Practice Nurse Report: Medical Care For An Old Person

Person-Centred Care

Describe about the Practice Nurse Report for Medical Care for an Old Person.

Person-Centred care is important for Loretta’s medical care because she knows better about the symptoms she perceives while she is alone at home. Her daughter Mary might not be knowing much about the sickness she is suffering because the only symptoms of sickness she could suspect what the struggle in speaking that could be felt over the phone. Surprisingly, she was better by the time they attended the medical appointment that Mary had booked so that they could seek medical assistance. As a general practice nurse, it is important that I ask questions about the previous medical reports. The medical report included the types of diseases that have been diagnosed and the type of medications that have or are already in the progress of being undertaken (Cloninger, 2010). Through the assistance of her daughter Mary, I would request to be assistance with Loretta’s specific details about the current medical conditions to understand the possible health problem that should be tested. In the person-Centred care program, Mary statement about her mother’s condition will be very important because he knows better about how her mom has been doing, and the physical symptoms observed or perceived. Based on their relationships, I would expect Mary to give information why she thinks her mother is ill (Butler, 2011).

Loretta knows more about herself and the health problems she is experiencing. I as a nurse, I am supposed to give her time to narrate her case as a patient (Ghebrehiwet, 2011). Based on the signs and symptoms she is experienced, she would make me understand better about the type of disease she might be suffering. All the information provided by Loretta or any of her family members about her health condition should be noted down to be used in creating a medical report. Ideas about what could be done to treat the disease suffered by Loretta should be provided by herself and Mary because she has also been diagnosed with congestive heart failure and its control might have made her feel better. The medical assistance to be provided in this particular medical center will be based on the ideas provided by Loretta and her daughter. This does not mean that every information provided by them is viable, rather the doctor will provide the best intervention approach based on medical knowledge and experience (Finset, 2011). As a nurse, the report I will generate based on Person-Centred care will be very important in assisting the doctor in understanding the possible medical problem that is suffered by Loretta.

Age-related Physiological Changes

As people get aged, some physical changes make them vulnerable to some diseases. For the case of Loretta, some of the physiological changes that have been I as the nurse have observed is that she struggles to stand up without the assistance of her daughter. There is a series of aging effects that might have made Loretta vulnerable to congestive heart failure and hypertension. As a person reaches the age of thirty years, cardiac functionality decreases at a rate of 1% percent per year. This means that the normal functioning of the body will be reduced, and the person will be vulnerable to heart-related diseases such as hypertension (Abdulraheem, 2004). At 80 years, the cardiac output is close to half of that of a 20-year-old (Mann & Felker, 2014). Therefore, much changes in daily activities might be seen, especially in talking, walking and thinking capacity among others. In conjunction with the reduction of cardiac output as a person ages, the blood pressure also reduces and the people at the age of 65 years and above are said to be hypertensive. Judging from the age of Loretta, she is highly hypertensive, and it will be good to test medical conditions such as blood pressure.

The walls of the arteries are threatened by aging, as the accumulation of phosphate and calcium reduce their sizes, increasing the chances of suffering arteriosclerosis and coronary artery disease. In this case, the chances of being diagnosed with myocardial infarction, which affect the normal functioning of the heart. People who have aged just like Loretta have a reduced volume of the lungs. In Loretta’s case, it is right to state that her lung volume might be reduced based on her case of struggling to breathe. It is perceived that the lungs’ size reduces at a rate of 26ml for men and 22ml for women per year starting at the age of 20year. This means that by the time a person is 80 year, the lung size struggles to manage the respiratory system (de Boer, Ter Horst, & Lorist, 2013). Therefore, this means that the oxygen breathed is not enough to sustain the body fully. Because of this problem, a higher chance of suffering heart-related disease will be high because it is struggling to support the functionality of all body part and processes. As the rate of oxygen intake reduces, the rate of gas exchange in the body is reduced. Other many physiological changes are as a result of aging, which makes every person vulnerable to congestive heart failure and hypertension (García & Wright, 2010). Therefore, Loretta is not an exception.

Relevant Assessments

The assessments to be undertaken by a registered to a registered nurse must be concurring to the roles and responsibilities of the professional in relation to its ethics. As a nurse, I am supposed to obtain the relevant information from the nurse to ensure that the intervention plan to be developed will be effective. Therefore, there is a range of assessments that will be undertaken in Loretta’s case to understand the possible medical approaches that can be used to treat of curb the emerging problem. Physical, psychological, psychosocial, biological, and functional aspects are the assessments that I will undertake to help in the development of a reliable medical report from a registered nurse (Silver, 2010). The health assessment will be more in the daily activities undertaken by Loretta and the experiences perceived. In the nursing profession, it is believed that ‘activities of the daily living’ are directly attached to the medical status of every person. The above-stated assessments will be simply undertaken in four simple steps; acquiring the biography of Loretta, health status, medical diagnosis reports and personal circumstances. If the information can be obtained based on these aspects, it will be enough to develop a decision for the possible intervention to be undertaken (Armstrong & Mitchell, 2008).

Mary will be the perfect person who will give a biography of her mother because they have lived together for sometimes. Although she does not know more about the life of her mother before she was born, Loretta must have told her. The biography will be much focused on the medical life of Loretta. In case, Mary is not much informed about her mother’s medical life; Loretta will have to be consulted about her life, thus giving all incidences she might have been diagnosed with any disease. These activities for acquiring the biography information will be undertaken if the medical department of the state has not a digital health system that stores medical information for every individual. In some other cases, a person might be having a person biography, which shows all the information about a personal life. In such cases, as registered nurse, I will only have to read the information as a write a report. The current health status information will be obtained from the previous treatment doctors’ report. It will be observed that Loretta is hypertension and congestive heart failure victim. Finally, personal experiences and circumstances will also have to be documented to make the report complete to be used for development of an effective medical intervention.

Recommended Strategies

The effectiveness of hypertension and congestive heart failure can be maximally managed by adhering to several medical interventions ("Hypertension", 2014). Firstly, before Mary booked an appointment for her mother in the hospital, she was already under medication that is focused on treating the previously diagnosed diseases. The medication taken was Carvedilol 6.25mg PO Mane, Furosemide 40mg PO BD, Amlodipine 5mg and Aspirin 100mg among others. In respect to the previous medical diagnosis and advice, it will be important to insist that Loretta sticks to her mediation program. This approach will help in reducing the chances of raise the chances of experiencing medical issues related to the diseases suffered (Sjögren, 2009). However, it will be good to put Loretta under medical diagnosis to confirm the disease and check if there is any health problem that needs attention. This procedure needs to be undertaken before further advice concerning Loretta’s medical issues. The drugs to be administered should be antihypertensive, which keep Loretta in a comfortable life with struggling with pains and complications. The most important thing is to motivate Loretta observe her treatment agreement and requirements in all cases and always follow doctor’s prescriptions. Mary among other family members will be providing guidance on how the medication should be taken on a daily basis (Golubev, 2010).

Loretta’s lifestyle should be managed effectively by the family members and the doctors through extended medical services (Sumantra, 2015). As a nurse, I will endorse domestic medical assistance strategy that will ensure that Loretta is medically checked frequently to observe her progress. This will help in evaluating impacts of the medical interventions, showing the possible improvements to be undertaken. The initial steps for hypertension management should also be used in Loretta’s case. The most effective method of managing hypertension is by obtaining information about lifestyles, which affect the level of hypertension. Therefore, the lifestyles that reduce the hypertension level should be advised and the others prohibited. The blood pressure level should be highly maintained or reduced because research has stated that a decrease in 2 mm Hg reduces the risk of hypertension by 15% (Hosenpud & Greenberg, 2013). It would be profitable if Loretta was induced into a therapy program that makes her do some exercises to stimulate his respiratory system (Michael Felker, 2010). Activation of her respiratory system will provide her body with enough oxygenation, thus reducing the risks of heart failure. In conclusion, standard medical care should be undertaken in Loretta’s case to ensure that she stays at home as long as possible.

References

Abdulraheem, I. (2004). The Physiology and Physical Changes of Human Aging. Nig Med Pract, 44(2). https://dx.doi.org/10.4314/nmp.v44i2.28679

Armstrong, J. & Mitchell, E. (2008). Comprehensive nursing assessment in the care of older people. Nursing Older People, 20(1), 36-40. https://dx.doi.org/10.7748/nop2008.02.20.1.36.c6346

Butler, J. (2011). Congestive Heart Failure Special Issue on Advanced Heart Failure. Congestive Heart Failure, 17(4), 159-159. https://dx.doi.org/10.1111/j.1751-7133.2011.00237.x

Cloninger, C. (2010). Person-centred integrative care. Journal of Evaluation in Clinical Practice, 17(2), 371-372. https://dx.doi.org/10.1111/j.1365-2753.2010.01583.x

De Boer, A., Ter Horst, G., & Lorist, M. (2013). Physiological and psychosocial age-related changes associated with reduced food intake in older persons. Ageing Research Reviews, 12(1), 316-328. https://dx.doi.org/10.1016/j.arr.2012.08.002

Finset, A. (2011). Research on person-centred clinical care. Journal of Evaluation in Clinical Practice, 17(2), 384-386. https://dx.doi.org/10.1111/j.1365-2753.2010.01608.x

García, J. & Wright, V. (2010). Congestive heart failure. New York: Nova Science Publishers.

Ghebrehiwet, T. (2011). Nurses and Person-Centred Care. The International Journal of Person Centered Medicine, 1(1), 20-22. https://dx.doi.org/10.5750/ijpcm.v1i1.17

Golubev, S. (2010). COMPLIANCE MEASUREMENT-GUIDED MEDICATION MANAGEMENT PROGRAMS IN HYPERTENSION: A HEALTH TECHNOLOGY ASSESSMENT: PP.15.70. Journal of Hypertension, 28, 1. https://dx.doi.org/10.1097/01.hjh.0000378996.67504.25

Hosenpud, J. & Greenberg, B. (2013). Congestive heart failure (2nd Ed.). New York: Springer-Verlag.

Hypertension. (2014). Hypertension, 64(1), 1-1. https://dx.doi.org/10.1161/01.hyp.0000451551.69453.ed

Mann, D. & Felker, G. (2014). Heart failure. Elsevier Health Sciences.

Michael Felker, G. (2010). Diuretic Management in Heart Failure. Congestive Heart Failure, 16, S68-S72. https://dx.doi.org/10.1111/j.1751-7133.2010.00172.x

Silver, M. (2010). Heart Failure: Current Clinical Understanding. Congestive Heart Failure, 16(5), 241-241. https://dx.doi.org/10.1111/j.1751-7133.2010.00179.x

Sjögren, A. (2009). Treatment of congestive heart failure. Acta Pharmacologica ET Toxicologica, 54, 93-101. https://dx.doi.org/10.1111/j.1600-0773.1984.tb03640.x

Sumantra, I. (2015). THE LEVEL OF MEDICATION COMPLIANCE OF HYPERTENSION IN ADULTS AND ELDERLY PATIENT. Journal of Hypertension, 33, e43. https://dx.doi.org/10.1097/01.hjh.0000469883.58487.e6