Adapting to Health Changes Assignment Example | Topics and Well Written Essays - 2250 words

Adapting to Health Changes - Assignment Example It also includes the topics related to elder abuse. Introduction The most difficult challenge a nurse could face is caring for an elderly ill client (Alexander, 2004, p. 1005). Due to developmental changes in physical and mental state, some of the clinical manifestations of certain diseases are hard to detect. One of these diseases is the diabetic ketoacidosis. Emergencies related to endocrine diseases account for approximately 1.5% of all hospital emergency admissions in England; the majority is related to diabetes and its complications (Dunning, 2005, p. 113). Mortality rates among elderly are 20% (Jevon, 2010, p. 9). Diabetic ketoacidosis (DKA) is a life-threatening diabetic condition caused by deficiency in insulin and results in severe hyperglycemia (Sinclair, 2009, p. 198). Diabetic ketoacidosis usually occurs in younger people with type 1 diabetes. Fortunately, older diabetics are less prone to DKA although a few cases exist (Roach, 2001, p. 324). Assessment Elderly people req uire individualized assessment ranging from simple screenings to in-depth evaluations. Health providers, particularly the nurses must be very knowledgeable and skillful in detecting deviation among elderly (Wold, 2004, p. 105). In the clinical scenario stated, the man is approximately in mid-sixties of age. The man is confused upon bringing him to the emergency department. He was not able to provide any information about himself or his condition so the staff called him Nic. He kept on insisting to leave the department and go home for dinner yet was unable to state his address. The hygiene was described as poor due to disheveled and unkempt condition. His appearance and odor suggested that he had not washed for some time and his breath had an acetone odor. The client frequently scratched his right upper arm and examination revealed that he had a hematoma (50 cents size) on the right side of his forehead and he repeatedly stated that he wanted to pass urine. Base on observation, the p atient has an indication of a fall due to hematoma; possible concussion due to confusion is exhibited. Nursing assessment undertaken are measuring of vital signs for blood pressure elevation and tachycardia, blood glucose level for determining hyperglycemia, neurological observations such as Glasgow coma scale to determine the client’s mental state, and mini-mental state examination (MMSE) for possible dementia (Melillo, 2011, p. 279). Plan of Care The plan of care for Nic depends upon the nursing diagnosis that has been found out and has been prioritized according to the assessment findings. The nursing diagnosis and each plan of care are elaborated below: Nursing Diagnosis #1: Risk for Injury related to unfamiliar environment and physical or mental limitations secondary to disease condition Assessment: The client is confused and unable to provide information of previous environment. He frequently scratched his right upper arm and has a fifty cents-size hematoma. Expected Ou tcome: The client will be free from further injury. Interventions and Rationales: 1. Orient the client to his environment. Orientation helps provide familiarity. 2. Instruct the client to wear slippers with nonskid soles and to avoid newly washed floors. These precautions can help prevent foot injuries and falls from slipping. 3. Teach him to keep the bed in the low position with side rails up at night. The low position makes it easier for the client to get in and out of the bed. 4. Make sure that personal belongings are within easy reach. Keeping objects at hand prevent falls from overreaching and overextending. 5. Instruct the client to request assistance whenever needed. Getting needed help with ambulation and