communication, as the language one, should be addressed as soon as possible. In addition, according to Bickley (2012) apart from physical examination, nurses should focus on living arrangements of the patient, their environment and social needs. All health data collection process should be culturally and religiously appropriate to the patient needs.

Once necessary data is collected, next step is analysing that data and preparing risk assessments related to the patient condition in order to provide best possible outcome for the patient (Koutoukidis et. Al, 2012). Considering Mrs Bowling current status falls risk assessment (FRAT) should be undertaken. As per Matarese & Ivziku (2016) there are multiple intrinsic and extrinsic factors to be considered when determining if patient needs FRAT. Some of the factors include age, mobility and current health status. In Mrs Bowling case, her advanced age, decreased mobility and diarrhoea put her in a high falls risk category. Mrs Bowling should be assessed for potential risks of dehydration by using a fluid balance chart (Koutoukidis et al., 2012). According to Goldberg et al. (2014) decreased mobility and certain health conditions increased the risk of dehydration. Some of the symptoms of dehydration include: increased heart rate, decreased blood pressure, dry skin, fever and delayed skin turgor. As Mrs Bowling suffers from persistent nausea and diarrhoea, has decreased mobility and displays all of the above mentioned symptoms she is in high risk category for dehydration. Another aspect to consider when performing risk assessments on Mrs Bowling is skin integrity. As per Gump & Schmelzer, (2016) patients suffering from diarrhoea and decreased mobility have problems with faecal incontinence which leads to skin excoriations. For prevention nursing staff should maintain regular skin assessments and implement preventive measures.

Patient hospitalisation has significant impact on the patient itself as well as immediate family members. Both patient and family members can face with anxiety and depression during this challenging time. This can occur due to disruption of familiar daily routine, fear from the consequences of the illness as well fear about the future. Moreover, there is a risk of social isolation for the patient and further decline in the health status while in hospital (Happ, Tate & Davidson, 2015) Mrs Bowling is at risk of developing all the above mentioned. Mr Bowling might develop anxiety and depression as well. Being in a situation where his partner of 55 years is in hospital in fragile condition with increased health care needs can put extreme pressure on Mrs Bowling. In order to assist Mr and Mrs Bowling Patient Centred Care (PCC) can be implemented. As per Flagg (2015) PCC is crucial in assisting patients and their family to obtain positive hospital experience. PCC incorporates physical, psychological and social impact of the illness to the patient and their immediate family including them in the decision making processes. In order for Mrs Browning to overcome her current issues and fears she and her husband will need more information regarding her current issues and education about management once discharged. Further referrals to appropriate services that can provide home support will be beneficial and will assist with relieving their anxiety.

This essay reviewed a case study involving hospital admission of elderly patient. Primary focus was on importance of appropriate processes in place while obtaining data regarding the health condition of the patient as well as determining adequate health risk assessment as necessity for providing efficient health care. Moreover, writer discussed the negative effects of hospitalisation on patient and significant others as well as the importance of PCC as a successful strategy in overcoming these obstacles.

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