1.The risks of immobility and drug interactions can be exacerbated for older adults undergoing surgery. What is the impact of immobility and anesthesia on an older adult in the outpatient surgery setting?
The impact of immobility and anesthesia on an older adult in outpatient surgery settings can affect an older person’s different system. The following are some of the immobility and anesthesia to the patients:
Gastrointestinal: the immobility in older women can lead to constipation in the gastrointestinal system. These conditions may be severe with time, and it can course death if it is left untreated for a long time because it can cause blockage in the body leading to infections.
Musculoskeletal: due to prolonged inactivity in the elderly, it can cause muscle deterioration. Due to deterioration, it can lead to muscle atrophy in the elderly, and the patient will suffer from bone loss, which may cause a patient to develop osteoporosis. the muscle deteriorations the leading cause of total immobility in elderly
Respiratory: the immobility in the elderly can cause the heart and lungs are also impacted. The elderly may develop pneumonia because inactivity can cause slow breathing to the elderly. The elderly may develop a fluid buildup n the lungs because shallow breathing can result in difficulty. The elderly may also create a shrieked heart because of inactivity, causing high blood pressure and circulation issues like edema.
Postoperative delirium: general anesthesia can cause a cognitive effect, mostly in the elderly. The elderly who have undergone surgery may develop confusion, focusing difficulty, and memory problems, mainly associated with postoperative delirium, but it may sometimes disappear.
Postoperative cognitive dysfunction is a condition that can be caused by older adults who are under the effect of sedation or general anesthesia, and it’s a very severe condition. This condition is characterized by either a long time or short time memory loss in can persist for months or weeks after the surgery.
2.Older adults are often catheterized in the hospital setting. Determine the atypical presentation of urinary tract infections in older adults. What are the best practices for using urinary catheters in older adults?
The atypical presentation of UTI in older adults. There are classic symptoms when you see that an elderly UTI is suspected, and further diagnosis must be made for confirmation.
- Fever
- Increased in confusion
- Decline in function
- Reduce urinary output
- Fecal continence
What are the best practices for using urinary catheters in older adults?
- Before inserting the catheter in the elderly, make sure you use a sterile technique.
- Only make sure you are inserting the catheter when necessary and remove it as soon as possible.
- When inserting the catheter, make sure you use the narrowest tube size to avoid any uncomfortableness to the elderly patient.
- Make sure you cleanse the urethra meatus with soap and also the perineum area daily.
- Ensure you practice a closed drainage system
- Check the tube to make sure there is no blockage the tube.
- Make sure the catheter is well secured to prevent any damage in the urethra of an elderly
- Make sure you don’t use any antiseptic solution during elderly care in the urethral meatus and the urinary bag.
3.Often, we as nurses and other health care professionals involved in direct care inform our patients of what they should eat to allow for a healthy, well-balanced diet. Yet many of our older adults often face financial constraints that limit healthful choices. Using this list, derive at least one days’ worth of menu planning, complete with recipes that an older adult can use to achieve optimal nutritional benefit. Upon completion of the meal plan, answer the following questions:
Elderly one-day menu plan
| Time of the day | Meal type |
| Morning | Ø One whole-wheat bagel
Ø One tablespoon butter peanut creamy Ø One banana Ø Coffee with two tablespoonsful of sugar
|
| Lunch | Ø Sandwich salad
Ø Three slices 100% whole wheat bread Ø 1 ounce canned tuna Ø 3/4 cup low-fat milk Ø One teaspoon mayonnaise Ø Two carrots Ø ½ resin cup |
| Dinner | Ø Spaghetti I cup
Ø diced tomatoes ¼ of a cup Ø cucumber slice two Ø one cup of water Ø one apple Ø beans ¼ of the cup
|
Were you surprised at your findings?
It’s about the elderly taste on different food because it tastes bitter or sour because of losing tasting sense in the elderly. How older people choose food by smell makes them choose a low diet when using food smells. Due to aging the elderly, they avoid fruits and vegetables, which causes them to have a gastrointestinal change like constipation.
How will you change your teaching and learning sessions related to nutrition based on this experience?
Before I teach the elderly, I will do my assessment of the elderly and know the area that I will cover in my lesson mostly. I will teach about ways to improve elderly diet:
- Critical of following the USDA MyPlate Plan
- Critical of taking carbohydrate and fruits in elderly
- Importance of green vegetable, legumes, and another meat alternative
- Importance of drinking low-fat milk and skim food
- Importance of drinking more water throughout the day
- Importance of following a special diet from doctor prescription and also following medical instruction
- Importance of regular exercise
How difficult was it to utilize only the ingredients provided to derive one days’ worth of healthful recipes?
It was challenging, but I could cope with it by applying the knowledge from my experience about elderly meal planning and elderly diet requirement, improving and maintaining elderly health, and preventing various kinds of elderly disease.
4.Search the Internet for a scholarly article or factual information related to osteoporosis. Provide your references and answer the following questions:
- How does osteoporosis affect women?
According to the world research, it proved that women have a higher incidence of osteoporosis approximately for every two women who are 50 years and above one of them is suffering from osteoporosis, and they will experience a broken bone issue more than any other condition that affects women like uterine, ovarian and breast cancer.
What is the incidence?
According to American research in 2010 in the USA about osteoporosis, around 99 million adults aged 50 years and above show a prevalence of 10.3% of osteoporosis. Approximately 10.2 million people have osteoporosis disease. The prevalence of low none mass was 43. 9%, which give a total figure of roughly 43.9 million people
- How does osteoporosis affect men?
This disease is called a silent disease in men because of its progression without any symptoms. This disease affects mostly women than men because men have an advantage of large skeletal than women, so these bone loss processes in men can start at a significantly later age in men and progress very slowly with no period of bone hormonal changes.
What is the incidence?
According to American research of men, osteoporosis shows that about 6 to 4 percentage of men with the age of 50 years and above have osteoporosis, and around 47 to 33 percent have osteopenia, which is a diminished bone loss. Still, it thus not meets the osteoporosis diagnostic criteria. Worldwide research proved that white men have an osteoporosis prevalence of around 7 %. Black men have a prevalence of 5 %, and Hispanic American men have a 3% prevalence.
Osteoporosis is called a “silent disease” because it progresses without symptoms until a fracture occurs. It develops less often in men than in women because men have larger skeletons, their bone loss starts later and progresses more slowly, and they have no period of rapid hormonal change and bone loss.
c.What are the current dietary, calcium, and vitamin D considerations for patients with osteoporosis? The present nutritional concern for the patient with osteoporosis according to the American Geriatrics Society and the National Osteoporosis Foundation they have recommended an increased dose of vitamin D and calcium of 800 to 1000 international unit daily, which can help in reducing any effect of falls and fracture in elderly
- What are some teachings to be used best to educate the public regarding osteoporosis and dietary concerns?
The most important teaching about osteoporosis and dietary concern is smoking, exercise, and diet with a specific recommendation for men and women.
Diet
The elderly should make sure they take enough calories, calcium, vitamin D, and protein, maintaining bone density and bone formation.
Diet — An optimal diet for bone health involves making sure you get enough protein and calories and plenty of calcium and vitamin D, which are essential in maintaining proper bone formation and density. Vitamin D and calcium of 800 to 1000 international units daily can reduce falls and fractures in the elderly.
Alcohol
The elderly should avoid Alcohol drinking a lot of alcohol more than one time a day can cause the rate of osteoporosis to develop in elderly people.
Exercise
The elderly should be encouraged to do daily exercise because it decreases the chance of elderly fracture by improving bone mass in premenopausal women and aged men. it can help in muscles strengthening, balance improvement, and reduce the risk of fall that may lead to bone fracture
Smoking
The smoking process in older adults is mostly known for increasing bone loss n the elderly, so the elderly should avoid the smoking practice to avoid developing low-density bones, which may increase the chance of fracture risk.
Avoiding falls
Falling in the elderly can increases the elderly risk of developing an osteoporotic fracture. There are different measures that an elderly may follow to prevent any osteoporosis fracture development:
- They should avoid working on any slippery surface.
- They should avoid working in an area in which they are not familiar with
- They should make sure they stay in an environment with adequate light.
- They should make sure they visit an ophthalmologist and optometrist to check their vision.
Medications
Some medications can cause bone loss when taken for a long time with a higher dose, so the elderly should stop such drugs. They should reduce the dosage or switch to alternative medicine. The following are some medications that may increase bone loss in the elderly.
- Glucocorticoid medications
- Heparin
- Antiepileptic drugs
- Aromatase inhibitors
6.Often in practice, we intertwine the concept of spirituality with religion, but there are differences in your readings in the text.
- Describe the differences between spirituality and religiosity.
Religiosity’s when someone is excessively religious it’s like a mental condition, while spirituality is the state of being concern mostly with the human spiritual matter than materialistic
How to incorporate spirituality and religiosity in nursing
Although spirituality means different in people, it gives a special meaning to life, gives people represent to life, and provides hope to people, so the spirituality and religiosity of a person can influence his health because both play a very special role during the patient illness. It can affect his or her positive or negative during the process of patient recovery, so as a nurse, you should respect any decision the patient makes concerning his spiritualism and religiosity as long as it plays a significant role in the health of the patient during the nursing care process. Religiosity and spiritualism have shown that they can positively influence mental health during the recovery process. It can change the suicidal thought of the patient’s behavior, substance misuse, and general wellness. So, as a nurse, you should encourage any religious and spiritual beliefs of the patient because it positively impacts general health during patient care. The sociological support from religious and spiritual groups play a significant role in the life of different patient t hospital setting so they should be encouraged to visit the patient in the hospital area and sing with them, pray with them and share a meal with them because it has a beneficial effect on lifestyle and health. When a patient has met is religiosity and spiritual needs, it will improve patient life quality, which can help in enhancing wellbeing during the end of life
C.What do you believe are basic spiritual needs requiring nurses to be attentive to providing holistic care?
- The nurse should assess the patient’s spiritual needs.
- The nurse should refer to a chaplain or clergy as needed.
- The nurse should support any patient spiritual beliefs and needs and individualize the spiritual care to the patient.
- Encourage spiritual screening to a patient.
- By Proving a range of primary spiritual care
- What are some ways in which a person’s religious beliefs can be incorporated into a care plan?
- By use of gifts of presence and touch
- By share and encouraging Thought or Word from the book of spiritualism
- By asking if you can pray with the patient
- By listening to fears and concerns without going into your stuff
- Supporting patients within their faith tradition
- By asking the patient how you can support them spiritually
- By demonstrating a Christ-like attitude
- By taking your cues from the patient
7.Using the Spiritual Needs Assessment guide compare and contrast this with the spiritual assessments you find in your clinical sites.
Answer the following questions. RELATE IT TO YOUR CLINICAL DUTIES
How comprehensive are the spiritual assessments utilized in your clinical facilities?
The spiritual assessment is not well utilized in the clinical facilities, although many patients may wish to discuss the nurse’s issue. Many of the nurses have reported barriers when approaching the spiritual matter due to lack of time and spiritual experience and difficulty identifying the patient who needs spiritual care in the hospital setting. There should be a spiritual assessment which will allow the nurse and the physician to support the patient by mostly focusing on the spiritual needs, documenting spiritual preference for a future visit, by encouraging the patient to use his spiritual belief for overall wellness and putting into care plan the spiritual needs to the patient.
What could be added to provide more insight?
Spiritual assessment tools in hospital area like the FICA and the HOPE questions
- Is the information obtained geared more toward religion/spirituality or both? Why do you think this is?
The patient was requesting prayers, and also, he wanted his church member to visit him in the hospital
c.What visual cues related to spirituality or religiosity did you notice in your patient’s room?
Some of the visual clues of spiritualism and religiosity were
- Bible
- Spiritual books
- Rosary
- What comments did your patient state that would allude to their beliefs and practices related to spirituality or religion?
- According to him, the patient said that he wants to be visited on Saturday, which was the day of the church.
- The patient was talking about the rosary.
- List some nursing interventions that can/could be utilized for a client with the nursing diagnosis of Spiritual Distress?
Observing the self-esteem of the client
Monitoring of the patient support system and accept any spiritual belief of the patient
Always ensure you are available to the patient to help in making any religious or spiritual choice
Proving the patient with a good time for relaxation, mediation, and prayers
Assisting the patient in to accomplish any short-term goals and task
The patient who is comfortable with touch hold the patient hands and talk together
help the patient to find her living reason and make sure you are available for support
Listening to the patient about death feeling and give the patient enough time for grieving
Provide the patient with the necessary material for religious purpose
Proving the patients with a private room which they can use for praying with others