Addressing Mobility, Hygiene, Pressure Area Prevention, Nutrition, Elimination, And Psychosocial Needs In Nursing Essay.

Mobility and falls prevention

· Subjective-“i have chronic pain in my hips and knees that gets aggravated on walking and is relieved on resting.”

· Objective- patient observed to have faced a fall 6 months ago and has been observed to be unsteady. He has been found to need assistance for movement and transfer.

Hygiene needs

· Subjective- “since i have difficulties in maintaining proper gait and movement, i cannot meet my hygiene and sanitation needs properly.”

· Objective- patient has been observed to require assistance for maintaining hygienic needs. Patient also needs assistance with oral hygiene.

Prevention of pressure area or taking care of wounds

· Subjective-“i do not have any visible wounds or pressure area as such that requires assistance.”

· Objective- patient does not require dressing of wounds or pressure area.

Nutritional needs

· Subjective-“i have complications such as hypertension, diabetes mellitus and oral denture which leads me to consume a properly planned diet.”

· Objective- patient has been observed to require assistance with planning of a proper diet.

Elimination

· Subjective-“i am suffering from incontinence and thus face difficulty in urinating.”

· Objective- patient has been observed to require assistance with elimination and treatment from incontinence. Patient uses aids of incontinence such as aids.

Psychosocial aspects of nursing care

· Subjective- “i sometimes face confusion and often feel anxious and stressed out with so many diseases.”

· Objective- patient requires psychosocial interventions such as talk therapy and counselling to instil positive thoughts within her mind.

Problem 1

Problem- inability of the patient to maintain steady gait and movement.

Etiology- patient had a fall 6 months ago.

Evidence- patient was suffering from osteoarthritis accompanied by pain in knees and hips.

Problem 2

Problem- inability of the patient to maintain hygiene.

Etiology- patient often became confused and forgetful. She also could not move properly thus was unable to clean herself on her own.

Evidence- patient was suffering from alzheimer’s disease.

Problem 3

Problem- patient needed proper diet planning to meet her nutritional needs

Etiology- she was a patient of hypertension and diabetes mellitus 2. She also had denture problem which made her difficult to eat and chew.

Evidence- patient carried full upper and lower dentures. Patient was place on oral hypoglycemic agents (oha).

Problem 4

Problem- patient suffers from incontinence and thus it is difficult for her to urinate.

Etiology- the reason behind incontinence may be due to neurological disorder, (alzheimer’s in case of mrs setiawan) and less drinking of water.

Evidence- patient uses pads.

Problem 5

Problem- patient often becomes confused and forgetful. Has risks of falling.

Etiology- patient suffers from alzheimer’s disease which leads to confusion. Patient had also suffered a fall 6 months back and suffers from osteoarthritis.

Evidence- patient usually remain confused. Patient uses a walking aid.

Intervention 1

Intervention- patient should be made to do aerobic exercise, resistance exercises such as band walking, walking with weights and normal walking (montero-odasso et al., 2021). Necessary medications and supplements can also be helpful along with balance training can be provided to the patient. Prescribing a well-balanced diet to the patient should also be done.

Rationale- the above-mentioned exercises can enhance the strength of muscles along with its mass to bring about improvement in the gait (montero-odasso et al., 2021). A diet rich in protein-rich will help the muscles and tissues to become strong thereby enhance the ability of the patient to walk on her own.

Intervention 2

Intervention- assisting the patient with bathing, taking her to the washroom and make her sit in the lavatory if needed. The attending nurse should keep the bathroom warm and ensure that she is given proper privacy (goldenhart & nagy, 2021). During dental cleaning, the patient’s dentures should be removed and cleaning them in a basin while placing a towel below. The dentures should be cleaned with toothpaste once they are removed. Hair and nail care should be given to the patient where the nurse must comb the hairs twice daily and cut the nails weekly. Since, the patient suffers from diabetes, foot hygiene also has to be undertaken. Nurse should ensure that there is sufficient lighting in the room when cutting the nails of the diabetic patient.

Rationale- providing regular assistance with cleaning and maintaining hygiene is important to prevent the occurrence of any kind of infections and skin diseases. Usage of a towel in the place where oral dentures are being handled shall be done to prevent breaking of dentures if they fall by chance (coker et al., 2017). For diabetic patients, cuts have to be avoided since healing of wounds is usually delayed in such patients.

Intervention 3

Intervention- a well-balanced therapeutic diet has to be prescribed to the patient as per her nutritional needs. A diet that is low in carbohydrates, fats buts rich in lean protein must be given to the patient (de boer et al., 2017). The patient should be encouraged to consume ample amount of drinking water. The patient should be advised restricted intake of salt as well as sugar (de boer et al., 2017). The diet prescribed to the patient must be comprising of semi-solid and fluid foods.

Rationale- since, the patient suffers from hypertension as well as diabetes mellitus, the diet prescribed shall be in consideration with this. A low carbohydrate diet will facilitate restriction of the glycaemic index of the patient and thus would keep the blood glucose level of the patient under control. A low-fat diet and lesser intake of salt will help in keeping hypertension under control. Lean protein will facilitate strengthening and building of muscles which is important for the patient (stokes et al., 2018). Semi-solid and fluids foods will facilitate some ease of eating for the patient due to the presence of dentures.

Intervention 4

Intervention- the patient should be trained with good toilet habits. Fluid intake must be increased to two litres a day. Patient should be encouraged to perform pelvic floor exercises and bladder training given may also be helpful. Oestrogen creams may also be applied on the vaginal walls and urethral tissues (capobianco et al., 2017). The toilet seat where the patient is urinating can be raised or wall-mounted since mrs setiawan is unsteady on her feet. The patient should not be given hurry and a relaxed as well as smooth atmosphere should be created when she is made to urinate.

Rationale- increased fluid intake will fill the bladder frequently, thereby enabling the patient to urinate more often. Oestrogen creams help to relieve stress of incontinence on the bladder walls. Since, it is difficult for the patient to urinate normally, she should be made comfortable to initiate the process flawlessly.

Intervention 5

Intervention- the patient should be interacted in a peaceful manner, where the patient can be motivated and encouraged to talk (alexiou et al., 2018). She should be counselled in a way that she is able to recall memories. Mrs setiawan should be given proper space so that she can express her emotions, griefs and other feelings. The patient must be given moral support and various strategies of coping which has rendered effective for her in the past should be taken into consideration (alexiou et al., 2018). Proper patient education on strategies to prevent falls must also be given to her.

Rationale- allowing her to recall memories will allow the patient to overcome her state of getting confused often. Motivating and encouraging her to become independent will allow her confidence to flourish. Giving education on falls prevention will enhance avoidance of future incidents of falls (moncada et al., 2017).

Evaluation 1

The patient will eventually gain back balance and her difficulties in walking and balancing gait shall be resolved eventually. She will get relief from the pain in knees and hips which she used to face while walking.

 Evaluation 2

With relief in pain and regaining of balance, the patient will eventually be able to meet her hygiene needs with time. She will be able to stand in the bathroom and clean herself without any problem.

Evaluation 3

With the consumption of a well-balanced and nutritious diet, the metabolic disorders which mrs setiawan has shall be kept under control. It will also support her outcome of maintaining body balance and regaining movement through the maintenance of body weight and maintaining muscle mass.

 Evaluation 4

With the utilisation of exercises and materials, urination would become smooth in the patient and would thus cure incontinence in the patient.

Evaluation 5

When the patient receives proper psychosocial support  throughout her nursing care, she will feel empowered and eventually this will be beneficial in bringing about positive outcomes of the care process.