HLTENN004 Implement Monitor And Evaluate Nursing Care Plans


Case Study

The following case study explores an 83-year-old man, George, admitted to an acute care hospital setting for a fracture resulting from a fall at home. The patient also presents with peripheral neuropathy and atrial fibrillation (AF) as co-morbidities. In addition, George’s wife has recently been diagnosed with dementia. Environmental change is experienced in terms of the need for hospital admission following his accident and the impact of his wife’s changing health care requirements. ?George, following assessment in the Emergency Department, was admitted to a surgical ward for a fractured left neck of femur (NOF) and multiple skin tears. He underwent an open reduction with internal fixation to repair the fracture, had multiple dressings in place to protect his skin tears and had a sudden onset of confusion after admission which was confirmed to be a consequence of a urinary tract infection (UTI) from postsurgical catheterisation. ?George lives with his 85-year-old wife and has two sons who both live in England. George migrated to Australia with his wife 18 years ago seeking a retirement lifestyle change. George sees his sons and five grandchildren every few years and upon learning of his father’s hospitalisation, one son flew out to be with him. ?Older patients frequently have multiple health co-morbidities in relation to their presenting condition which further complicates their current health status and therefore the patient’s care plan. George has been diagnosed with peripheral neuropathy, secondary to type two diabetes, which is characterised by nerve damage in the peripheries resulting in varying manifestations of extremity pain and numbness (Farhat & Yezback, 2016). As George underwent a surgical procedure to repair his fractured NOF, mechanical venous thromboembolism (VTE) prophylaxis is routinely performed to prevent the formation of harmful clots which can damage vital organs. However, as George suffers from severe lower limb pain due to peripheral neuropathy, TED stockings and sequential compression devices are contraindicated which prevents their utilisation. Likewise, George is also diagnosed with AF which is extremely rapid electrical impulses caused by disorganised atrial electrical activity, resulting in a rapid heart rate and irregular ventricular excitation (Frazer, 2016). Enga et al. (2014) report that individuals with AF are at an increased risk of developing VTE in comparison to those without. These co-morbidities complicate George’s current situation as he is at increased risk of developing a deep vein thrombosis (DVT) due to immobility post-surgery. Together with his history of AF, the importance of implementing interventions which are appropriate for his current situation and health status are vital.
  • Stereotypes about an individual’s age can be tremendously damaging to the delivery of patient-centred care and the achievement of positive patient outcomes. A common ageist stereotype is memory loss, forgetfulness and confusion as being normal in all older people. This can be detrimental to the care of an older patient, particularly in George’s situation, as these signs can indicate a UTI and if left untreated due to the assumption his age is responsible for his confusion, morbidity and mortality may result.
  • A recent environmental change that has occurred in George’s life is his wife’s recent diagnosis of dementia. This has rendered George a full-time primary carer for his wife. He is adamant that his wife be cared for in their home. Consequentially, this change in their relationship has negatively impacted on George as the prospect of caring for his wife while he is recovering from his fracture injury, coupled with his worsening co-morbidities, seems near impossible.

Care Plan Template

In your plan you must:

1. Identify and justify the top five objectives for nursing care, 2. Describe and justify evidenced-based nursing interventions to achieve each objective, and, 3. Create and describe the evaluation criteria that you will use to judge whether the plan addressed the identified objectives.

Five nursing objectives.

2. What is nursing objective 1? What is a significant health care need for George?

3. How did you evaluate each nursing intervention? What measures did you use? What time line was chosen and why? Was the plan of care successful?

Get a 10 % discount on an order above $ 100
Use the following coupon code :
Open chat
Hello, you can now chat with our live agent via WhatsApp +1 (347) 428-6774
Our professional nursing writers will work on your paper from scratch.
We guarantee a plagiarism-free custom-written nursing paper.