Care Plan (G.Palo).pdf - vSIM for Nursing Describe Disease Process Affecting Patient(Include Pathophysiology of Disease Process Alzheimer\u2019s disease(AI

Care Plan (G.Palo).pdf - vSIM for Nursing Describe Disease...

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vSIM for Nursing Describe Disease Process Affecting Patient (Include Pathophysiology of Disease Process) Alzheimer’s disease (AI) is a chronic, progressive, neurodegenerative disease of the brain. It is the most common form of dementia, accounting for 60% to 80% of cases of all cases of dementia. It is estimated that 11% of people age 65 and older, and nearly one third of those over age 85, have AD. Ultimately the disease is fatal, with death typically occurring 4 to 8 Years after diagnosis, although some patients live for 20 Years Characteristic findings of AD relate to changes in the brain’s structure and function: (1) amyloid plaques, (2) neurofibrillaryTangles, (3) loss of connections between neurons, and (4) neuron death. As part of aging, people develop some plaques in their brain but in AD more plaques appear in certain parts of the brain. These plaques consist of clusters of insoluble deposits of a protein called B-amyloid, other proteins, remnants of neurons, non-nerve cells cells such as microglia (cells that surround and damage cells or foreign substances), and other cells such as astrocytes (Lewis, 2017). Diagnostic Tests (Reason for Test & Results) Patient Information Anticipated Physical Findings No definitive diagnostic test exists for AD CT/MRI may show atrophy of the brain in later stages of the disease PET scan to differentiate between AD and Dementia Mini-Cog assessment tool (4) Used as a brief assessment tool for cognitive impairment and guide the need for further evaluation Geriatric Depression Scale (10) Self report measure of depression in older a (Lewis, 2017, p. 1405-1408). Pt: George Palo Age 90 y.o male DOB: 08/01/30 Hx of minor neurocognitive decline, depression R/T AD, and was started on a Rx of Galantamine 6 months ago. Currently lives alone. Accompanied by daughter, Maggie, for today’s evaluation. Memory loss that affects job skills Difficulty performing familiar tasks Problems with language Disorientation to time and place Poor or decreased judgment Problems with abstract thinking Displacing thing; Changes in mood or behavior Changes in personality Loss of irt itiative (Lewis, 2017).
Anticipated Nursing Interventions Assess patient memory and level of function. Teach patient and caregivers memory enhancement aids (ex: calendars, notes) Monitor for physiologic problems associated with AD, such as pain, swallowing difficulties, urinary tract infection, pneumonia, skin breakdown, and constipation. Assess patient’s nutritional and fluid intake and develop a plan to ensure adequate intake Evaluate patient’s safety risk factors. Determine possible precipitating factors for behavioral changes and develop strategies to address difficult behavior. Assess the family caregiver’s stress level and coping strategies. Make referrals for community services such as adult day care and respite care.

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