Geriatrics and fluid balance assignment1 (1)
ASSIGNMENT
Geriatrics and Fluid Balance Simulation Game (Please hand in via D2L drop box labeled Module #1 prior to WebEx debriefing)
- When giving report to members of the Health Care Team we use a format called SBAR. What does each letter of the SBAR acronym stand for? Then in your own words summarize the report the nurse gives the Doctor in SBAR format.
Situation
Patient has deteriorating respiratory and cardiovascular status, HR = 124 Resp = 26 BP = 90/60, decreased air entry to the bases with mild crackles and weak peripheral pulses, O2 = 90% RA, Oxygen 2L NC, Saturation = 94%, short of breath
Background
A 70-year-old woman brought in by ambulance from a retirement home with lethargy, dehydration, and periods of confusion. She has decreased appetite, vomiting, diarrhea and a dry cough. Also has a decreased sense of taste and smell as well as a headache. Her mouth is dry.
Assessment
Fluid volume imbalance relating to vomiting and diarrhea
Recommendation
The nurse recommended to do some bloodwork and get the patient started on some IV fluids
- At the end of the game the nurse gives report to the Doctor, this is to relay the patients condition to the Doctor and receive direction for the Doctor regarding the care of the patient. This is called Doctor’s orders and because it is done via telephone, they are called Telephone Orders. When the doctor is finished give an order or orders via telephone what is the best practice for the nurse receiving the orders to do and why? Explain in your own words.
When the doctor has finished giving an order it is best practice for the nurse to confirm the order. This way the nurse can ensure she received the correct order, and the doctor can make sure the right order was given. This approach will reduce the risk of mistakes in a telephone order.
- In the game the patient (Minnie Frost) arrives in the Emergency Department You observe the nurse do a full head to toe assessment. Write down all the data the nurse collected and then divide it into Subjective and Objective data.
| Subjective | Objective |
| Complain of shortness of breath | Confused/Delirium |
| loss of sense of smell and taste and decreased appetite | Bowel sound present in all 4 quadrants, abdomen is flat |
| Worsening Headache | Fever |
| Feeling nauseous
|
Irregular and weak heart rate
|
| Difficulty breathing | |
| Increase in blood sugar | |
| Chest rising symmetrically | |
| Pupils are 2ml and reactive | |
| Dehydration | |
| Dry cough |
Assignment – The Aging Process Chart1 (1)
Fill in the chart below to create a summary of the physiological and physical changes associated with aging. You should use your textbook readings and the videos (listed under demonstration videos) for resources to complete this assignment. (Note: if you use Word to work on this table, it should expand as necessary)
Included your References under chart
| SYSTEM AFFECTED BY AGING CHANGE | RELEVENT CHANGES TO ANATOMY AND PHYSIOLOGY
(Give 4 or more) |
WHAT ARE THE SPECIFIC RISKS TO THE PATIENT DUE TO THESE CHANGES?
(Give 4 or more) |
HOW WOULD YOU APPROACH OR MANAGE THE PATIENT NOW THAT YOU ARE AWARE OF THE CHANGES?
(Give 4 or more Nursing Interventions with rationales that you would implement when giving care) |
| Sensory
(sight, smell, hearing, taste) |
– Less efficient
– Narrowing of visual field – Poor right vision – Depth perception decrease – Decrease sense of taste, smell, or temperature sensation |
– Presbyopia
– Dry eyes – Cataracts – Macular degeneration – Presbycusis – Poor equilibrium |
– Avoid driving at night
– Provide night lights – Avoid loud noises – Clean ears as needed |
| Integumentary | – Cells will decrease
– Impaired sweating mechanism – Darkening and wrinkling of skin around eyes – Collagen and elastin fibers that make up cartilage begins to break down – Thinning of skin |
– Greater risk of infection
– Decreased pain with injury – Susceptible to hyperthermia – Larger ears and nose – Cheeks and lips lose volume – Higher risk of skin tear |
– To help prevent wrinkling help patient avoid:
– sun exposure, – maintain good sleeping habits – stay hydrated and healthy – Help patient avoid injury or falls by minimizing clutter – Dress according to whether to decrease risk of hyperthermia and hypothermia – Treat any skin tear as soon as possible to help prevent infection |
| Musculoskeletal | – Decrease in number of muscle fiber present
– Tendons of the body shrink and harden – Bone density and mass decrease – Muscle mass and strength decrease |
– Sarcopenia
– Higher risk for falls – Osteoporosis – Risk for fractures |
– Encourage participation in balance and strength training
– Adequate vitamin D and calcium intake – Maintain a balanced diet – Weight bearing exercises – Wear shoes or socks with strong grip to help prevent falls |
| Genitourinary | – Kidneys decrease in size
– Decreased blood flow – Decreased filtration – Decrease bladder size and muscle strength |
– Poor control of water, sodium and glucose
– Nocturia and urinary frequency or urgency – Incontinence – Decrease in renal growth – Increase ability to metabolize medication |
– Smaller medication dosage requirement
– Create a frequent washroom schedule – Maintain hydration – Maintain good physical activity to increase blood flow |
| Gastrointestinal | – Teeth enamel becomes harder
– Teeth dentin becomes more fibrous – Gingiva retracts exposing tooth and nerves – Tongue gets smaller – Muscle of tongue and jaw become weaker – Decrease in neuron impulses to the colon |
– Ability to taste
– Saliva production decreases and becomes thicker – Difficulty of chewing or swallowing – Difficulty in absorption of some nutrients – Constipation |
– Maintain dental hygiene
– Encourage sitting up for at least 30 minutes after a meal – Increase nutrients intake – Create a washroom schedule for a patient with difficulty identifying a bowel movement |
| Cardiovascular | – Slight increase in size of left ventricle
– Atrial ventricular valves tend to become thicker and more rigid – Aorta tend to become dilated and elongated – Pacemaker cells decrease in number and become more irregular – Blood vessels tend to become more rigid |
– May lead to incomplete valve closure in the presence of systolic or diastolic murmurs
– Heart failure – Increased myocardial irritability – Increased likelihood of the development of arrhythmias – Atherosclerosis – Chronic hypertension – Stroke – Heart attack |
– Encourage walking
– Provide good coping stress mechanism – Regular exercise – Make sure patient takes their time to get up, without rushing |
| Respiratory | – Change in nose connective tissue
– Mucous in the nose becomes drier – Tissue and ribs become more rigid – Cilia becomes less effective – Decrease in number of alveoli – Lungs become smaller, lighter and more rigid |
– Tipping of nose downward
– Nasal stuffiness – Difficulty in chest expansion and extraction – More likely to breathe through their mouths which may contribute to snoring or sleep apnea – Higher risk for respiratory infections like pneumonia
|
– Avoid crowded places during cold seasons
– Maintain good hygiene to prevent germs to cause respiratory problems – Have patient lay down in ways that reduce snoring and sleep apnea – Have patient perform physical exercises that do not cause stress on the body to make chest expansion and extraction easier |
References in APA Format:
BYU Nursing Gerontology. (2018, August 16). Visible aging changes. YouTube. Retrieved November 16, 2022, from https://www.youtube.com/watch?v=XN5VSuQgc1Q&t=300s&ab_channel=BYUNursingGerontology
BYU Nursing Gerontology. (2018, August 31). Aging Changes of the Cells, Respiratory, and Cardiovascular System. Youtube. Retrieved November 16, 2022, from https://www.youtube.com/watch?v=7tlUTHN_TPM&ab_channel=BYUNursingGerontology
BYU Nursing Gerontology. (2018, August 31). Aging changes of the gi, Gu, and reproductive systems. YouTube. Retrieved November 16, 2022, from https://www.youtube.com/watch?v=To9q9ZAYzeM&t=320s&ab_channel=BYUNursingGerontology
BYU Nursing Gerontology. (2018, September 1). Musculoskeletal and nervous system aging changes. YouTube. Retrieved November 16, 2022, from https://www.youtube.com/watch?v=KMsdYup42qI&ab_channel=BYUNursingGerontology
BYU Nursing Gerontology. (2018, September 6). Aging changes of the senses endocrine and immune systems and mentation. YouTube. Retrieved November 16, 2022, from https://www.youtube.com/watch?v=uKK3scUthMs&t=338s&ab_channel=BYUNursingGerontology