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Clinical assessment in nursing care

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Q.1.Throughput history people have been trying to understand the process of ageing Theories of aging include:

Biological theories

 The process through which a person’s physiological functions start to progressively change leading to a decline of the biological functions and ability to adapt to metabolic stress (National Institute of Ageing, 2020).

Psychosocial theory

The process through which a person’s ability to effectively interrelate socially with him/herself and other people starts to deteriorate due to decline of the brain capacity.

Disengagement theory

This is the process through which ageing adults start to withdraw from the society and personal relationships as they advance in age (Lumen, 2020).

Social exchange theory 

This theory states that social behaviour and interactions among individuals is as a result of exchanges. Therefore, the more an ageing person partakes in social exchanges, the more they will feel connected and love longer.

  • Wear and tear theory

This theory states that the effects of ageing are due to the progressive damage to cells and body systems over a long period of time (MSD Manual Consumer Version, 2020).

  • Activity theory

Unlike disengagement theory, this theory states that when older adults stay mentally and physically active, they extend the ability to be happier and more socially connected with other people.

Provide a comparison summary of your understanding for each of the 6 theories listed above.

Q.2.

1. Distraction

This strategy uses distraction techniques to draw the attention of the person with challenging behaviour away from the behaviour. Distraction could be in form of telling a joke, playing music, dropping something “accidentally” etc. the form of distraction varies with the type of challenging behaviour been exhibited by the person (Mayo Clinic, 2020).

  • Behaviour modification

This involves getting the person with challenging behaviour to modify their behaviour by use of a conditioning (rewarding or punishment) mechanism. Here, the care-giver gets the patient to change their behaviour to an acceptable one through offering them a “reward” or punishment which could be in form of a physical reward, an applause, encouraging words or a deterrent punishment depending on the nature of the challenging behaviour (Michele, 2020).  

Q.3.

When providing care for the elderly, an enrolled nurse should ensure that the care regimen for the patient is sensitive of the patient’s special needs as an elderly person and the patient’s input (or that of a nominated dependant) is sought at all times when making care decisions. The rights of the patient to choose what he/she wants and his/her right to confidentiality and respect should also be upheld (World Health Organization, 2020). Patient-care regimen should be administered in a humane, dignified and respectful way and the patient’s comfort should be the top priority during care-giving. 

Q.4

Dual/multiple diagnosis in older people usually results in increase in risks of the patient falling, injuring themselves or having suicidal thoughts, decreased tolerance, adverse reaction to medication and others. As such, care-giving for such patients is a challenge to the care-giver since he/she has to prioritize on the care needs that are crucial for the patient’s health. The type of care needs for such a patient have to be modified so that they encompass treatment of all the diagnosed conditions with minimum physical and mental distress (Joao, 2020). At the same time, care has to be prioritized according to the seriousness of each of the multiple conditions which may lead to deterioration of the other condition(s) if the right care-balance is not applied.

QUESTION 5.

Older people or persons suffering from dementia should be provided with a safe physical, social and emotional environment because they are vulnerable physical, emotional and social risks.

  • Dementia causes confusion, memory loss and disorientation which leads to higher risks of the patient becoming socially and emotionally distressed.
  • A patient with dementia is at higher risk of been exposed to physical hazards that may cause injury, accidents or death (Medline Plus, 2020).

It is therefore imperative for family, friends and care-givers to create an environment that is free of physical hazards and social/emotional (peaceful, calming and socially engaging) risks. A safe environment will make the patient less agitated, more physically safe and emotionally nourished which will contribute to his/her overall wellbeing (The Canvas Network, 2020).

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