Tuesday, August 27, 2019

Geriatric Category Patients and Their Treatment Essay

Geriatric Category Patients and Their Treatment - Essay Example Healing, especially, has been identified as an issue in the elderly’ due to characteristic age related changes in skin texture, reduced processes of wound healing which are clearly distinct from the rapid healing in young patients (Gosain & Dipietro, 2004: 321). The particular patient shortlisted for this assessment belongs to the geriatric category as he is an 80 years old man, with an established diagnosis of Chronic Obstructive Pulmonary Disease (COPD), probably precipitated due to a history of excessive smoking. The man has also suffered an episode of shingles, as revealed from his medical history sheet. Due to the multiple comorbidities he is suffering from, he is currently being administered a combination of medications, which complicate his care further due to the multifarious side-effects associated with them. Taking history of a patient is an art which needs to be mastered by each nursing professional. It needs preparation of a proper environment, good communication s kills of the nursing practitioner, and is a thoroughly systematic, sensitive and professional activity (Lloyd & Craig, 2007: 42). The Calgary Cambridge Framework, a widely accepted standard for collecting the anamneses of a patient is generally recommended and includes five stages which summarize the history taking process (Lloyd & Craig, 2007: 44). ... tween the patient and the nurse for establishment of a true interaction, proper planning for shared decision making with the patient’s compliance, and closing the consultation amiably in accordance with the patient’s expectations (Lloyd & Craig, 2007: 44). Unhelpful interview techniques involving questions which are too probing, offensive, misleading or inappropriate are expressly prohibited in the Calgary Cambridge Framework. The framework advises against the use of defensive responses and tendency to jump to conclusions. A properly structured sequence of questioning aimed at obtaining comprehensive information about the patient's condition yielding pertinent data should be strictly followed. Discretion should be employed while obtaining answers to sensitive questions such as sexual and social history, and while gathering details about alcohol, tobacco or substance abuse (Lloyd & Craig, 2007: 47). The patient shortlisted for assessment is dependent on PEG tube for feed ing but is fully capable of taking care of his toilet and bathing needs with some guidance. Currently he suffers from cellulitis, especially in the lower body and the resultant wounds in both legs are causing considerable pain. The severely affected left leg is kept raised to reduce his discomfort and the wound is dressed aseptically on a daily basis. On immediate observation, the patient is afebrile, has a blood pressure (BP) of 140/95, a respiration rate (RR) of 20-37, and a heart rate (HR) of 80 beats per minute. His health parameters have consistently remained at this level for the last few days with only slight variations. However, as the patient was a regular smoker with an established diagnosis of COPD, he is in need of special care and oxygen therapy due to his compromised respiratory system

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