Nursing Diagnostics in Assisted Living Facility

Introduction

The work of nurses depends on how well they follow their patients and health changes. In this paper, attention will be paid to a 70-year-old patient, Mr. M., who lives in an assisted living facility, has not smoking habits, does not use alcohol, and has no allergies. Recently, certain changes in his behaviors have been observed, and the analysis of clinical manifestations and abnormalities should contribute to the establishment of diagnoses and related problems.

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Clinical Manifestations

During the last two months, Mr. M is challenged by trouble remembering his room number and recalling his family members’ names. It becomes difficult for a man to repeat what has just been read. Other manifestations are his aggressiveness and agitation that are accompanied by fear. He could walk at nights, being unable to recognize his way back. Finally, additional help with activities of daily living is required.

Diagnoses

There are some primary and secondary diagnoses that can be given to Mr. M. The primary diagnosis is Alzheimer’s disease due to rapid cognitive decline and behavioral changes (Koskas, Henry-Feugeas, Feugeas, Ou, & Drunat, 2017). Limbic encephalitis is another diagnosis due to high white blood cells (WBC) levels and memory loss as signs (Grause et al., 2016). Dementia can be developed due to a number of risk factors like age (70 years), gender (male), and hypertension (Langa & Levine, 2014). Therefore, dementia and aphasia are secondary diagnoses due to continuous changes and the decline of mental abilities.

Abnormalities

During a nursing assessment, a practitioner should be ready for a number of abnormalities being discovered. Vision perception can be impaired due to the already identified laboratory results like increased systolic blood pressure (123), heart rate (93), and respiratory rate (22). Language disorders are observed due to uncontrollable brain changes. According to Langa and Levine (2014), poor assessment is explained by the possibility of anxiety and fatigue as psychological and behavioral abnormalities. Finally, the patient experiences fear and demonstrates aggressiveness, and such disturbances like urinary incontinence (high WBC levels) and excessive wandering should not be ignored.

Current Health Status

The current health status of the patient, including his physical, emotional, and psychological changes, will influence him and his family. It can be hard for the patient to take care of himself and memorize all the remarkable events in his life. Medication control and report on recent health changes are also impossible due to memory loss and disorientation, which contributes to the development of other dangerous diseases (Graus et al., 2016). Family members may not get used to his cognitive decline and the inability to memorize their roles and relationships.

Interventions

Along with medical treatment to control infections and hypertension, the staff can facilitate the condition of Mr. M. with the help of non-drug interventions. Memory training, social stimulation, and physical exercises must be regularly in his life (Koskas et al., 2017; Langa & Levine, 2014). Group cognitive-behavioral therapies are effective either for patients or for their families because they promote a sense of competence and belonging to someone.

Problems

Regarding the current state of the patient, the staff, as well as his family, should be ready for certain actual and potential problems. First, cognitive decline is hard to control or prevent. Therefore, new behavioral and physiological changes may occur with time (Koskas et al., 2017). Second, the impossibility of the patient to identify his health problems and concerns provokes the omission of vital signs and the development of new inflammations and diseases. Third, the lack of control contributes to fast getting lost and unpredictable behaviors. Finally, brain changes influence the work of the hypothalamus and change the reality in which the patient lives.

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Conclusion

In general, Mr. M. has already experienced certain changes due to the work of the brain and other symptoms of rapid cognitive decline. Alzheimer’s, dementia, and apathy are the diagnoses that can be established. Still, such factors as inflammation should not be ignored. The patient’s health status is not stable, and he or his family needs to be ready for new challenges and the feeling of hopelessness.

References

Graus, F., Titulaer, M. J., Balu, R., Benseler, S., Bien, C. G., Cellucci, T., … Dalmau, J. (2016). A clinical approach to diagnosis of autoimmune encephalitis. The Lancet Neurology, 15(4), 391-404.

Koskas, P., Henry-Feugeas, M. C., Feugeas, J. P., Ou, P., & Drunat, O. (2017). Factors of rapid cognitive decline in late onset Alzheimer’s disease. Current Aging Science, 10(2), 129-135.

Langa, K. M., & Levine, D. A. (2014). The diagnosis and management of mild cognitive impairment: A clinical review. JAMA, 312(23), 2551-2561.

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