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Critical Thinking Essay-Mr. M Case Study

Critical Thinking Essay-Mr. M Case Study

Sample Answer 

Critical Thinking Essay-Mr. M Case Study

critical-thinking-essay-mr-m-case-study

Mr. M Case Study

Describe the clinical manifestations present in Mr. M.

Mr. M is experiencing a variety of symptoms or rather syndromes as they are diverse, and relatively unrelated. This includes memory loss characterized by the inability to remember things such as the room he is staying in, information read, or names and faces of his family members. This can be defined as dementia due to his old age. Another symptom present is increased restlessness, as the patient is easily agitated and has an increased temper. An increased presence of fear follows this since it can only be assumed that due to his proposed dementia, he feels cornered/trapped as everything is unfamiliar to him and hence is in defensive mode. Night waking is also present, as well as increased physical inability requiring assistance in basic daily activities such as feeding and bathing.

Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.

The primary medical diagnosis for Mr. M is infection/nosocomial infection. Since he has had previous surgical history and is still recovering at the assisted living facility, the laboratory and objective data evidence only point to one abnormal reading: increased white blood cells and lymphocytosis. This normally occurs in response to a current active infection, especially secondary to a previous attack. It is possible that one of the surgical sites has gotten infected, leading to a spike in leukocytes and white blood cells. The secondary medical diagnosis for Mr. M is infection-induced dementia. Dementia is characterized by memory loss, usually due to nerve cell death in the brain. During the cause of an infection, if this manages to reach the brain, it will target the special brain cells called microglia charged with protecting the brain. The result is the induction of inflammation in response to the infection, and this worsens a current dementia situation or a developing one by causing nerve cell death in the brain (Muzambi et al., 2020). The evidence to support this is the increased number of white blood cells and leucocytes, which are only indicative of a present and active infection in Mr. M’s body at the time of laboratory testing for the data provided.

When performing your nursing assessment, discuss what abnormalities would you expect to find and why.

For a patient with an active infection and present active infection-induced dementia, they’ll be likely will be likely to manifest the following abnormalities; depression since the patient cannot remember his surroundings and immediate family; hence the pressure from people acting as if they know him is likely to lead him to depression. An active depression, if left unchecked for a long time, is more than likely to cause psychosis as the patient will reach a point of believing they have gone mad as they cannot remember anything. Sleep disturbances are already present in this case; hence, the patient is always uneasy at night due to the fear of being in an unknown and dangerous environment. Aggression and agitation are also related to the fact that they cannot account for how they got there and who the strangers around them; hence, the need to protect themselves always kick in. Lastly, anxiety is very much expected in this stressful situation for them (Muzambi et al., 2020).

Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. Discuss the impact it can have on his family.

For a patient with infection-induced dementia, a number of things can occur as a result of this. They are categorized into two major classes that are physical and psychological and emotional aspects. On the physical aspects, there is expected to be increased bowel incontinence; this is due to the psychological pressure the patient is on to try and remember hence inhibition of the autonomic nervous system, specifically the actions of the parasympathetic nervous system. There is also the rapid loss in mobility functions; hence they will not be able to walk or even take a bath or stand from a chair or a supine position without the help of nurses or persons assisting them. This negatively impacts their quality of life, and in most cases, people give up in such situations. Another aspect of dementia on their physical abilities is that the condition is associated with an increased number of falls among the elderly, and this could lead to damage to their skeletal structure and pain associated with falling. This can be a disturbing situation for the family seeing, for example, the elder member of the family incapacitated, and it could be a depressing encounter for the family members (Janbek et al., 2020). On the Emotional and psychological aspect, the patient is likely to experience anxiety, depression, stress, euphoria, hallucination, apathy, and disinhibition, with these factors coming into play at different times and in different severities.

Discuss what interventions can be put into place to support Mr. M. and his family.

Currently, there is no cure for dementia, with its treatment relying on preventive and supportive measures for the patient. Unlike many other conditions where pharmacological therapy (use of drugs ) will be the first line of management, in dementia, nonpharmacological methods are what is used as the first line of management. These include daycare enrolments for the patient if they are living at home with the rest of the family, counselling for the rest of the family to help them understand the disease better and be in a position to be of use and not a stress factor to the patient and the rest of the family. For risk factors likely to worsen the condition, such as vitamin B12 deficiency and hypothyroidism, medical intervention can be applied, which will include a properly balanced diet, hydration plans, management of existing comorbidities such as hypertension and hypercholesterolemia (Janbek et al., 2020). In addition, the management of the psychological diseases associated with the disease, such as depression, anxiety, and psychosis, is encouraged.

Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.

Dementia comes with various inhibitions, which have been shown to affect balance and posture; hence the first problem for the patient includes falls, leading to broken bones and pain. The second problem is malnutrition and dehydration since the condition is associated with reduced appetite; hence, the patient will not easily eat and drink as they should. This would lead to the third potential problem: weight loss (Janbek et al., 2020). Lastly, the fourth problem will be continued memory loss affecting even language, thinking, and speech. This will lead to the patient slowly becoming non-existent while still alive, as they’ll be unable to talk, remember, or move around.

References

Janbek, J., Taudorf, L., Musaeus, C. S., Frimodt‐Møller, N., Laursen, T. M., & Waldemar, G. (2020). Increased short‐ and long‐term mortality following infections in dementia: a nationwide registry‐based cohort study. European Journal of Neurology, ene.14595. https://doi.org/10.1111/ene.14595

Muzambi, R., Bhaskaran, K., Brayne, C., Davidson, J. A., Smeeth, L., & Warren-Gash, C. (2020). Common Bacterial Infections and Risk of Dementia or Cognitive Decline: A Systematic Review. Journal of Alzheimer’s Disease, 76(4), 1609–1626. https://doi.org/10.3233/JAD-200303

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Question 


Critical Thinking Essay-Mr. M Case Study

it is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Critical Thinking Essay-Mr. M Case Study

Critical Thinking Essay-Mr. M Case Study

Health History and Medical Information
Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario
Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

  • Temperature: 37.1 degrees C
  • BP 123/78 HR 93 RR 22 Pox 99%
  • Denies pain
  • Height: 69.5 inches; Weight 87 kg

Laboratory Results

  • WBC: 19.2 (1,000/uL)
  • Lymphocytes 6700 (cells/uL)
  • CT Head shows no changes since the previous scan
  • Urinalysis positive for moderate amount of leukocytes and cloudy
  • Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L
Critical Thinking Essay
In 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:

  1. Describe the clinical manifestations present in Mr. M.
  2. Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.
  3. When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
  4. Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. Discuss the impact it can have on his family.
  5. Discuss what interventions can be put into place to support Mr. M. and his family.
  6. Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

RUBRIC
Maximum Points: 120.0

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