NRS 410 Case Study: Mr. M. Assignment Paper

NRS 410 Case Study: Mr. M. Assignment Paper

NRS 410 Case Study: Mr. M. Assignment Paper

Clinical Manifestations

The purpose of this paper is to delve into the presented case of MR. M. In particular, the paper will provide clinical manifestations diagnosis, and emotional, psychological, and physical support to enhance the patient’s recovery. Based on the descriptions provided in the case scenario of Mr. M, numerous clinical manifestations could be considered based on the objective and subjective information provided. First, the presented clinical symptoms suggest the possibility of Alzheimer’s disease. Alzheimer’s disease characterizes as a condition that usually begins at the age of 65 years and above for many adults (Rajan et al., 2021).  In this case scenario, Mr. M reports the onset of serious memory loss and confusion. Patients with Alzheimer’s disease usually have challenges in remembering known places and names. In this case, Mr. M is reported to have forgotten the names of his close relatives and the room he lives. In addition, patients demonstrate aggressiveness and agitation and can potentially injure others.

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Patients with Alzheimer’s disease also have challenges in thinking appropriately and making decisions. They also fail to engage in the activities of daily living (Rajan et al., 2021). In the present case, Mr. M could not manage self-care, which prompted his admission to an assisted facility where could be bathed, feed, and dressed. Patients with Alzheimer’s disease also tend to experience anxiety and tend to get worried without reason. As a result, patients are often restless and lack sleep at night. This can tell why Mr. M was wandering outside in the darkness.

The patient examination also revealed that Mr. M has an elevated respiratory rate of 22. This could be indicative of tachypnea. This condition could be associated with respiratory distress or challenges in breathing. He also has a high body temperature of 37.1 degrees Celsius, which may imply an infection or pathophysiological process in the body. This is validated by the increase in the number of white blood cells. Ordinarily, white blood cells should range between 4 and10 1000/ul. A higher volume of leucocytes is an indication of a possible bacterial infection, especially a urinary tract infection.

Primary and Secondary Diagnosis

A primary diagnosis or principle diagnosis connotes the major reason for admission and is achieved after performing a radiological, physical, and laboratory patient assessment. Primary diagnosis emanates from the primary clinical findings of the patient (DeTure & Dickson, 2019). In the case scenario at hand, the primary diagnosis of Mr. M is Alzheimer’s disease. This condition is demonstrated by an acute beginning of confusion and inability to ensure self-care. This condition can be validated by testing the thinking and memory skills of Mr. M. The clinician should also perform a neurological assessment to evaluate Mr. M’s ordination, muscle power, balance, sense of hearing, and reflexes. The other primary diagnosis is the urinary tract infection, which can be verified by the availability of leukocytes in the patient’s urine.

On the other hand, secondary diagnosis characterizes conditions that a patient develops following admission to the care facility and impacts the current treatment for primary diagnosis. Secondary diagnosis often influences the overall patient outcomes and increases the hospital stay days. In addition, it is attributed to disease severity and high mortality rates (DeTure & Dickson, 2019). In the case at hand, the neurodegenerative disorder could be the secondary diagnosis for Mr. M. This assumption is based on the inability to perform routine activities such as dressing, bathing, and feeding. Additionally, Parkinsonism should be considered due to a reduction in physical activity and unstable gait. The other important diagnosis to consider is dementia. Dementia is common among seniors with chronic conditions and characterizes by memory loss. The medical history of Mr. M also indicates that he has controlled hypertension. A comprehensive confirmation of the secondary diagnosis can be realized through mental health assessment, laboratory tests, and radiological imaging to substantiate the existence of brain tumors and atrophy, mineral shortages, trauma, and deposits.

Abnormalities in the Nursing Assessment

A methodological nursing examination is often conducted to establish deformities in all systems of the patient. In the present case, Mr. M demonstrated unstable gait, slowed speech, and an inability to self-care. These conditions can be attributed to the neurodegenerative brain cell condition and chemical transmission. The conditions are corroborated in the case scenario where Mr. M could not bathe or feed. Moreover, the nurse is likely to identify elevated respiratory rates since the patient cannot achieve balance in walking and sustaining gait. Additionally, the worsening health of the patient warrants reduced physical activity. The examination of the cognitive functions may also portray poor thought processes, loss of memory, and inability to remember immediate things. These areas should be the major areas to focus on in Mr. M.

Physical, Psychological, and Emotional Effects

The physical effects of the disorders that Mr. M experience are distressing. He has challenges in movement, which messes with self-care. Deterioration of physical health also compromises his strengths and causes fatigue. Regarding emotional effects, the patient is affected by the rapid development of his health conditions. Mr. M lost the ability to move properly and fulfill his basic needs within one month. This is devastating for Mr. M and his family. Mr. M and his family are also affected psychologically due to the anxiety and agony concerning the prognosis of the conditions. Therefore, there is a need for psychological counseling for the patient and family to ease the stress, solitude, and avert implications (Agüera-Ortiz et al., 2021).

Support Interventions

There is a need for proper persistent care for Mr. M to ensure enhanced quality of life. The patient should also be given memory training to help in regaining his ability to remember things. Moreover, Mr. M deserves social and mental activation exercises to kindle mental and thinking worthiness. Physical exercises should also be provided alongside social and mental activation exercises (Rosenberg et al., 2020). There is also a need for dietary changes that involve vital mineral supplements and vitamins to enhance brain function. Mr. M is undergoing intense stress, which warrants social and psychological support.

Actual or Potential Problems

Mr. M is at risk of trauma, falls, and injury because he is unable to get balance and coordination. These risks are associated with fatalities. The other actual problem is the inability to self-care and Mr. M cannot realize routine activities such as bathing, feeding, and dressing as a result of dilapidation of brain cells and chemical transmitters that activates responses to specific stimuli (Sharma et al., 2019). Mr. M also experiences an actual problem of mental risks and psychological distress because of the long duration of the disease and has to rely on nurses for assistance and medication compliance. Finally, Mr. M faces a potential risk of imbalanced nutrition based on a poor diet that comes with patients with Alzheimer’s patients. The patient can also suffer from damaged self-image due to the possibility of developing symptoms of constant constipation and urinary incontinence.

Conclusion

Persistent care of patients with cognitive and neurological disorders is crucial and requires comprehensive theoretical understanding and skills. Alzheimer’s disease needs thorough care both at home and in a healthcare facility to get maximum patient output.  Mr. M requires proper physical activity, diet, and emotional, and psychological support to improve rehabilitation, quality of life, and health outcomes.

References

Agüera-Ortiz, L., García-Ramos, R., Grandas Pérez, F. J., López-Álvarez, J., Montes Rodríguez, J. M., Olazarán Rodríguez, F. J., … & Porta-Etessam, J. (2021). Depression in Alzheimer’s disease: a delphi consensus on etiology, risk factors, and clinical management. Frontiers in Psychiatry, 12, 141. https://doi.org/10.3389/fpsyt.2021.638651

DeTure, M. A., & Dickson, D. W. (2019). The neuropathological diagnosis of Alzheimer’s disease. Molecular neurodegeneration, 14(1), 1-18. https://doi.org/10.1186/s13024-019-0333-5

Rajan, K. B., Weuve, J., Barnes, L. L., McAninch, E. A., Wilson, R. S., & Evans, D. A. (2021). Population estimate of people with clinical Alzheimer’s disease and mild cognitive impairment in the United States (2020–2060). Alzheimer’s & Dementia, 17(12), 1966-1975. https://doi.org/10.1002/alz.12362

Rosenberg, A., Mangialasche, F., Ngandu, T., Solomon, A., & Kivipelto, M. (2020). Multidomain interventions to prevent cognitive impairment, Alzheimer’s disease, and dementia: From FINGER to World-Wide FINGERS. The Journal of Prevention of Alzheimer’s Disease, 7(1), 29-36. https://doi.org/10.14283/jpad.2019.41

Sharma, P., Srivastava, P., Seth, A., Tripathi, P. N., Banerjee, A. G., & Shrivastava, S. K. (2019). A comprehensive review of mechanisms of pathogenesis involved in Alzheimer’s disease and potential therapeutic strategies. Progress in neurobiology, 174, 53-89. https://doi.org/10.1016/j.pneurobio.2018.12.006

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Points
120
Rubric
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Status
Active
Assessment Traits
Requires Lopeswrite
Assessment Description
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

Temperature: 37.1 degrees C
BP 123/78 HR 93 RR 22 Pox 99%
Denies pain
Height: 69.5 inches; Weight 87 kg
Laboratory Results

WBC: 19.2 (1,000/uL)
Lymphocytes 6700 (cells/uL)
CT Head shows no changes since previous scan
Urinalysis positive for moderate amount of leukocytes and cloudy
Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L
Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:

Describe the clinical manifestations present in Mr. M.
Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.
When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
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.
Discuss what interventions can be put into place to support Mr. M. and his family.
Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.