Download Clinical Coach for Effective Nursing Care for Older Adults by Dorothy Carlson DEd RN, Ellen Pfadt PhD(c) RN PDF

By Dorothy Carlson DEd RN, Ellen Pfadt PhD(c) RN

A medical trainer sequence e-book! this convenient reference transitions from category to medical to perform to supply the details nurses have to take care of older adults in any perform surroundings. they are going to have entry to the entire symptoms, indicators, and collaborative administration of universal stipulations skilled by way of older adults as good as neighborhood assets. A spiral binding and ten thumb tabs make it effortless to fast locate the data they wish.

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Additional resources for Clinical Coach for Effective Nursing Care for Older Adults (Davis's Clinical Coach)

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A member of the • Withhold medications, if ordered, if dopamine agonist class, drug-induced parkinsonism is suspected this drug activates dopamine • Prepare patient for laboratory studies, receptors in the body. The such as complete metabolic panel, CBC, medication is delivered transdermally and replaced prealbumin, drug screens, and coagulation every 24 hours.

Improvement in a patient’s status may be noted when symptoms are immediately recognized and surgically treated. Disorders 51 • Impaired bladder control • Progressive decline in mental capabilities • Withdrawn behavior Priority Assessment • Obtain history of onset and duration of symptoms • Perform a neurological assessment, including cranial nerves, motor strength, gross and fine motor abilities, gait, and use of the Glasgow Coma Scale (see Chapter 10) • Obtain a complete medical and surgical history and current treatment regimen, including prescribed and OTC medications, dosages, and frequency • Obtain vital signs including pulse oximetry Immediate Nursing Interventions • Place patient on telemetry • Notify physician, NP, or PA • Administer supplemental O2 via nasal cannula and titrate to maintain pulse oximetry Ն90%, if ordered • Obtain IV access, if ordered • Monitor vital signs • Prepare patient for MRI or CT of brain, if ordered • Prepare patient for laboratory studies, such as complete metabolic panel, CBC with differential, coagulation studies, and ABGs, if ordered • Prepare patient for 12-lead ECG and chest x-ray, if ordered • Assist physician with lumbar puncture, if ordered Ongoing Nursing Actions • Review results of laboratory and diagnostic tests with physician, NP, or PA • Notify neurologist or neurosurgeon, if ordered • Perform periodic neurological assessments • Prepare patient for surgical placement of shunt, if ordered • Provide ordered and routine postoperative care • Advance diet as ordered and monitor patient response • Educate patient to follow up with physician routinely and as needed Risk Factors • Advancing age • Head trauma • Meningitis • Previous brain surgery 52 Disorders • Subarachnoid hemorrhage • Tumor Etiologies • Gradual impeded CSF flow causing ventricular enlargement and pressure on the brain Parkinson’s Disease A degenerative disease of the pigmented and brainstem nuclei, particularly the substantia nigra in association with the formation of Lewy bodies and loss of the neurotransmitter dopamine, that produces movement disorders and changes in cognition and mood Clinical Manifestations The patient may have • Bradykinesia • Change in voice quality • Decreased blinking • Depression • Drooling • Excessive perspiration • Flexed posture • Gait disturbances • Handwriting changes • Loss of facial expression • Muscular rigidity • Oily skin • Pill-rolling tremor of the hands • Seborrhea Priority Assessment • Obtain history of onset and duration of symptoms • Obtain a complete medical and surgical history and current treatment regimen, including prescribed and OTC medications, dosages, and frequency • Assess neurological status including ocular movements and frequency of tremors • Assess musculoskeletal system including range of motion, muscle strength, and gait • Assess vital signs including orthostatic BP and P readings • Assess functional ability to perform self-care activities • Assess nutritional status by using the Mini Nutritional Assessment tool (see Chapter 10) Disorders 53 • Assess for depression by using the Geriatric Depression Scale (see Chapter 3) On May 9, 2007, the Food • Perform skin assessment and Drug Administration Immediate Nursing Interventions (FDA) approved the Neupro • Provide for patient safety (rotigotine) patch for treat• Notify the physician, NP, or PA ment of early Parkinson’s disease.

27 ALERT Because of decreased sensation of the lower extremities, elderly individuals should be instructed not to walk barefoot and to inspect their feet daily for early detection of sores or pressure points so early intervention can take place. COACH CONSULT A loss of hearing can occur for a variety of reasons, including impacted cerumen. The physician, nurse practitioner (NP), or physician assistant (PA) can perform an inspection of the ear canal and remove cerumen if present. If cerumen is not the cause of the symptoms, additional testing should be pursued.

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