Nursing case analysis assignment on making accurate patient prognosis

Question

Task: how can Nursing case analysis assignment research techniques be used to make accurate prognosis

Answer

1. What might be an assumption of the nursing and medical staff on the first presentation of this woman?

This Nursing case analysis assignment assesses how nursing and the medical staff found Mrs. Jones in a mentally unstable condition. She was confused, drowsy, and vomiting. The eighty-two years old lady refused to get on the bed from the trolley and murmured about a bus crash which was irrelevant to her condition and the situation. Some basic ideas can be justified by evaluating her condition by the medical crew. This had started three days ago after being bitten by a spider. In thisNursing case analysis assignment situation, the medical crew primarily assumed for the common causes which generally occur to older people. In this contemporary society every average older adult faces this neurological disorder as they could not relate to things properly, they cannot cope with every surrounding action. This issue grows gradually as they get older(Nahian et al. 2020). The working pressure creates problems for them just like Mrs. Jones as she lived alone, she used to operate all the work by herself and she also served her duty for 60 years in school. Work pressure at a grown old age might gave a deep impact on her mental stability. Considering this situation there is a change in her behavior and psychology this can be a cause of Alzymers which is very much common in the case of disorders in memory and impaired reasoning which leads to dementia. Delirium or trauma could be suspected as a reason for her condition. delirium or trauma happens in case of any external influence like intoxication. As Mrs. Jones is experiencing illusions of a bus crash, this kind can be justified with delirium.

2. Outline why an older woman would be drowsy and confused after three days of nausea and vomiting
Nursing case analysis assignment research shows as soon as a person gets older, he/she starts having physical deterioration and got various diseases that affect drowsiness and confusion. This can be happened due to long-term diseases like diabetes, issues with kidneys, hearts, and livers, and also getting thyroid, COPD, anemia, and sleeping disorders. Vomiting in the elderly is the effect of liver malfunction, g gastric problems, and infections. Continuous vomiting can lead a person to dehydration, and hypoglycemia, deficiency of the brain supply is the possible cause of this drowsy and confused mental condition (Rajan, Rahman, & Kumar,2021). Any kind of toxication by any food or insect bite can cause infection or inflammation in the stomach as a result of which vomiting and nausea occur. This sudden deterioration in the physical condition is often defined as the effect of delirium which signifies a sudden and unexpected effect of toxication by any external influence on the human body.

3. From the information you have been given, determine whether Miss Jones has dementia or delirium and provide a rationale for your answer
In the aspect of the current Nursing case analysis assignmentstudy after analyzing the pieces of information on the symptoms developed in Mrs. Jones, it is suspected that she is suffering from delirium, not dementia. Delirium and dementia both are related to impaired cognition and generally affect older adults. But this two have some basic differences which can be distinguished by analyzing the properties and functioning processes as delirium grows rapidly in the human body whereas dementia takes long-term progress to develop(Fong& Inouye, 2022). In the case of Mrsjones, she did not face any kind of mental disorder or confusional state. Her disorientation in mental stability grew suddenly in three days. It is also a fact that delirium is a cause of lack of awareness, that's why she refused to go to the hospital and kept opposing the medical crew. Delirium is happened by infections, and intoxication in the human body. The infection spread by the spider is the possible reason for intoxication. On the other hand, dementia grows step by step, and people have a family history of this disease and also this can be noticed in the appearance of a person previously when it was in its primary stage. It is also a fact that delirium can happen in a person who has dementia too. The long-term dementia is the cause of delirium. The sudden change in mental orientation can affect memory which is the fundamental property of delirium, whereas dementia causes the loss of memory step by step and permanently(Mulkey et al. 2019). As we can see Mrs. Jones forgot about the situation but still was able to understand the surrounding actions, if it was the effect of dementia, she would not able to recognize anything and grab the trolley tightly for not willing to go to the hospital.

4. Consider her reasons for grabbing the trolley and outline how you would approach thissituation
Along with the growing disorder in mental stability, and nervous breakdown, older people avoid any kind of inconvenience that makes them feel interrupted. It is observed that people veteran persons having delirium tend to have anxiety and panic disorder. They have very little trust in the surrounding people and their actions as they are frightened to be disturbed.Nursing case analysis assignment research shows they suffer from insecurity. Due to this scare and defensing nature, Mrs. Jones grabbed the trolley for securing herself(Kuusisto?Gussmann et al. 2021). The sudden unexpected incidents and their negative effects lead the person to delirium which is also related to mental illness, depression, and loneliness as we can also see in this case where Mrs Jones was living and working alone for years(Weng et al. 2019). As soon as older people lose consciousness about the surrounding nature their psychological thinking process changes from normal people, and the medical staff and their families need to take care of them very carefully.In this situation special care is needed for the patient. The trust and security should be given by the medical crew and her brother. If she is comfortable with the trolley then there is no necessity of ambulance bed.

5. Would the matter of the bus crash be significant and how would you determine this?
Nursing case analysis assignment research shows the consequences of delirium or dementia show that there is a huge change in the psychological thinking process and behavior and response to external influences. There is also a symptom in the case of delirium which is caused by having irrelevant conversations. They got hallucinations and illusions related to various topic which has no connection with the contexts (Tachibana et al.2021).This is the reason; Mrs. Jones was talking about a bus crash.This can be determined by studyng the symptoms of Delirium in older persons.

6. What other assessments would you initiate and why?
The medical team uses ISBAR handover for the analysis of the patient’s condition and then transfers the data to the medical center(Burgess et al. 2020). The physiciansdiagonises delirium by following the criteria of Satistical Manual or Mental Disorders Fourth Edition. The DSM-IV-TR is used for the analysis of the scale of DSM. The DSR-R-98 scale is used for the diagonis of the severity and physical disorder. There is also a scale used globaly that is CAM which signifies Confusion Assessment Method. This is used to evaluate the elements of acuteonset fluctuation, lack of attention, disorientation of thinking(Pérez-Ros, &Martínez-Arnau, M2019).After the detection of the actual disease, the patient is needed to be treated accordingly with psychological therapies and proper medications with full care. The stress of work and the pressure need to be reduced by helping them with good communication and support. Delirium is curable just like it attacks a person rapidly.Nursing case analysis assignment findings also emphasis on the importance of trust and belief of the patients need to be earned with more care thus the development in their mental condition will be shown.

References
Burgess, A., van Diggele, C., Roberts, C., &Mellis, C. (2020).Teaching clinical handover with ISBAR. BMC medical education,Nursing case analysis assignment 20(2), 1-8.https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-020-02285-0
Fong, T. G., & Inouye, S. K. (2022). The inter-relationship between delirium and dementia: the importance of delirium prevention. Nature Reviews Neurology, 1-18. https://www.nature.com/articles/s41582-022-00698-7
Mulkey, M., Everhart, D. E., Hardin, S., Olson, D., & Munro, C. (2019). Distinguishing delirium from dementia. Journal of Health and Caring Sciences, 1(1), 56-67.https://journalofhealthandcaringsciences.org/index.php/jhcs/article/view/8
Nahian, M., Ghosh, T., Uddin, M. N., Islam, M., Mahmud, M., & Kaiser, M. S. (2020, September).Towards artificial intelligence driven emotion aware fall monitoring framework suitable for elderly people with neurological disorder.In International Conference on Brain Informatics (pp. 275-286).Springer, Cham.Nursing case analysis assignmenthttps://link.springer.com/chapter/10.1007/978-3-030-59277-6_25
Rajan, S., Rahman, A. A., & Kumar, L. (2021). Preoperative oral carbohydrate loading: Effects on intraoperative blood glucose levels, post-operative nausea and vomiting, and intensive care unit stay. Journal of Anaesthesiology, Clinical Pharmacology, 37(4), 622.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944379/
Tachibana, M., Inada, T., Ichida, M., & Ozaki, N. (2021).Factors affecting hallucinations in patients with delirium. Scientific Reports, 11(1), 1-6. https://www.nature.com/articles/s41598-021-92578-1 Weng, C. F., Lin, K. P., Lu, F. P., Chen, J. H., Wen, C. J., Peng, J. H., ... & Chan, D. C. (2019).
Effects of depression, dementia and delirium on activities of daily living in elderly patients after discharge. BMC geriatrics, Nursing case analysis assignment19(1), 1-8.https://link.springer.com/article/10.1186/s12877-019-1294-9
Kuusisto?Gussmann, E., Höckelmann, C., von der Lühe, V., Schmädig, R., Baltes, M., & Stephan, A. (2021). Patients’ experiences of delirium: A systematic review and meta?summary of qualitative research. Journal of Advanced Nursing, 77(9), 3692-3706.https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.14865

Pérez-Ros, P., &Martínez-Arnau, F. M. (2019).Delirium assessment in older people in emergency departments.A literature review. Diseases, Nursing case analysis assignment7(1), 14.https://www.mdpi.com/403786