John Grant has been diagnosed with the bilateral knee osteoarthritis who is 63 years of age. He was under medication as prescribed by his GP but was advised to go for the Knee replacement for both right and left legs. Though he recovered from the operation he has the history of suffering from angina, hypertension, hyperlipidemia, depression, and type 2 diabetics. He used to work in his café earlier, but now it is managed by his elder daughter and his household work is managed by him but help is offered by his son and daughter in law (Bae, et al., 2014).
Pathophysiology can be defined as the term which deals with the etiology, development, and the elimination of the pathological processes. In addition to this, the processes underlying these basic mechanisms are contributed by this, model systems and the approaches that are interdisciplinary are encouraged strongly.
Discussion of medical history and family
John Grant was being medicated with Endone 5 mg prn under the GP prescription but because of these bad conditions of pain he was suggested for the right knee replacement and plan was made for the left knee also. He completely recovered from the first operation and had the history of some other complexities of health (Bae, et al., 2014). His social environment was absolutely fine as he was taken care by his elder daughter who helped in taking care of the café. His son and daughter in law are helping him with the household work and cooking. His family consists of an elder daughter who is with the workload in the café and son and daughter in law who are in support to John Grant (Breimaier, Halfens & Lohrmann, 2015).
Identify and discuss risk factors for respiratory infection
It is not possible to get rid of the viruses and bacteria, yet there are certain factors of risks such as social, environmental, and economic factors which are involved in developing the acute respiratory infection. The immune systems of the adults of old age and children are highly prone to viruses (Carlson, 2014). It can be contacted through virus carriers. The virus can be spread from the environment if the sanitary conditions, neatness, and tidiness are not maintained. Individuals with the lung problems and heart disease are likely to be affected with a respiratory infection. The risk is also caused if the immune system is weakened by any other diseases.
In the literature published by Carlson, the study found that the socioeconomic and environmental factors are associated with the respiratory infections. The results from this study are pointing towards the potential areas of involvement in which campaigns of the community regarding the respiratory infection symptoms are included (Carlson, 2014). Many strategies have been initiated for reducing the poverty in which the modern stove distribution and the rural electrification are included which might be useful in reducing the dirty way of cooking fuel, enhancing the living conditions, and reducing the barriers to the health care in the future.
The critical care patient has to be conducted with the principles of the bedside assessment according to the patient condition in the current report. This type of assessment is considered to be the important skill of nursing which will integrate the history knowledge of taking and the physical assessment of the patient (Drageset, et al., 2015). Since the patient, in this case, is having the strong history of ill health the ABCDE approach and the head to toe assessment are necessary. In addition to this, the specific screening and the assessment tools for the comprehensive mental health assessment is included.
In the current situation of the patient, the risk assessment can be considered to be the careful tool of making the decisions for comparing the options and the study that is needed for reducing the risk measures. This is chosen because the patient is suffering from knee pain and the decision of replacing the both knees was appropriate if it was not taken at the right time in a right way he would have suffered a lot (Drageset, et al., 2015). The other risk assessment is patient safety it is because he has the strong history of other health problems so for his safety he has been treated at the right time where the risk of consequences and the associated uncertainties are avoided.
Compare and contrast differing views
John Grant after getting treated for his knee pain problem, he has joined the ward for further care of his ill health. The patient who has been hospitalized has to be monitored regularly for their betterment. The falls is considered to be the serious problem for this patient, reducing his quality of life and the duration. Some of the falls tools for risk assessment were developed and was tested while others have the serious validity discrepancies. So it is suggested to determine the accuracy of the instruments in detecting the fall risk and to predict the falls for the patients.
In assessing the risk of falls the STRATIFY scale has been found to be the best tool for the patients will ill health. With the help of this scale, it was found that that the DOR was high when compared with that of MFS and HFRM II. However, the behavior of these instruments will be varying considerably based on the environment and the population. Hence, before implementation, their operations are to be tested (Drageset, et al., 2015). For reassessing the instruments with regards to the ill patients and the actual compliance of the personnel health care with the procedures that are related to the safety of the patient the effect has to be investigated.
Healthcare needs: For meeting the needs of the client, in this case, the things that benefit his health such as prevention of the disease, diagnosis in the early stage, appropriate treatment, terminal care, etc. are to be provided. Most of the nurses believe that the need of the patient is in terms of healthcare services, but from the view of the patient, it is the things that will make them be healthier (Simmons, et al., 2015).
Health needs: The health needs will be incorporating the broad range of determinants of health in terms of social and environmental factors such as employment, diet, housing, etc. In the population, the health needs will be changing constantly and most of them will not be agreeable to the medical intervention (Toles, et al., 2014).
Plan to prevent a postoperative respiratory infection
The evidence-based practices are to be organized by the critical care nurse for preventing the post-operative respiratory infection. The risk factors of the patient have to be assessed and they are to be closely monitored which is the part of the prevention. The strategies of preventing the post-operative respiratory infection in the clients should be in the form of care bundles which has to be structured for improving the outcomes of the patient (Hirst & Cole, 2014). It is very important that the patient should be educated regarding the following five key interventions which have been proven to decrease the infection in the client. The following interventions are included in the care bundle for effectiveness:
The post-operative respiratory infection is known to be influenced by a varied number of risk factors that has become very much relevant in the clients who are mostly exposed to the hospital-borne environment. Most of the risk factors can be modified and by creating awareness about these factors, along with the attempts of limiting its occurrence will help in reducing the HAP rates (Carlson, 2014). These risk factors can be categorized into 3 mechanisms such as the aerodigestive tract will be colonized with the pathogenic bacteria, taking in the secretions that are contaminated, and host defenses being impaired because of the critical illness.
The post-operative respiratory infections in patients are suspected usually when the client is developing the progressive pulmonary infiltrate along with fever, leucocytes, and the tracheobronchial secretions (Carlson, 2014). However, these criteria of a clinical trial are considered to be non-specific for diagnosing the post-operative respiratory infection in the client and hence numerous things which have noninfectious which been causing the fever and the infiltrates of pulmonary which are to be considered.
The interpersonal collaboration in health care is found to show the improvements in the outcomes of the patient. If the patient experiences the relocation of the place, then the social and the environmental conditions will be helping in enhancing the ill health conditions of the patients (Carlson, 2014). This will be helpful in optimizing the dosages of medication by providing the moral support at the care center by nurses, doctors, co-patients, etc. the providers of health care are also benefitted in which the extra work is reduced and the job satisfaction will be increased.
Strategies to evaluate plans of care
The evaluation is the final step which is used for determining the expected outcomes regarding the plan of caring by the nurses. It is evaluated by testing whether the well-being of the patient is improved or not. It is evaluated whether the caregiving by the nurse is effective or not. The outcomes that are expected is considered to be the standards against which the goals of the nurses are judges of being met or not and is the care successful (Breimaier, Halfens & Lohrmann, 2015). The plan of care is evaluated by estimating on providing the health care in a timely, competent and the cost effective manner. The process of evaluation will be determining the effectiveness of the care given, make any modifications that are necessary, and to consistently make sure for favorable outcomes of the clients (Breimaier, Halfens & Lohrmann, 2015).
Bae, S. H., Kelly, M., Brewer, C. S., & Spencer, A. (2014). Analysis of nurse staffing and patient outcomes using comprehensive nurse staffing characteristics in acute care nursing units. Journal of nursing care quality, 29(4), 318-326.
Boockvar, K., Signor, D., Ramaswamy, R., & Hung, W. (2013). Delirium during acute illness in nursing home residents. Journal of the American Medical Directors Association, 14(9), 656-660.
Braden, H. J., Ko, M., Bohmfalk, M., Hortick, K., & Hasson, S. (2013). Gait Speed Improves During Physical Therapy in General Acute Care, Skilled Nursing, and Inpatient Rehabilitation?a Pilot Study. The Journal of Acute Care Physical Therapy, 4(1), 20-25.
Breimaier, H. E., Halfens, R. J., & Lohrmann, C. (2015). Effectiveness of multifaceted and tailored strategies to implement a fall-prevention guideline into acute care nursing practice: a before-and-after, mixed-method study using a participatory action research approach. BMC nursing, 14(1), 18.
Carlson, B. (2014). Nursing 751: Advanced Practice Nursing: Acute/Critical Care Theory and Technology.
Coffey, A., Tyrrell, M., Buckley, M., Manning, E., Browne, V., Barrett, A., & Timmons, S. (2014). A multicentre survey of acute hospital nursing staff training in dementia care. Clinical Nursing Studies, 2(4), p39.
Drageset, J., Eide, G. E., Harrington, C., & Ranhoff, A. H. (2015). Acute hospital admission for nursing home residents without cognitive impairment with a diagnosis of cancer. European journal of cancer care, 24(2), 147-154.
Hirst, S., & Cole, M. (2014). The Process of Gerontological Competence in the Delivery of Acute Nursing Care. Indian Journal of Gerontology, 28(4), 456-468.
Parker, M. S. (2014). Interprofessional Collaborative Approaches to Reduce Risk, Decrease Financial Loss, and Improve Patient Care Outcomes in Acute Care and Skilled Nursing Facilities.
Pizzingrilli, B., & Christensen, D. (2014). Staff perceptions of pod nursing on an acute mental health unit. Journal of Nursing Education and Practice, 4(12), 88.
Simmons, S. F., Schnelle, J. F., Saraf, A. A., Coelho, C. S., Jacobsen, J. M. L., Kripalani, S., ... & Vasilevskis, E. E. (2015). Pain and satisfaction with pain management among older patients during the transition from acute to skilled nursing care. The Gerontologist, gnv058.
Toles, M., Anderson, R. A., Massing, M., Naylor, M. D., Jackson, E., Peacock?Hinton, S., & Colón?Emeric, C. (2014). Restarting the cycle: incidence and predictors of first acute care use after nursing home discharge. Journal of the American Geriatrics Society, 62(1), 79-85.
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