SCENARIO

Clinical Scenario

Clinical Scenario

Introduction

This scenario is mainly focused on the care of a 79 year old woman who lives at home with her daughter and her grandchildren. The nurse will be introduced to Mrs. Huang because she is admitted to the facility of hospital in the department of respite care and her daughter takes care of her at a primary level and she is on a six week holiday. The old woman has weight of 45 kilogram and she is very skinny with a paper thin skin. She also suffers from Dementia which is at an early stage. Her daughter has indicated that she do not have a habit of eating or drinking well. It is further told that she becomes very red often and has sore genitalia from urinary incontinence. Mrs. Huang is also not able to stand on her feet and usually she tends to pull back on her walking frame.

Clues and information

Body temperature 37

Respiratory rate 22

Pulse rate 70

Blood pressure 90/50

Oxygen saturation level 97%

BGL 4mmol/L

Hourly urine output 26ml/hr

New information

Appetite nil

Condition of body thin paper skin

Oral intake very less

Level of thirst nil

Memory Usually forgets things

Color Turns red sometimes

Physical condition not able to walk properly

Information processing

The priorities for caring Mrs. Huang are her dementia and, sore genitalia. A research states that every one person out of ten is suffering from dementia. Dementia is a step wise destruction of the cognitive skills of an individual and it can occur due to any disease or any damage to the brain cells. Dementia affects the functioning of the brain socially and occupationally (APA 2000). The symptoms for dementia are difficulty in understanding language and expressing, impairment of memory and mood swings.

There is no cure of dementia discovered yet and the treatments for the symptoms of the disease are regulated by the medical model that focuses on the pharmacological treatments Taft, et al. 1997 pp. 13-20). The medical model has been tested again and again because there are several side effects of the medication like delirium, confusion and higher risks of mortality and morbidity (Hajjar, et al. 2007 pp. 345-351). Sore genitalia are the eruption of the skin in a dermatomal manner of distribution. The patient suffers varicella initially, and the virus proceeds in an asymptomatic manner up to the ganglia of spinal dorsal root and the sensory cranial nerve ganglia (Harpaz 2008 pp.28-30). The immunity level reduces with age and the virus moves from the sensory nerves to the skin. This eventually results in a prominent prodormal pain along with rashes on the skin. It can be predicted that every one person out of three establishes sore genitalia once in their life time. This results in producing approximately 1 million patients in the United States every year.

Although the disease can occur in any age but it is more severe in older people. The rates of morbidity and mortality associated with the disease are higher in elderly (Yawn 2007 pp.225). The symptoms of the disease that are prodormal are ...