Nursing Informatics
The scenario described herein is in grounded in geriatric medicine, and utilizes the NANDA, NIC, and NOC elements to link the various components in standardized language to the data, information, knowledge, and wisdom associated with this exercise. The key parts of the paper are as follows: 1) Introduction; 2) nursing diagnosis (NANDA), including actual diagnosis, risk diagnosis, and wellness diagnosis; 3) nursing outcomes classification (NOC); 4) nursing interventions classification (NIC); 5) conclusions.

Case Presentation

The patient is an elderly woman with early stage dementia, who reports her age as 87 years. The patient's family brought her to the clinic because she has been complaining of malaise and refuses to receive help with dressing, both of which are unusual for the patient. Vitals were taken and all are within normal range, except that the patient had a temperature just above 37.9C. Examination revealed that the patient was experiencing suprapubic pain and costovertebral….

Client Evaluation
The client is a 78-year-old female. She has been divorced for 30 years. She is retired. Her social class is upper middle class. Her medical history is free from significant trauma. She had six hospitalizations, all for childbirth, and one surgery; a cesarean section combined with a tubal ligation. She has two chronic health conditions: high blood pressure and chronic obstructive pulmonary disease (COPD). She is a former smoker. She lives with an adult son and her other children live nearby. She was a domestic violence victim for the 20 years of her marriage and has some lingering physical problems (an improperly healed broken rib) and emotional problems from that period of abuse. Her parents, a younger brother, and two of her children predeceased her.

Medical Issues

The patient is not currently suffering from any acute medical issues. She does have two significant chronic medical issues: high blood pressure and COPD.….

Geriatric Patient Assessment
Temperature

Pulse

espiration

Blood Pressure: 110/70

Pulse Oximetry: 97% on room air

General Appearance: Fairly good, decently nourished. Non-toxic, Ambulatory female

Mental Status: Patient is alert and fully oriented times 3 . . . .Glasgow coma scale is

Abdomen: Benign

Heart: Mild tachycardia

Lungs: Clear, no noticed issues

Extremities: Pulses are symmetric and seem to be intact

Known Issues/Comorbidities: Type II (Adult Onset) Diabetes, family history of heart disease and arthritis

2A) MMSE will be attached

Pulled from: http://www.dementiatoday.com/wp-content/uploads/2012/06/MiniMentalStateExamination.pdf

2B) KATZ Index will be attached

Pulled from http://micmrc.org/system/files/11.2-ADL.pdf

Vitals fairly in line what is expected a normal for patient of this age, family/patient history of type II diabetes but fairly well controlled, mild arthritis but decently controlled, no sign of heart disease despite family history

4) Patient is putting on a little weight, lives a mostly sedentary lifestyle (but not abnormally so for age bracket), diet a bit substandard based on what is self-reported

5) See goals below where abnormal challenges are listed

6) Four interventions would….

Geriatric Population
hat is the best way to assure that older people are well cared for in an acute healthcare setting? hat are the roles that nurses should play when it comes to providing the best possible care to older, frail people? These questions will be addressed in this paper using scholarly research from the available literature.

Advanced nursing skills for frail older people

Sarah Goldberg is a senior clinical academic nurse at the University of Nottingham's University Hospitals, and she writes in the journal Nursing Older People that an "innovative solution" in terms of providing the necessary skilled care to older people is to train experienced nurses to become "advanced nurse practitioners (ANPs) (Goldberg, 2014). An advanced nurse practitioner will be able to conduct comprehensive geriatric assessments, which will be important given that many very old and frail patients have "cognitive impairment, depression and anxiety," which can lead to a sense….

Monitoring Home Medication AdministrationIntroductionMonitoring home medication administration for the elderly is essential because this population is at higher risk for medication-related problems due to several factors, including age-related changes in pharmacokinetics and pharmacodynamics, the presence of multiple chronic conditions, and the use of multiple medications. In addition, elderly patients may have cognitive impairments, functional limitations, and social isolation, which can further increase their vulnerability to medication errors and adverse drug events. Monitoring home medication administration for the elderly is essential because this population is at higher risk for medication-related problems due to several factors, including age-related changes in pharmacokinetics and pharmacodynamics, the presence of multiple chronic conditions, and the use of multiple medications. In addition, elderly patients may have cognitive impairments, functional limitations, and social isolation, which can further increase their vulnerability to medication errors and adverse drug events.The MCIOne tool that is used for monitoring home medication administration for….

The Argument -- She Could be Given a Transplant

I could not find a prohibition against liver transplants for those 70 or over, but there is a good deal of information in the literature supporting transplants for older people. In the PubMed section of the National Institutes of Health a study of 1,446 "consecutive liver transplant recipients was conducted" and 241 elderly patients (over 60) in that group were compared with younger counterparts. The conclusion: "Low-risk elderly patients fare as well as younger patients after liver transplantation" (Levy, et. al, 2001).

Meanwhile, Dr. Gerald S. Lipshutz, assistant professor of surgery at the David Geffen School of Medicine at the University of California reports the results of the findings at the orld Transplant Congress in 2006. In a study of 62 patients (Group I) between the ages of 70-79 that had received liver transplants -- compared with a group of 864 patients getting….

hospitals profits come from the cardiology department. One key strategy the hospital should adopt is specializing for growth. Not only has the rise in specialty hospitals increased in the last few years, but it has also enabled hospitals facing stiff competition to maintain or gain new patients. A specialized care strategy must be adopted for proper implementation of strategy. Hospital administrators in this role have to take the time to examine potential or existing specialty healthcare providers within the community. By identifying an area of opportunity, it becomes much easier put into effect a strategic plan that will gain the hospital national and even worldwide recognition.
Specialty hospitals satisfy the needs of a specific population. In the case of the hospital, those are elderly patients with cardiac problems. By examining if the local demographics match this population group, hospital administrators can then focus their attention on recruitment of specialized personnel….

Elderly Falls
With the help of a thorough clinical evaluation, the risk factors, risks associated with falling and working out adequate intervention methods to curb the rate of elderly falls can be achieved. As per the 2011 AGS / BGS guidelines, (Panel on Fall, 2011) certain particulars need to be incorporated in a particular clinical evaluation: 1: Patient history, physical examination, mental and physical functionality; 2: Number of falls occurring, number of medications taken; issues regarding mobility, balance and gait; blurred eyesight; various mental disabilities; weak muscular strength; uneven heartbeat and rhythm; postural hypotension; problems in feet and risks related to environment (Shubert, 2014).

Strategies to Prevent Elderly Falls and Health elated Consequences

Assistive Devices and Other Protective Equipment: Appropriate footwear is required for particular conditions, for instance, wintery weather necessitates anti-slip shoes whilst warmer weather requires cleated footwear, facilitating decreased falls (Panel on Fall, 2011).

Clinical Disease Management (Acute and Chronic Illness): Using….

Patient Access to Experimental Drugs
Experimental drugs are being used in treating cancer and other life-threatening diseases in the hopes that effective cures and treatments can be identified. There are however, ethical questions relating to the use of experimental drugs and this work seeks to answer the question that asks whether patients should have access to experimental drugs and to answer why or why they should not have this access.

Experimental Drugs

Experimental drugs have carved inroads to treating cancer patients and most recently; this has been reported in the form of a drug that serves to "neutralize two mechanisms cancers need to survive." (Coghlan, 2012) The new drug is Cabozantinib. This drug is reported by one individual interviewed in this study to have been used by a family member who died while taking the drug for non-small cell carcinoma in the form of lung cancer. When asked the question of how this….

Patient Assessment
DIAGNOSIS AND TREATMENT PLAN

Diagnosis and Disease Processes

Using an appropriate patient assessment form (Sample Forms, 2013), D.M. has been found to have uncontrolled Type 2 diabetes, hypercholesterolemia, uncontrolled hypertension, chronic anemia, and probable hypothyroidism (Sample Forms).

Diabetes Type 2

is most probably on a poorly controlled diet of high cholesterol and high simple sugars. Diabetes mellitus type 2 is a metabolic disease wherein the body is not able to properly use ingested food because of insulin resistance. If more simple or refined sugars are consumed, the less the body is able to process them as nutrients. These tend to stay and float in the blood stream, un-used, and in this condition, they cause trouble in the different parts of the body. These include the end organs, such as the brain, the eyes, the kidneys, the heart, and even the feet. A poorly controlled diet and the lack of physical activities in many….

The results of this analysis highlight the need for hospitals to fine-tune their discharge process to reduce readmissions, and support the expenditure of additional resources for this purpose as a cost-effective intervention; as an example, author cites a hospital in Iowa that implemented a rigorous post-discharge planning process for patients with heart failure and 30-day readmission rates were reduced by 3-9% during the 3-month period following implementation.
Conclusion

The research showed that many elderly patients who suffer from congestive heart failure also suffer from a wide range of comorbid conditions, including diabetes and hypertension. These patients can be reasonably expected to require periodic or even frequent treatment in emergency departments and/or hospitalizations for these conditions, making the need for effective and seamless post-discharge planning especially important. In this regard, the research also showed that there are some valuable evidence-based practice guidelines available, though, that can help clinicians better coordinate post-discharge care,….

Difficult Patients
Mitigating isks from Dementia

Providing adequate care for an individual suffering from dementia presents many difficulties for nurses. Patients with dementia often have debilitating conditions such as Alzheimer's or similar neurologic diseases which are progressive, thereby making it challenging for them to remember, think lucidly, communicate effectively or complete activities of daily living. Furthermore, dementia can cause rapid variations in mood or even modify personality and behavior. With the tremendous number of elderly in society more and more nurses are required to care for patients with progressive dementias. It is imperative that a diagnosis be reached early in the course of the cognitive impairment and that the patient is closely monitored for coexisting morbidities. Nurses have a central role in assessment and management of individuals with progressive dementia. This essay provides some evidence-based practical strategies for managing the behavioral problems and communication difficulties often encountered in this population.

I currently….

Nurse-Patient Relations
The main focus of this essay is going to concern the nurse-patient relationship idea, and why it is important. This was chosen because the researcher desired to achieve a better accepting of how a helpful nurse-patient relationship can be advanced and even from different theorists who have discovered this idea. In this essay, the researcher sets out to demonstrate what they have learnt regarding the nurse-patient relation concept and how this connection can utilized in the clinical practice setting. T The nurse patient connection, according to a study done by Press Gamey Associates Inc., creates the quality of the care experience and generates an influential influence on patient gratification. Nurses will a lot of their time with patients. Patients see nurses' relations with people among the care team and make their own conclusions about the hospital founded on what they are observing. Furthermore, nurses' approaches toward their vocation, those….

Treatment to Patients
The main objective of providing treatment to patients is to relieve symptoms along with decreasing the progression of the disease as well as the mortality or morbidity. However, in some cases, this objective is not fully achieved, especially in the case of the patients who are admitted to the ICU with some serious and almost always a terminal stage of the disease. For example, when old patients are admitted in the ICU, their immunity is extremely low and this is the perfect time for the opportunistic infections to make matters worse for these patients. There are many infections that are specifically associated with patients admitted in the hospitals. Pseudomonas Aurigeonosa is a micro-organism that is well documented to cause bacterial pneumonia and bacteremia in the patients who are terminally ill and are receiving treatment in the hospital setting. Since most of the patients in the ICU are….

" (Stone, 2006) Treatment is stated by Stone (2006) to be "diagnosis dependent and may be medical or surgical." Practical modifications include simple steps such as crushing of pills or opening of capsules to ease and facilitate swallowing.
The work of Leibovitz, et al. (2007) entitled: 'Dehydration Among Long-Term Care Elderly Patients with Oropharyngeal Dysphagia" states that long-term care (LTC) residents in the nursing home "especially the orally fed with dysphagia are prone to dehydration. The clinical consequences of dehydration are critical. The validity of the common laboratory parameters of hydration status is far from being absolute, especially so in the elderly." (Leibovitz, et al., 2007) it is related however that "combinations of these indices are more reliable." (Leibovitz, et al., 2007) the study reported by Leibovitz et al. is one that assessed hydration status among elderly LTC residents with oropharyngeal dysphagia and in which a total of 28 orally fed….

1. The impact of technology on the nursing profession
2. The role of emotional intelligence in nursing practice
3. The importance of evidence-based practice in nursing
4. The ethical dilemmas faced by nurses in healthcare settings
5. The challenges of caring for elderly patients in nursing homes
6. The role of cultural competency in providing nursing care
7. The impact of nursing shortages on patient care
8. The importance of effective communication in nursing practice
9. The role of nursing leadership in improving patient outcomes
10. The benefits of interdisciplinary collaboration in healthcare settings.
11. The role of nursing education in shaping the future of....