CLC – Evidence-Based Practice Project: Intervention Presentation on Diabetes Part 1 Assessment Description This is a Collaborative Learning Community (CLC) assignment. As a group, identify a resea

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Introduction:

The given assignment is a part of a Collaborative Learning Community (CLC) project focusing on a research or evidence-based article published within the last 5 years that comprehensively explores a specific intervention or new treatment tool for the management of diabetes in adults or children. Additionally, the assignment involves evaluating the health history and medical information of a patient named Mr. M. who is a 70-year-old male resident of an assisted living facility. The critical thinking essay assignment requires the student to analyze Mr. M.’s situation and critically evaluate it based on various clinical manifestations and medical data.

Question 1:

Describe the subjective and objective clinical manifestations present in Mr. M.

Answer:

Mr. M. is experiencing various subjective and objective clinical manifestations that indicate an overall deterioration of his health. The subjective manifestations include difficulty recalling family members’ names, room numbers, and retaining new information. He is becoming increasingly agitated and aggressive and feels afraid and fearful during these episodes. He is also experiencing fear when he is lost and requires help finding his way back to his room. The objective manifestations include the following:

1. Temperature: 37.1 degrees C
2. Blood pressure: 123/78 mmHg, Heart rate: 93 beats per minute, Respiratory rate: 22 breaths per minute, Oxygen saturation: 99%
3. Mr. M. denies pain
4. Height: 69.5 inches; Weight: 87 kg
5. Laboratory results: WBC count: 19.2 (1,000/uL), Lymphocytes count: 6700 (cells/uL), CT Head: no changes since previous scan, Urinalysis: moderate leukocyte and cloudy, Protein: 7.1 g/dL, AST: 32 U/L, ALT: 29 U/L

Question 2:

Based on the information presented in the case scenario, state what primary and secondary medical diagnoses should be considered for Mr. M. Formulate a nursing diagnosis from the medical diagnosis and explain why these should be considered and what data is provided for support.

Answer:

Based on the given information, the primary medical diagnosis for Mr. M. could be Alzheimer’s disease or another form of dementia. The secondary medical diagnoses could be urinary tract infection (UTI), leukocytosis, hyperproteinemia, and mild liver function test abnormalities. The nursing diagnosis could be ‘Acute Confusion related to the neurological effects of Alzheimer’s disease or another form of dementia’. This diagnosis is supported by the patient’s subjective and objective manifestations, such as difficulty recalling information, becoming increasingly agitated and aggressive, and getting lost frequently. Additionally, the laboratory results demonstrate the presence of moderate leukocytes and cloudy urine, which are indicative of a UTI.

Question 3:

What abnormalities would you expect to find and why when performing your nursing assessment using the identified primary and secondary medical diagnoses?

Answer:

When performing a nursing assessment of Mr. M. using the primary and secondary medical diagnoses identified, the following abnormalities might be expected:

1. Cognitive impairments: This may include memory loss, difficulty with language, inability to perform simple tasks like dressing or feeding oneself, disorientation, or confusion.

2. Behavioral changes: This may include agitation, aggression, anxiety, depression, or social withdrawal.

3. Sleep disturbances: The patient may have difficulty sleeping or may become restless during the night, leading to daytime sleepiness.

4. Physical symptoms: The patient may experience changes in appetite, weight loss, or gain, reduced mobility, falls due to unsteady gait, or infections such as UTIs.

These abnormalities are common in patients with Alzheimer’s disease or another form of dementia, and Mr. M.’s clinical manifestations are consistent with these diagnoses.

Question 4:

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.

Answer:

Mr. M.’s current health status may have several physical, psychological, and emotional effects on him. The physical effects of dementia, such as memory loss and confusion, can result in difficulty managing daily activities, including self-care and meal preparation. Patients with dementia may also become at risk of falls, infections, or injuries. It can lead to reduced mobility and dependence on caregivers for support.

The psychological effects of Mr. M.’s condition could include confusion, anxiety, depression, agitation, and aggressive behavior. These changes can cause distress and frustration, making it more challenging for Mr. M. to interact with others in his social environment. The emotional effects of dementia may include feelings of sadness, frustration, loss of self-worth, and confusion.

The impact of Mr. M.’s health status could also extend to his family, who may need to provide him with additional care and support. Caregivers can experience significant psychological and emotional stress and may require additional resources and support to manage their caregiver role successfully.

Question 5:

Discuss what interventions can be put into place to support Mr. M. and his family.

Answer:

Several interventions may be put into place to support Mr. M. and his family, including:

1. Cognitive stimulation therapy: This therapy can help improve memory, problem-solving, and communication skills for patients with dementia.

2. Improved communication: Communication strategies can be developed to meet Mr. M.’s cognitive and sensory needs, such as clear and simple language, using visual aids, and avoiding distractions.

3. Behavioral management: Strategies such as redirection, therapeutic touch, or calming the patient’s environment can be used to manage Mr. M.’s agitation and aggressive behavior.

4. Caregiver support: Family members can receive caregiver training, respite care, and counseling to manage their caregiving responsibilities.

Question 6:

Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide a rationale for each.

Answer:

Mr. M. faces several actual or potential problems, including:

1. Risk of falls and injuries: Mr. M. is experiencing an unsteady gait, making him more prone to falls and injuries.

2. Risk of infections: Mr. M.’s clinical manifestations indicate an increased risk of developing infections such as UTIs or pneumonia.

3. Nutrition deficits: Mr. M. could face malnutrition or dehydration due to difficulty eating or drinking.

4. Social isolation: Mr. M.’s condition may lead to social isolation due to difficulty engaging with others, leading to loneliness and depression.

These problems are common in patients with dementia and require appropriate interventions to mitigate their impact.