EXTENDED CARE - EXTENDED CARE Patients in the acute care...

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EXTENDED CARE Patients in the acute care setting may be discharged to an extended care facility. Patients requiring relatively short-term rehabilitation and those needing long-term care/permanent nursing care are included in this group. The level of care and needs of the patient (e.g., physical, occupational, rehabilitation therapy; IV and respiratory support) are frequently the deciding factors in the choice of placement. Although elderly people are the primary population in extended care facilities, increasing numbers of younger individuals are requiring care for debilitating conditions when they cannot be managed in the home setting. RELATED CONCERNS Acquired immunodeficiency syndrome (AIDS) Cancer Cerebrovascular accident/Stroke Craniocerebral trauma Multiple sclerosis Psychosocial aspects of care Spinal cord injury Surgical intervention Ventilatory assistance (mechanical) Patient Assessment Database Data depend on underlying physical/psychosocial conditions necessitating continuation of structured care. TEACHING/LEARNING Discharge plan Projected mean length of stay: Depends on underlying disease/condition and considerations: individual care needs. Therefore, this may be temporary or permanent placement. May require assistance with treatments, self-care activities, homemaker/maintenance tasks, or alternate living arrangements (e.g., group home) Refer to section at end of plan for postdischarge considerations. DIAGNOSTIC STUDIES (dependent on age, general health, and medical condition) CBC: Reveals problems such as infection, anemia, other abnormalities. Chemistry profile: Evaluates general organ function/imbalances. Age-related changes include decreased serum albumin, up to 20% increase in alkaline phosphatase, decreased urine creatinine clearance. Urinalysis: Provides information about kidney function; determines presence of urinary tract infection (UTI) or DM. Note: Bacteria is common in some populations, especially the elderly and bed-ridden, reflecting urinary stasis. Pulse oximetry: Determines oxygenation, respiratory function. Communicable disease screens: To rule out tuberculosis (TB), HIV, venereal disease, hepatitis. Drug screen: As indicated by usage to identify therapeutic or toxic levels. Visual acuity testing: Identifies cataracts/other vision problems. Tonometer test: Measures intraocular pressure. Chest x-ray: Reveals size of heart, lung abnormalities/disease conditions, changes of the large blood vessels and bony structure of the chest. ECG: Provides baseline data; detects abnormalities, e.g., ST segment and T wave changes, atrial and ventricular dysrhythmias, and various heart blocks are common in the elderly. NURSING PRIORITIES 1. Promote physiological and psychological well-being.
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This note was uploaded on 02/01/2011 for the course PNR 182 taught by Professor Toole during the Spring '10 term at Orangeburg-Calhoun Technical College.

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EXTENDED CARE - EXTENDED CARE Patients in the acute care...

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