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Professionals may have a negative experience while working with patients with mental health and diagnosing them with specific medical labels. The professionals mainly address the patients towards diagnostic labels for treatment as well as research purposes. Acopia is a disorder that has greater underlying symptoms than a diagnosis (Jaul, Barron, Rosenzweig & Menczel, 2018). The symptoms of Acopia are identified with signs of decreased ability to cope up with daily life activities and manageing them effectively. This is also a sign of increasing frailty. The patient Edith was 87 years old and therefore she had normal signs of ageing that lead to frailty. Being an RN one should ensure that the label diagnosis may interfere with adequate care and provision of the patient. Frail ageing occurs within individuals above 65 years which is mainly identified on the basis of impaired mental functioning and also shows the signs of a reduced mental score. The labeling of the patient shall be best in accordance to the scenario of the old patient. She has the tendency to forget her daily life activities which shall address her towards discomfort. Sometimes the stigma associated with the labels of diagnosis tends to interfere with adequate provisions of care and the willingness of the patient to seek the care (Garand, Lingler, Conner & Dew, 2009). The hospital had no vacant wards and therefore Edith was placed outside the corridor on an ED Trolley. Significant labeling would address that the other RNs are able to identify the seriousness of the patient and diagnose her according to the schedule for Acopia treatment.
Normal signs of ageing lead to common chronic diseases and also develops ulcer within the patients. For the case of Edith, ulcer, peripheral vascular diseases and low albumin content and obesity are some common symptoms of frail ageing. Normal ageing gradually makes the patient weaker and comparatively less efficient in making normal movements (Alderden, 2020). Often while addressing diagnosis for the patient the skin is put under a significant amount of pressure over a short duration, which results in the development of pressure ulcers within her body. Patients mainly with the conditions of immobility with prolonged confinement to chairs or beds have a greater tendency to develop these types of symptoms (Bhattacharya & Mishra, 2015). Even Edith was also subjected to several other treatment methods during her diagnosis such as capillary perfusion and blood supply increases the tendency of the patient to develop pressure ulcers. The patient is 87 years old and may be required to be accessed with other severe treatment procedures that may include prolonged compression of the skin. Hence it is obvious that she will be highly vulnerable to developing the pressure ulcers mainly over her bony prominence. Even her condition of Acopia and old age she is highly subjected to develop or show the symptoms of type-2 –diabetes, which is another cause of the development of pressure ulcers (Dyer, Ryan & O’Callaghan, 2018). Apart from that the soaring of skin, darkening of skin areas and discoloring of the skin are also common in old age people which is also a major cause of pressure injury.
Chronic Pain is uncontrolled and ongoing as well as has a deteriorative and detrimental effect, especially on older women's bodies. In this case study, Amita who is 76 years old is suffering from chronic pain as she is having a venous ulcer in her lower leg. It is much difficult for her to manage this pain as she leaves alone at home (Wells, Pasero & McCaffery, 2020). She would face emotional distress and anxiety and it would have a negative impact on her health. The functional capacity to perform any work gets disturbed due to this type of pain in the body. She might be unable to fulfill social, vocational and family roles and further face difficulties in maintaining a safe environment. Leg ulcers sometimes are very complex for doing proper treatments. Older women like Amita usually face this type of chronic illness and pain. Therefore they face mobility problems, sleep disturbances and severe pain in the legs. A safe environment means where there are no active threats and no severe harm present around the environment that might affect the well-being and health of any person. Chronic pain can also affect her brain, the front portion of the brain that is the cortex which is responsible for emotional behavior in unable to deactivate itself when it is necessary (Wayne, 2020). The Registered Nurse (RN) should be giving some specific suggestions like continue using non-pharmacological methods for controlling pain like imagery, distraction, massage, relaxation and cold and heat application to Amita so that she could be able to manage her pain and maintain a secure and safe environment.
Normal physiological changes are seen as a part of ageing in the body of women and men. The changes include the occurrence of neurological disorders, the development of Parkinson's and Alzheimer's disease, ulcers, etc. Cellular and molecular damages arise over time and enhance the chance of death and illness (NIA, 2020). The comorbidities linked with ageing make the elderly person develop polypharmacy quickly. Besides that, the cognitive and physiological changes make their interference with drug pharmacokinetics and pharmacodynamics resulting in drug-oriented issues that are found in a large number of elderly patients. Due to this, quick hospitalizations and emergency treatments are required for reducing the health risks of aged patients but the costs for these treatments gradually increase (Amarya, Singh & Sabharwal, 2018). According to the RN, elderly persons like Amita is more vulnerable to adverse drug events due to an increase in the age and the frequency of application of drugs, sensitivity arising due to effects of drugs as well as the abundance of predisposing situations which might result in increasing the severity and frequency of severe drug reactions. Medications can also pose adverse events or general serious manifestations including orthostatic, falls, delirium and heart failure. Metabolic changes in her body reduced drug clearance connected with ageing can also pose a great risk for developing drug toxicity. The risk gets multiplied when the utilization of drugs is done in a huge amount (A. Rodrigues & Teresa Herdeiro, 2020). The capability for interacting with drugs is increased by polypharmacy and due to the prescriptions which show potentially unsuitable medications.
The normal physiological changes that occur during ageing include an increase in blood pressure (BP). The patient Oliver can experience decreases in cardiac output. The rate of flow within the respiratory system may become slow than usual. Moreover, the ageing patient may experience the development of arteriosclerosis when the endothelium is damaged due to excessive smoking and an increase in the level of cholesterol and fat in the blood (Janssens, Pache & Nicod, 2020). The respiratory system becomes very weak. The patient may experience trouble during breathing. Various changes occur in the lung tissues which results in the patient has fully lost their capacity to fully open the airways which creates breathing problems. The air sacs also lose their original shapes and become very much baggy. Due to this, it loses the ability to hold air. The anatomical change that occurs in an ageing person is weight loss. Due to the loss of reticular fibers in the dermis and reduction of the elasticity of the collagen the hair, nails and skins become thinner. The skins become very much fragile.
The Registered Nurse (RN) can understand the changes in the respiratory system by analyzing the patient. A respiratory problem patient experiences various problems. The patient was not able to breathe properly. The patient may experience shortness of breath (W. Besdine, 2019). The care that the RN provides for the respiratory changes in Oliver helps to reduce the problems of the respiratory system. The nurse provides nutritional support to meet the demands of the respiratory system.
It is very much important for Oliver to increase her mobility in healthcare. This is because it can help to speed up the rehabilitation process. Increasing mobility also helps Oliver to improve her respiratory system. It helps Oliver to increase the flexibility of her joint and also help to strengthen the muscle (Shnorhokian, 2020). This is very much important for Oliver because of the ageing she had to lose her flexibility and muscle strength (Healthvic, 2020). This also helps Oliver to increase social engagement with other patients in healthcare. Apart from that, it also helps to improve cognitive function of Oliver. It helps to improve the outcomes of Oliver in terms of mobility. Moreover, it helps to prevent various muscle problems that develop due to prolonged bed postures.
The RN may use her skills to tell Oliver regarding the benefits of incidental exercise for an ageing patient. The RN needs to give relevant information about how incidental exercise helps her to reduce her diseases as it helps him to regain the flexibility of her muscle which loses due to ageing problems (TheGreenFields, 2020). Apart from that, it helps to improve the respiratory system. She can able to breathe properly and live a healthy life even at that age with any problem. It further helps to increase the capacity of the lungs which helps Oliver to improve her ability to holding her breath for a long time. The RN needs to provide the instructions of doing incidental exercise like it helps to prevent the risk of cognition in an ageing person.
Rodrigues, D., & Teresa Herdeiro, M. (2020). Elderly and Polypharmacy: Physiological and Cognitive Changes. Retrieved 21 October 2020, from https://www.intechopen.com/online-first/elderly-and-polypharmacy-physiological-and-cognitive-changes
Alderden, J. (2020). Pressure Injuries Among Critical Care Patients. Critical Care Nursing Clinics Of North America. doi: 10.1016/j.cnc.2020.09.001
Amarya, S., Singh, K., & Sabharwal, M. (2018). Ageing Process and Physiological Changes. Gerontology. doi: 10.5772/intechopen.76249
Bhattacharya, S., & Mishra, R. (2015). Pressure ulcers: Current understanding and newer modalities of treatment. Indian Journal Of Plastic Surgery, 48(01), 004-016. doi: 10.4103/0970-0358.155260
Dyer, A., Ryan, D., & O’Callaghan, S. (2018). ‘Acopia’ and ‘inability to cope’ remain unhelpful and pejorative labels for complexity in older adults presenting to the acute hospital. Age And Ageing, 47(3), 488-488. doi: 10.1093/ageing/afy013
Garand, L., Lingler, J., Conner, K., & Dew, M. (2009). Diagnostic Labels, Stigma, and Participation in Research Related to Dementia and Mild Cognitive Impairment. Research In Gerontological Nursing, 2(2), 112-121. doi: 10.3928/19404921-20090401-04
Healthvic. (2020). Improving mobility and self-care in older people in hospital. Retrieved 21 October 2020, from https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/older-people/falls-mobility/mobility/mobility-improving
Janssens, J., Pache, J., & Nicod, L. (2020). Physiological changes in respiratory function associated with ageing. Retrieved 21 October 2020, from https://pubmed.ncbi.nlm.nih.gov/10836348/
Jaul, E., Barron, J., Rosenzweig, J., & Menczel, J. (2018). An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatrics, 18(1). doi: 10.1186/s12877-018-0997-7
NIA. (2020). Supporting Older Patients with Chronic Conditions. Retrieved 21 October 2020, from https://www.nia.nih.gov/health/supporting-older-patients-chronic-conditions
Shnorhokian, K. (2020). The Importance of Maintaining Mobility during Hospitalization » ForeverFitScience. Retrieved 21 October 2020, from https://foreverfitscience.com/recovery/the-importance-of-maintaining-mobility-during-hospitalization/
TheGreenFields. (2020). 5 Benefits of Exercise for Seniors and Ageing Adults | The GreenFields. Retrieved 21 October 2020, from https://thegreenfields.org/5-benefits-exercise-seniors-ageing-adults/
Besdine, R. (2019). Changes in the Body With Ageing - Older People’s Health Issues - MSD Manual Consumer Version. Retrieved 21 October 2020, from https://www.merckmanuals.com/home/older-people%E2%80%99s-health-issues/the-ageing-body/changes-in-the-body-with-ageing
Wayne, G. (2020). Chronic Pain – Nursing Diagnosis & Care Plan. Retrieved 21 October 2020, from https://nurseslabs.com/chronic-pain/#:~:text=Maintain%20the%20patient's%20use%20of,participation%20in%20their%20own%20care.
Wells, N., Pasero, C., & McCaffery, M. (2020). Improving the Quality of Care Through Pain Assessment and Management. Retrieved 21 October 2020, from https://www.ncbi.nlm.nih.gov/books/NBK2658/
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