NRNP 6540 WEEK ONE: Mr. Perkins, age 81 Week 1: Assessment of Older Adults

NRNP 6540 WEEK ONE: Mr. Perkins, age 81 Week 1: Assessment of Older Adults

Case Study 1:

Mr. Perkins, who is 81 years old, presents himself for an annual physical examination. He indicates that he is in good health. His sole known health issue is osteoarthritis. Additionally, he requests a flu vaccination. The only medication he takes is Tylenol for relief from arthritis-related pain. Upon entering the examination room, you observe that he is using a straight cane in his right hand. When you inquire about the cane, he explains that he started using it because the pain in his right hip has significantly worsened over the past six months.

Subsequently, please analyze the case study and contemplate a potential plan for assessing the patient. In your planning for evaluation, consider the location of the assessment, the necessity of involving other healthcare professionals or family members, suitable assessment tools and guidelines, and any other pertinent information you may wish to address. Also, take into account whether the assessment tool you have selected has been validated for use with this specific patient demographic and whether this presents any challenges. Reflect on additional factors that could complicate assessments, such as language barriers, educational levels, prosthetics, or missing limbs. Additionally, consider any immunization requirements that may be applicable to this patient. Keep in mind that as nurse practitioners, regardless of whether you specialize in primary care or acute care, patient and family education always plays a vital role. This includes educating patients and their families about medications, tests, treatment plans, vaccinations, diagnoses, and methods for promoting overall health.

PLEASE ENSURE THAT YOUR DISCUSSION ADDRESSES ALL THE POINTS MENTIONED ABOVE. NRNP 6540 WEEK ONE:

Mr. Perkins, age 81 Week 1: Assessment of Older Adults. MARKS WILL BE DEDUCTED IF ANY POINTS ARE OMITTED. I strongly recommend that you compose your discussion in a word processing program on your computer, run a spell and grammar check, save your work, and then copy and paste it into the Blackboard platform. Don’t forget to review the grading rubric on Blackboard.

REMEMBER TO FOLLOW APA 7TH EDITION CITATION AND REFERENCING GUIDELINES WHERE APPLICABLE. I also advise you to reference the sources provided in your mandatory and recommended reading lists!

BY DAY 6:

Respond to at least two of your classmates on two separate days using one or more of the following methods: – Include this in your calendar reminders or make a note on your computer to ensure you respond to two peers; failure to do so will result in an incomplete grade.

Propose alternative assessment tools and elucidate why these tools might be suitable for your peers’ patients.
Offer suggestions for addressing issues related to the use of the assessment tools your peers have discussed.
Discuss other aspects of health promotion that pertain to patients in this demographic or with similar health concerns.
There are numerous excellent geriatric assessment tools available!

NRNP 6540 WEEK ONE: Mr. Perkins, age 81 Week 1: Assessment of Older Adults. I hope you will explore and become familiar with many of them! I have shared some valuable resources in the document sharing section for your reference.

NRNP 6540 – Week One: Mr. Perkins, Aged 81 – Week 1: Assessment of Older Adults

Student Name: [Your Name]
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Course Code: [Your Course Code]
Course Name: [Your Course Name]
Instructor’s Name: [Instructor’s Name]
Date: [Current Date]

Case Synopsis

This case pertains to an individual named Mr. Perkins, who is 81 years old and has come for his annual physical examination. Mr. Perkins reports that he is in good health, aside from being diagnosed with osteoarthritis. During his visit, he also requests a flu vaccination. Notably, Mr. Perkins does not take any medication except for Tylenol, which he uses to manage arthritis-related pain. As Mr. Perkins enters the examination room, it becomes evident that he is relying on a straight cane held in his right hand. Upon inquiring about the cane, Mr. Perkins explains that he started using it due to a significant increase in pain in his right hip over the past six months.

Analysis of a Significant Healthcare Issue – Nursing Staffing

Osteoarthritis (OA) is a degenerative joint condition that frequently affects the knee joint. It is characterized by the gradual deterioration of articular cartilage, often leading to permanent disability in severe cases. The prevalence of OA is higher in males than in females. Among individuals aged 70 years and older, OA has a prevalence as high as 40%. Additionally, among those aged 60 years and older who exhibit symptomatic OA, the prevalence is 10% for males and 13% for females (Chen et al., 2017). An in-depth assessment of Mr. Perkins reveals that, apart from the pain associated with OA, the condition is adversely affecting his mobility. According to Chen et al. (2017), among elderly patients diagnosed with OA, reduced mobility and pain increase the risk of falls, resulting in fall-related injuries. These limitations also affect their ability to independently perform instrumental activities of daily living (IADLs) and activities of daily living (ADLs), ultimately leading to a diminished quality of life (QOL).

Conducting a comprehensive geriatric assessment (CGA) on Mr. Perkins is essential, as the findings can help identify individual healthcare needs and potential gaps in care. The nurse can utilize the CGA results to formulate a personalized care plan that prioritizes the patient’s well-being. As per Ball et al. (2019), the CGA should encompass various components, including psychological, physical, socio-environmental, functional, and QoL assessments. Given Mr. Perkins’ age and underlying diagnosis, he is at a heightened risk of other chronic illnesses, such as cancers that may also cause pain. Consequently, during the comprehensive physical examination, the nurse should ascertain whether Mr. Perkins’ pain is solely attributed to OA or if there are underlying chronic causes contributing to it. The comprehensive laboratory evaluation should encompass assessments related to glycemic control, Urea Electrolytes and Creatinine (UECs), anemia, renal function, liver function (metabolism), iron levels, folate levels, and vitamin B12 deficiencies.

Considering Mr. Perkins’ advanced age and comorbid OA, his susceptibility to falls is a significant concern. Therefore, conducting a fall risk assessment is imperative. One of the most recommended and reliable tools for this assessment is the Hendrich II Fall Risk Model (Ball et al., 2019). Following this assessment, the nurse can propose practical fall prevention measures to mitigate Mr. Perkins’ overall fall risk. Moreover, Mr. Perkins’ current health status places him at an elevated risk of geriatric depression, which carries a high morbidity and mortality rate. To evaluate geriatric depression in Mr. Perkins, a valid and reliable tool such as the Short Form Geriatric Depression Scale (Ball et al., 2019) should be employed. The assessment should ideally take place in the comfort of Mr. Perkins’ home, preferably in collaboration with a home health agency. During the assessment, the nurse should also evaluate the patient’s support system, including family dynamics.

Mr. Perkins should be educated about immunization recommendations for older adults, with a particular emphasis on the flu vaccine and pneumococcal vaccine (Coll et al., 2019). The care plan should prioritize effective pain management through adjustments in dosage, medication choice, and administration frequency until optimal pain control is achieved. Additionally, Mr. Perkins may benefit from the intervention of an occupational and physical therapist to regain physical and functional independence.

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Chen, D., Shen, J., Zhao, W., Wang, T., Han, L., Hamilton, J. L., & Im, H. J. (2017). Osteoarthritis: Toward a comprehensive understanding of pathological mechanisms. Bone Research, 5, 16044. https://doi.org/10.1038/boneres.2016.44

Coll, P. P., Costello, V. W., Kuchel, G. A., Bartley, J., & McElhaney, J. E. (2019). The prevention of infections in older adults: Vaccination. Journal of the American Geriatrics Society, 68(1), 207-214.