Week 2 discussion
As geriatric patients age, their health and functional
stability may decline resulting in the inability to perform basic activities of
daily living. In your role as the advanced practice nurse, you must assess
whether the needs of these aging patients are being met. Comprehensive
geriatric assessments are used to determine whether these patients have developed
or are at risk of developing age-related changes that interfere with their
functional status. Since the health status and living situation of geriatric
patients often differ, there are a variety of assessment tools that can be used
to evaluate wellness and functional ability. For this Discussion, consider
which assessment tools would be appropriate for the patients in the following
three case studies:
Case Study 1:
Mr. Smith, age 77, reports for an annual physical
examination. He says he is doing well. His only known problem is
osteoarthritis. He also requests a flu shot. He takes no medications other than
Tylenol for arthritis pain. When he walks into the exam room, you notice that
he is using a straight cane in his right hand. When you ask about the cane, he
says he began using the cane because the pain in his right hip had increased
significantly over the past 6 months.
Case Study 2:
Mr. Jones, a 68-year-old man, was referred to your office
for a hearing evaluation. He continues to work in a printing company, although
he works only part-time. He has worked at the printing company for the past 35
years. He complains that he cannot hear much of the dialogue on the television.
He is accompanied by his wife, who states that her husband cannot hear her at
home. He has no history of dizziness, tinnitus, or vertigo. He has had cerumen
impactions removed from both ears in the past. Overall, his medical history is
quite benign. His only medications are aspirin 81 mg daily, a multivitamin
daily, and occasional ibuprofen for back pain.
Case Study 3:
Mrs. Roberts, an 83-year-old widow, is brought to the office
by her daughter. The daughter claims that her mother seems to be depressed.
There is a history of depression approximately five years ago, shortly after
Mrs. Robertsâ€™ husband died. At that time, she was successfully treated with
antidepressants. Currently, the daughter states that her motherâ€™s memory for
appointments and events has declined severely, and she can no longer drive
because she does not remember the route to the store or other familiar places.
The daughter also noted that her motherâ€™s house seemed very disorganized and
dirty, there was a limited amount of food in the kitchen, and the checkbook had
not been balanced for several months. Mrs. Roberts appears slightly disheveled,
she has a flat affect, and she does not maintain eye contact during your
Review the Rosen and Reuben article in this weekâ€™s Learning
Resources. Consider how assessment tools are used to evaluate patients.
Select one of the three case studies. Based on the provided
information, think about a possible patient evaluation plan. As part of your
evaluation planning, consider where the evaluation would take place, whether
any other professionals or family members should be present, appropriate assessment
tools and guidelines, and any other relevant information you may wish to
Consider whether the assessment tool you identified was
validated for use with this specific patient population and if this poses
issues. Think about additional factors that might present issues when
performing assessments, such as language, education, prosthetics, missing
Post on or before Day 3 an explanation of your evaluation
plan for the patient in the case study you selected and explain which type of
assessment tool you might use for the patient. Explain whether the assessment
tool was validated for use with this patientâ€™s specific patient population and
whether this poses issues. Include additional factors that might present issues
when performing assessments, such as language, education, prosthetics, missing
Read a selection of your colleaguesâ€™ responses.
Respond on or before Day 6 to at least two of your
colleagues on two different days in one or more of the ways listed below.
Respond to colleagues who selected different case studies than you did.
Suggest alternative assessment tools and explain why these
tools might be appropriate for your colleaguesâ€™ patients.
Recommend strategies for mitigating issues related to use of
the assessment tools your colleagues discussed.
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