Assignment: Pathophysiology and Nursing Management of Clients Health

Assignment: Pathophysiology and Nursing Management of Clients Health

Assignment: Pathophysiology and Nursing Management of Clients Health

Pathophysiology and Nursing Management of Client’s’ Health

 Nurses rely on the presented clinical manifestation and medical history in their assessment. Both subjective and objective data indicate possible clinical conditions, thus providing a nurse practitioner with the basis for conducting a further evaluation, which leads to appropriate management. This discussion will focus on Mr. M’s case, including clinical manifestation, medical diagnosis, abnormalities that might occur during the nursing assessment, the physical, psychological, and emotional impacts, interventions for support, and actual problems experienced by Mr. M to his current health status.

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Clinical Manifestations of Mr. M.

Mr. M. portrays various clinical manifestations, which are represented by both subjective and objective data. First, the subjective data indicates that the client is having difficulty in recalling family members’ names. He is also experiencing a challenge in remembering his room. Consequently, the care providers have found him wandering at night looking for someone to show him his room. He gets lost frequently if he is not assisted in tracing his room. He cannot repeat something that he has just read. He also seems to become aggressive and agitated quickly. The aggressiveness is accompanied by being fearful and afraid. Besides, Mr. M has become dependent on performing some tasks that he could a few months ago. Secondly, objective data indicates that Mr. M has a relatively high blood pressure of 123/78.

Medical Diagnosis

            Mr. M’s clinical manifestations illustrate the possibility of various medical manifestations. A condition known as Alzheimer’s should be considered as the primary medical diagnosis for this client. Alzheimer’s is a mental condition, which is common in individuals aged 65 and above. Thus, being 70 years old increases the risk of developing this condition. According to DSMV, Alzheimer’s disease is mainly characterized by loss of memory and confusion. Individuals diagnosed with these people cannot recognize people with who they were familiar, including their close relatives (Joe & Ringman, 2019). More so, individuals diagnosed with this condition also become dependent on their caregivers or family members. Mr. M. demonstrates these symptoms. He has been having difficulty in recalling family members’ names. He is also experiencing a challenge in remembering his room. Consequently, he gets lost frequently if he is not assisted in tracing his room. Mr. M again cannot repeat something that he read a while ago. Besides, the client has become dependent on performing his daily tasks such as dressing and feeding himself, which he could do some months comfortably back. In addition to cognitive symptoms, Alzheimer’s disease is characterized by behavioral symptoms, including aggression, agitation, and irritability. These symptoms are demonstrated by Mr. M, who seems to get aggressive and agitated quickly.

The secondary medical diagnosis for Mr. M should be high blood pressure. The client had a blood pressure of 123/78, which portrays his high blood pressure. The systolic and diastolic indicate someone’s blood pressure. The blood pressure of 123/78 implies that the systolic pressure and diastolic pressure are 123 and 78. The normal systolic blood pressure should not exceed 120. A value above 120 indicates high blood pressure. Additionally, diastolic blood pressure should not exceed 80. A value above 80 portrays hypertension. The values of systolic and diastolic blood pressure should be within the normal range. Although diastolic blood pressure (78) is within the normal range, his systolic pressure (123) is above the normal range, indicating high blood pressure. Additionally, Mr. M has a medical history of hypertension, which he controls using ACE inhibitors, thus increasing this condition’s risk.

Explanation of Expected Abnormalities During Nursing Assessment

            Some abnormalities are likely to be experienced during nursing assessment. First, the subject data is expected to be incorrect or vital details might be omitted. Most of the information is given by the care provider since Mr. M cannot remember his medical history due to memory loss. Therefore, the assessment will be based on what is observed about the client rather than his expression about what he is feeling or experiencing. Secondly, the value of blood pressure is likely to be high at 123/78 due to nonadherence to the prescribed medication. Having a history of hypertension, the client has been using ACE inhibitors to control this condition. Loss of memory might have resulted in skipping the drug or taking inappropriate dosage, making his blood pressure rise.

The Physical, Psychological, and Emotional Impacts

            Mr. M’s current health status has various impacts on him and his family. First, his health status has multiple physical effects, inducing loss of coordination or balance, difficulty sitting upright or standing, stiff and weak muscles, and inability to control the bladder or bowels. The client’s health status is also associated with various psychological effects such as depression, hallucination, or paranoia. According to Bemelmans et al. (2016), Alzheimer’s disease is associated with some psychological effects. Thirdly, Mr. M’s health status has some emotional impacts such as anger, general discontent, apathy, loneliness, or mood swings. In addition to affecting the client, Mr. M’s current health status impacts his family. His family will be affected financially, psychologically, and emotionally. The family members will spend their financial resources to fund Mr. M’s care services. Additionally, some family members will have to forego their income-generating activities to take care of Mr. M since he has become highly dependent since he cannot take care of himself anymore. For instance, he requires someone to dress, feed, and show him around the facility. The primary psychological effects include being depressed and stressed upon seeing how he is deteriorating quickly. Lastly, his health status will have an emotional impact on his family. The family members might be sad or sympathize with him.

Interventions for Support

            Various interventions can be adapted to support Mr. M. and his family. First, Mr. M’s health issue can be resolved through pharmacological treatment. The patient should be prescribed Acetylcholinesterase inhibitors (AChEI). These drugs are recommended as the first treatment of this condition due to their capacity to lower acetylcholine in the brain (Bishara et al., 2015). Thus, behavioral and psychological symptoms are anticipated to decline after taking the medication for some weeks. In addition to medicines, non-pharmacological interventions should be used to support the patient and his family. Fists, Mr. M and his family, should be educated to create awareness about Alzheimer’s disease, its symptoms, diagnosis, and progression. They should also be provided with more information sources to enable them to read widely to cope with the condition. Additionally, the client should be referred to groups such as the Alzheimer’s Association for further education and support.

Actual Problems

            First, Mr. M faces the challenge of forgetting people’s names and places due to memory loss. According to Joe and Ringman (2019), memory loss makes it hard for people diagnosed with Alzheimer’s disease to remember places and people who were familiar to them. Secondly, the client faces the challenge of taking care of himself since patients with Alzheimer’s disease tend to become dependent. Moreover, it’s challenging for Mr. M to move around due to unsteady gait and difficulty ambulating. Finally, the client experiences difficulty in taking his current medications appropriately due to memory loss.

Conclusion

Subjective and objective data indicate various clinical manifestations, including loss of memory, agitation, and high blood pressure. These symptoms lead to the client being diagnosed with Alzheimer’s disease and high blood pressure as the second diagnosis. However, some abnormalities were experienced during clinical assessment due to the client’s inability to provide subjective data due to loss of memory. The condition has physical, psychological, and emotional impacts on the clients. Additionally, it has financial, psychological, and emotional effects on the family members. Both pharmacological and non-pharmacological interventions are effective in supporting the patient and his family members.

References

Bemelmans, S. A. S. A., Tromp, K., Bunnik, E. M., Milne, R. J., Badger, S., Brayne, C., … & Richard, E. (2016). Psychological, behavioral and social effects of disclosing Alzheimer’s disease biomarkers to research participants: a systematic review. Alzheimer’s research & therapy, 8(1), 1-17.

Bishara, D., Sauer, J., & Taylor, D. (2015). The pharmacological management of Alzheimer’s disease. Progress in Neurology and Psychiatry, 19(4), 9-16.

Joe, E., & Ringman, J. M. (2019). Cognitive symptoms of Alzheimer’s disease: Clinical management and prevention. BMJ, 367.

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Evaluate the Health History and Medical Information for Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

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 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.

Case Scenario

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 will frequently become lost, needing help to get back to his room. Mr. M has become dependent with 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.

Objective Data

Temperature: 37.1 degrees C
BP 123/78 HR 93 RR 22 Pox 99%
Denies pain
Height: 69.5 inches; Weight 87 kg
Laboratory Results

WBC: 19.2 (1,000/uL)
Lymphocytes 6700 (cells/uL)
CT Head shows no changes since previous scan
Urinalysis positive for moderate amount of leukocytes and cloudy
Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L
Critical Thinking Essay

**In 750-1,000 words, critically evaluate Mr. M.\’s situation. Include the following:

Describe the clinical manifestations present in Mr. M.
Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.
When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
Describe the physical, psychological, and emotional effects Mr. M.\’s current health status may have on him. Discuss the impact it can have on his family.
Discuss what interventions can be put into place to support Mr. M. and his family.
Given Mr. M.\’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

***This assignment uses a rubric***. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.