"Elderly Patient CareOVERVIEWThis is a case of 50 years Mrs Rhonda Green who underwent total knee arthroplasty 3 days ago.She is complaining about severe where due to which she was not able to perform her normaldaily activities. It has been found that 40 to 52 per cent of patients with knee surgery mostly facesuch pain that might persistent for about one year or above. Knee replacement always aims toprovide a painless and easily movable locomotors. However many patients, 1 among 3 patients,complain about the severity of pain post operation.To make an effective knee arthroplasty andto provide better patient outcome, a proper diagnostic planning is essential. This will aim forexposing to acute exercise of three times per week (Daniels, 2015). QUESTION 1 Case Study 1Diagnosis – It is done based on the internal and external analysis of the patient. Both actual andpotential diagnosis was done for Mrs. Green.? Actual diagnosis 1: Chronic and awful pain related to physical immobilization thatresulted from the knee arthroplasty? Actual diagnosis 2:Exposureto acute exercise of three times per week? Potential diagnosis 1:Risk for falls related to advanced age, and regimen of post- operative medication? Potential diagnosis 2: Unbalanced posture making difficulty in performing the Activitiesof daily living (ADLs)Planning - 90 percent knee surgery cases mostly undergo such kind of pain.The plan will aimfor creating capability to tolerate the ADLs and to maintain body weight. Also this aims for1 Elderly Patient Caretolerating the ambulating conditions without any kind of support. The main outcome is tosupport in reducing the knee pain. QUESTION 2 Case Study 1History of Mrs. Green shows a Catholic upbringing type wherein it becomes very difficult for anindividual to loss her fertility or inability of giving a life. It is create lot of depression andfrustration in her mind as each religion does have their own ethics and beliefs. She belongs to aconservative culture that makes her difficult to adjust with the current situation. QUESTION 3 Case Study 1Basic health teaching would help he patients in overcoming lot of issues associate withtheirhealth as well as mental thought process. She would be taught how exercise would help inrecovering faster, how she could support her both mentally and physically, etc. Health teachingfor Mrs. Green includes assistance from a female physiotherapist who could help her inproviding assistance for exercising, also she should be assisted for all the services required for afemale patient and also she would be assisted for performing all her ADLs (Inzucchi, Bergenstal,Buse, Diamant, Ferrannini, Nauck, & Matthews, 2015). QUESTION 5 Case Study 1The discharge planning should include three basic priorities, ? Providing basic health education to the patient along with his family regarding the entiremedical treatment and the after-discharge care (Galanti, 2014). This could be achievedthrough following the specific patient care guidelines or plans.2 Elderly Patient Care? Establishing effective referrals with other departments like the primary care providers,the physiotherapists, etc. (Quill, & Abernethy, 2013)? Guidance should be provided in the case of Mrs. Green and her family that how she couldperform her ADLs along with the support of the family members (Temel, Greer,Muzikansky, Gallagher, Admane, Jackson, & Billings, 2010).The discharge plan will also include the medical plan along with the exercise requirements forher. QUESTION 6 Case Study 1Human development is a crucial part for any patient, especially for females. Mrs. Green is of 50years that signify that she is in her mid-age.Considering the Erickson`s theory of developmentalstages of human beings, each stage have some significant characteristics that need to beaddressed (Daniels, 2015). In Mrs. Green case fear inactivity along with meaningless are the twofeatures that is identified and that should be taken care of through care, emotions andunderstandings (Inzucchi, Bergenstal, Buse, Diamant, Ferrannini, Nauck, & Matthews, 2015).Lot of physical and psychological changes is associated with this stage like greying of hair,lessening of skin, lessening of the physical stamina, etc. QUESTION 7 Case Study 2Please refer the attachment admission notesQUESTION 8 Case Study 2Please refer the attachment Nursing diagnosis Nursing Care Plan 3 Elderly Patient Care? Actual diagnosis 1: Felt unconscious related to swelling to his right hip and shoulder witha large skin tear to his right forearm. No fractures identified.? Actual diagnosis 2:Acute physical pain associated with forearm dressing? Potential diagnosis 1:Risk for falls related excessive skin swelling and chronic has bonyprominences on his hips and pelvis? Potential diagnosis 2: Risk of developing pressure areas on the bony prominences withunmanaged nutrition would affect himQUESTION 9 Case Study 2Stress management could be done through various ways and methods. The primary thing is toidentify the reason behind it, assessing the risk associated with and eventually adopting one ormixed methods of stress management plan. For Mr. Grandin’s Nursing Care Plan stressmanagement technique includes four major best practices, following the stress polices, accessingthe stress risk assessment, Stress Management Support structures and management training(Inzucchi, Bergenstal, Buse, Diamant, Ferrannini, Nauck, & Matthews, 2015). Four keys arewould help in achieving this that includes, general awareness, responding to the issues related tostress, prevention of stress and monitoring it periodically. QUESTION 10 Case Study 2Various ways are included while collecting data for nursing plan or medical interventions thatcould be from the family, patient history, hospitals, community centers, etc. Considering the caseof Mr. Grandin, he do not have any history of any medical issue along with not data were foundfrom family information (Inzucchi, Bergenstal, Buse, Diamant, Ferrannini, Nauck, & Matthews,4 Elderly Patient Care2015). He used to go for bowling and churches and thus community health center could be oneof the best media to gather data regarding him. QUESTION 11 Case Study 2Low BMI along with the injuries is making Mr. Grandin weak and gradually he is losing hisstrength.His condition is worsening as he was putting more pressure on the areas where bonesare close to the surface that eventually created the pressure sores. He should start changing theposition so that body pressure could be distributed all through (Temel, Greer, Muzikansky,Gallagher, Admane, Jackson, & Billings, 2010).Use of pressure relieving devices is alsorecommended along with advising to eat and drink right things. Regular self-checks are alsoimportant. He could take help of his family, mostly his wife who supports him although. Hisregular assessment chart will also include all the above mentioned things. QUESTION 12 Case Study 2Older patient needs little more care and attentions as compared to the normal aged patient. Thisis due to their weakness in the psychological and physical stamina that ask for assistance andsupport. Aging when gets associated with chronic illness becomes a big issues, mostly amongolder individuals (Galanti, 2014). Some major risk factors include, Alzheimer's disease, heartstroke, chronic pain along with body’s susceptibility of getting side effects from various kinds ofmedications. These are some of the common yet major considerations that should be taken careof in the hospital while treating elderly patients (Temel, Greer, Muzikansky, Gallagher, Admane,Jackson, & Billings, 2010). Some other risk factors include independent locomotion orperforming their ADLs. QUESTION 13 Case Study 25 Elderly Patient CareDischarge of patient form the hospital does not complete the entire treatment process. There arevarious steps and procedures that need to be followed post-discharge. This sheet includes someof the basic planning of the care and medication that need to be provided to the patients forhaving a better outcome (Inzucchi, Bergenstal, Buse, Diamant, Ferrannini, Nauck, & Matthews,2015). Mr. Grandin is being advised not to take on heavy works that will increase pressure on thebody, mainly in the affected areas. His family was also educated for the same so that they cansupport him during the time of need. QUESTION 14ANMC (Australian Nursing and Midwifery Council) Code of Conduct provides ethical ways thenurses and the medical professional should follow so as to provide best patient care service. Italso guides that they should perform their duty with care and education so that it would helppeople to get well soon (Temel, Greer, Muzikansky, Gallagher, Admane, Jackson, & Billings,2010). Considering the above two cases, one code of conduct that will fit the best for both is theconduct statement 4 (Nurses respect the dignity, culture, ethnicity, values and beliefs of peoplereceiving care and treatment and of their colleagues). Both the above discussed cases are for theelderly patients and having two different gender types (Daniels, 2015). This conduct specifiesthat nurses should get biased or influenced by any such characteristics like age, gender, race,ethnicity, etc. Irrespective of all these, their duty should be equal to all and that should respectthis diversity as well. QUESTION15ANMC Code of Ethics is the framework that guides the medical professional to help the patientin providing the best medical care. Countries like Australia and others have some policies or6 Elderly Patient Carestandards that are used to maintain the quality of health are services provided to the patients. Italso ensures the well-being and quality care along with defining their duties and responsibilities.These ethics guides to follow the procedure ethically and limits any kind of actions that are notacceptable (Inzucchi, Bergenstal, Buse, Diamant, Ferrannini, Nauck, & Matthews, 2015). Themain purpose is to provide support to the professionals to make critical decisions but thoseshould be ethical and for the well-being of humanity.Considering the above two cases, ValueStatement 3 of the AN MC Code of Ethics would stand good which states Nurses value thediversity of people. Both the patients belongs to different background, culturally, family wiseand even socially. The nurses should never consider this as a part of the care she is entitled togive. QUESTION 16NMBA (Nursing and Midwifery Board of Australia) Enrolled nurse standards for practiceprovides support to the professionals to conduct their profession in an ethical manner. TheNational competency standards for the enrolled nurse (2002) have been replaced by The Enrollednurse standards for practice. It provides fact sheets for each case and the justification of the factsand figures of the treatment conducted (Inzucchi, Bergenstal, Buse, Diamant, Ferrannini, Nauck,& Matthews, 2015). These would be helpful for keeping evidences along with legal support.QUESTION 17Local, relevant State/territory Nurse Regulatory Nurses Act is some of the ethical procedures andpolicies that need to be followed at each level to provide better patient care (Galanti, 2014). TheNursing and Midwifery Board of Australia along with other national and international healthcareauthority board came together to discuss the significance of quality healthcare services and how7 Elderly Patient Careunethical practices could be controlled (Temel, Greer, Muzikansky, Gallagher, Admane,Jackson, & Billings, 2010). They put forth some policies and guidelines that need to be followedat various levels to maintain the best patient outcome and human health. QUESTION 18? two (2) requirements that must be met, before a client can be dischargedPhysical conditions of the patient along with the post-discharge plan are the two requirements.? two (2) signs/symptoms of hyperglycaemiaBlurred vision, increased thrust, weight loss and Blood sugar level higher than 180 mg/dL? two (2) signs/symptoms of hypoglycaemiaHunger, sweating, dizziness, unplanned chills and anxiety? two (2) health teaching of a diabetic patientDiabetic patient do not have capability of producing enough quantity of insulin that eventuallyincrease their body sugar level (Daniels, 2015). They should be aware and conscious of takinglow carbohydrates and sugar in their diet and should also take insulin regularly on time. ? Interpreter Services Good communication, effective body language and positive attitude would help in facing thischallenge. They should be addressed politely and should made convinced about your content. ? best communicate with people from different spiritual needs, ages, gender andcultures8 "