Appraise the importance of nursing theory and the patterns of knowing to nursing. Read/Study

• Chinn & Kramer (2018)
• • Chapter 9 – “Knowledge Authentication Processes”
  • Chapter 10 – “Integrated Expression of Knowledge in Practice”
  • Chapter 11 – “Integrated Expressions in Practice: Strengthening the Discipline”

The nurse is assessing a bedridden client when a large erythematic area is noted on the client’s sacrum.  In addition, the center of the injury looks like an abrasion with a shallow center.  The nurse would classify this ulcer as:

How will the nurse treat this type of pressure ulcer?

What risk factors could have contributed to this patient developing a pressure ulce

Medical history of Hypertension. Mr. Peter is an 80-year-old that lives at home with his daughter. His daughter must work Full Time and is not home with him during the day. He presents to the hospital with a 4-week history of 7/10 pain in the right foot, and you have noticed an open wound underneath the right heel. When you asked what happened, Mr. Peter replied, “I can’t remember if I hit it against the counter, or if it’s because I don’t move around much, but I have been just putting a dressing over it and taking Tylenol for the pain. It is not getting any better and I am worried about it not improving.” He is rocking back and forth on the stretcher and rubbing his right foot stating, “how am I going to cope with this now?”

Past medical history of Hypertension, High Cholesterol, Anxiety, and Dementia, and had a stroke 8 years ago with minimal deficits.

You are the Practical nurse assigned to Mr. Peter

1. What 3 priority assessments would you complete for Mr. Peter?
2. Explain why it is important to complete these assessments?
After the doctor assessed Mr. Peter it is discovered that he has a stage 3 ulcer in the area. He is
admitted to the hospital for 2 weeks and is now being discharged home. As you are preparing him to go
home, he tells you that he is worried about going home. Mr. Peter asks, “so how am I supposed to do
the dressing to the area again?”
1 What additional concerns would you have if any about Mr. Peter being home alone? This
should not be related to your priority assessments.
2. Are there any other assessments that you may want to do at this time? 
3. What concerns if any do you have about Mr. Peter being discharged home?
4. What will you do about it?

5. What would be a SMART goal for Mr. Peter?

6. Based on your chosen nursing diagnosis, what kind of nursing interventions would be most appropriate?

Normal age Cardiovascular changes. Mr. Amar is a 73-year-old, Muslim man, who has just been admitted to your residential facility for long-term nursing care. Mr. Amar has been diagnosed with early dementia and he and his family have found it increasingly difficult to manage at home, as Mr. Amar has had numerous falls in the past few months and is forgetting to attend to his own self-care needs, including bathing and eating.

You have been asked by the RN to complete a health assessment on Mr. Amar and complete a nursing care plan, in collaboration with Mr. Amar and his family. You will need to report the findings of your assessment and discuss the plan of care for Mr. Amar with the RN.

Question:

Verbally discusses and can identify normal age related changes to the following systems;

•  Cardiovascular
•  Respiratory
•  Integumentary
•  Gastrointestinal
•  Musculoskeletal
•  sensory

Discusses with the client and their loved ones how age related changes can affect the abilities to provide self-care

Identifies possible areas of limitation or concerns for the client and can discuss preventative measures with the client and their loved ones, for example high falls or pressure are risks