Centennial CollegePNUR 104

Ms. Jessop, a 68-year-old woman lives alone and has lived alone since her husband died 20 years ago. She does not have any children but she lives close to her younger sister, Mary. Ms. Jessop lives in a small two-storey house in the country. She was recently discharged from the hospital following rehabilitation for a fractured right femur after falling on the ice approximately 6 weeks ago. Her home has a small kitchen with a gas stove where she loves to cook. She states she has a good appetite, "so I have to cook my own food." Although she is concerned about how she will manage with meal preparation now that she is home, she refused her sister's help.

Since returning home, Ms. Jessop states that she occasionally feels weak and unsteady on her feet. She tends to forget things more often now. Yesterday she forgot the pot on the stove and only remembered when the fire alarm went off. She loves to drink tea "I like it piping hot," she states. Today she fills up the bath tub and steam could be seen coming from the water before she got in. She is still able to do her ADL's, every other Saturday she irons her sheets before replacing them on the beds. The iron cord looks worn but she refuse to replace it, "it works just fine," she told the nurse when the nurse suggested that she gets a new iron.

Ms. Jessop has been an active member of her community. She belongs to a senior's daily walking group and previously attended water aerobics classes three times a week at her local community pool. She enjoys attending her weekly church group. Ms. Jessop states she is worried that she may not be able to continue these activities.

 

Identify One Priority Nursing Diagnosis

?Develop (2) Expected outcomes (Patient Goals) based on your priority diagnosis

?Determine Two (2) Nursing Interventions for each expected outcome 

?Provide Rationales for each intervention using reference to support your answers

Answer:

Several conditions can cause memory loss in older adults, and thus getting an apt diagnosis and appropriate care is essential. In the case of Ms. Jessop, one priority nursing diagnosis would be that of Alzheimer's disease or Dementia. This would be attributed to her frequent memory loss and general body weakness.

Step-by-step explanation

This would be attributed to her frequent memory loss and general body weakness. However, in some degree of memory issues and a modest decline in other cognitive abilities is objectively a mutual aspect associated with aging. Memory loss that tends to disrupt daily life involvements of an individual is a likely symptom of Dementia or Alzheimer's (Rockwood et al., 2017). 

The condition is a brain syndrome that grounds slow decline in memory. The expected patient goals for Ms. Jessop based on Alzheimer's would be that of improving the quality of life and that of her caregivers. Subsequently, other goals of the condition include fostering a safe environment and promoting social engagement. These goals are essential since they aid in connecting the patient with the family and the society at large. 

Additionally, Alzheimer's disease necessitates various nursing conditions. In Ms. Jessop case the first intervention towards improving the quality of her life would be to assess her ability for thought dispensation every single shift as well as monitoring her cognitive functioning, disorientation, memory changes, and changes in the thinking patterns. 

The rationale to evaluate the intervention would be to check if they are changes in status which will indicate advancement of deterioration or enhancement in condition. Subsequently, assessing the level of cognitive disorders for instance change to orientation to individuals, range, time, places and thinking skills is essential (Atri, 2019). 

The rationale being that of providing for the monitoring and evaluation or comparison that will emerge as well as influencing the choice of intervention. Other necessities for Ms. Jessop would be a living will, planning for self-centered patient care, and preferences for end-of-life care. 

References

Atri, A. (2019, April). Current and future treatments in Alzheimer's disease. In Seminars in neurology (Vol. 39, No. 02, pp. 227-240). Thieme Medical Publishers.

Rockwood, K., Howlett, S. E., Hoffman, D., Schindler, R., & Mitnitski, A. (2017). Clinical meaningfulness of Alzheimer's Disease Assessment Scale-Cognitive subscale change in relation to goal attainment in patients on cholinesterase inhibitors. Alzheimer's & Dementia, 13(10), 1098-1106.