NRS410 Week 2 Discussion: Mr. M Case Study Essay

NRS410 Week 2 Discussion: Mr. M Case Study Essay

NRS410 Week 2 Discussion: Mr. M Case Study Essay

Mr. M. Case Study
Describe the subjective and objective clinical manifestations present in Mr. M.
Mr. M, a male patient, is 70 years old and has been admitted to a nursing facility for assistance with activities of daily living due to his declining health. The patient does not have a history of smoking or drinking. Furthermore, no allergic reactions are shown in his portrayal. His unstable gait and walking difficulties exacerbate his inability to engage in physical activities. His medical background includes hypercholesterolemia, hypertension managed with ACE inhibitors, a healed tibial fracture, and appendectomy. In addition, he portrays aggressiveness and confusion. Because of his anxiety and confusion; he has trouble recalling the names of his loved ones.

ORDER A PLAGIARISM-FREE PAPER HERE

Also, he needs help recognizing his bedroom when wandering around at night. The laboratory findings suggest that the patient may have a urinary tract infection. The white blood cell count of Mr. M is 19.2, whereas the normal range is 4.0-11.0. This suggests the patient may be infected. Mr. M. also has a high number of lymphocytes, which suggests a long-term bacterial infection. His urinalysis results are out of the ordinary because they were cloudy and positive for leukocytes. A urinary tract infection may be present due to increased leukocytosis.

Primary and Secondary Medical Diagnosis
Considering the information provided by Mr. M, the most likely primary diagnosis is Alzheimer’s disease. His escalating aggression and confusion lead to this conclusion. Early signs of Alzheimer’s disease include trouble focusing, remembering recent events, recognizing familiar faces, mood swings, memory loss, language difficulties, inability to carry out routine tasks, withdrawal from social interaction, and impaired judgment (Scheltens, 2021). The evidence suggests that a urinary tract infection is the most likely secondary nursing diagnosis for Mr. M. The elevated white blood cell count, positive urinalysis for moderate leukocyte amounts, and increased lymphocytes indicate a bacterial infection, as shown by the laboratory results. Decreased movement, agitation, and drowsiness are additional symptoms of a urinary tract infection in a person with dementia (Scheltens, 2021). Given that Mr. M exhibits all of these signs, it is reasonable to assume he has Alzheimer’s disease and a UTI.
Abnormalities
Variations in Mr. M’s vital signs, like body temperature, blood pressure, and respiration rate, may suggest the existence or absence of a particular infection and contribute to the abnormalities observed during the assessment. The client denies feeling any pain, but a nursing assessment indicates otherwise. Because of the factors mentioned earlier, the nurse would need extreme caution when monitoring the patient’s vital signs. The nurse should keep tabs on them regularly, informing them of Mr. M.’s progress and what subsequent interventions might be necessary because the vital signs reflect abnormalities and changes in the client.
Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him.
The patient appears at risk for several physical complications, including malnutrition, falls, reduced mobility, and compromised skin integrity. As the client’s mobility and strength deteriorate, the risk of them falling and getting hurt increases. Mr. M is at risk of malnutrition because he cannot track when meals are served in his state of confusion. Mr. M’s skin may also irritate and eventually break down if he becomes incontinent of urine and feces.
Mr. M’s mental state currently includes anxiety, fear, and agitation. Patients with Alzheimer’s disease are often aware of their increasing confusion, which can frighten the individual and have an emotional impact (Soria Lopez et al., 2019). The patient’s loved ones may feel discouraged and frustrated upon recognizing the symptoms Mr. M describes. Mr. M and others with similar health problems may experience severe depression as their health worsens. The inability to function physically and mentally causes depression in individuals with dementia.
Discuss what interventions can be implemented to support Mr. M. and his family.
Mr. M. and his loved ones can receive help through various interventions. The first step toward the client’s recovery and reduced violence and aggressiveness is to have his mental health evaluated and refer him to a therapist. Second, having a private nurse designated to the client can ease some strain on the family by assisting with the patient’s ADLs. Identifying the source of the patient’s symptoms—liver, kidney, stroke, UTI, or heart attack—is the third step in treating their condition. Patients can receive the care they need to recover fully with an accurate diagnosis. Understanding that the correct medication will speed up the patient’s recovery is vital for healthcare providers, individuals, and their loved ones (Khan et al., 2020).
Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide a rationale for each.
Mr. M’s high risk of injury from falling is one of his many challenges. Mr. M is in danger of falling due to his diminished strength and increased dependence on others; as an older adult, injuries are also a concern. In addition, the infection could lead to sepsis, which could be fatal for Mr. M. If the bacterial infection is not managed, he could develop septic shock. If Mr. M is diagnosed with Alzheimer’s or dementia, he risks becoming malnourished and dehydrated (Khan et al., 2020). Finally, the patient’s life itself may be in jeopardy. Alzheimer’s disease ranks sixth among the leading causes of death.
References
Khan, S., Barve, H., & Kumar, S. (2020). Recent advancements in pathogenesis, diagnostics and treatment of Alzheimer’s disease. Current Neuropharmacology, 18(11). https://doi.org/10.2174/1570159×18666200528142429
Scheltens, P. (2021). Alzheimer’s disease. The Lancet, 397(10284), 1577–1590. https://doi.org/10.1016/S0140-6736(20)32205-4
Lopez, S. A., González, M., & Léger, C. (2019). Alzheimer’s disease. Handbook of Clinical Neurology, 167, 231–255. https://doi.org/10.1016/b978-0-12-804766-8.00013-3

ORDER A CUSTOM PAPER NOW

WEEK 2 NRS 410

Case Study: Mr. M.

Requires Lopeswrite
Assessment Description
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.
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 known 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
1. Temperature: 37.1 degrees C
2. BP 123/78 HR 93 RR 22 Pox 99%
3. Denies pain
4. Height: 69.5 inches; Weight 87 kg
Laboratory Results
1. WBC: 19.2 (1,000/uL)
2. Lymphocytes 6700 (cells/uL)
3. CT Head shows no changes since previous scan
4. Urinalysis positive for moderate amount of leukocytes and cloudy
5. 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 subjective and objective clinical manifestations present in Mr. M.
2. Based on the information presented in the case scenario, state what primary and secondary medical diagnoses should be considered for Mr. M. Formulate a nursing diagnosis from the medical diagnosis and explain why these should be considered and what data is provided for support.
3. What abnormalities would you expect to find and why when performing your nursing assessment using the identified primary and secondary medical diagnoses.
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 a rationale for each.
You are required to cite a minimum of three 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.
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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

ORDER A CUSTOM PAPER NOW

RUBRIC
Skip to main contentEnable accessibility for visually impairedOpen the accessibility menuOpen the Accessible Navigation Menu

Case Study: Mr. M. – Rubric

Rubric Criteria

Clinical Manifestations of Mr. M.

Criteria Description
Clinical Manifestations of Mr. M.
1. Target

Subjective and objective clinical manifestations are thorough.

Diagnoses and Secondary Diagnoses

Criteria Description
Diagnoses and Secondary Diagnoses
1. Target

Discussion on what primary and secondary medical diagnoses should be considered, nursing diagnosis formulated from the medical diagnosis, and rationale and data that supports the medical and nursing diagnoses are thorough.

Explanation of Expected Abnormalities During Nursing Assessment

Criteria Description
Explanation of Expected Abnormalities During Nursing Assessment
1. Target

A thorough discussion of abnormalities a nurse would expect to find during a nursing assessment is presented. Strong rationale and evidence are provided for support.

Health Status Effect on Physical, Psychological, and Emotional Aspects of Patient and Family

Criteria Description
Description of the physical, psychological, and emotional effects of the health status on the patient, and the impact the health status has on the family.
1. Target

Description of the physical, psychological, and emotional effects of the health status on the patient, and the impact the health status has on the family is thorough.

Interventions for Support

Criteria Description
Discussion of interventions that can be put into place to support patient and his family
1. Target

Discussion of interventions that can be put into place to support the patient and his family is thorough.
Actual or Potential Problems Based on Condition

Criteria Description
Discussion and rationale of four or more actual or potential problems faced by the patient
1. Target

Discussion and rationale of four or more actual or potential problems faced by the patient are thorough.

Discussion and rationale of four or more actual or potential problems faced by the patient are omitted.
Thesis, Position, or Purpose

Criteria Description
Communicates reason for writing and demonstrates awareness of audience.
1. Target

The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific audience.
1. Acceptable

The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is evident.
Development, Structure, and Conclusion

Criteria Description
Advances position or purpose throughout writing; conclusion aligns to and evolves from development.
1. Target

The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent and unified. A clear and logical conclusion aligns to the development of the purpose.

No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are missing or inappropriate. No conclusion is offered.
Evidence

Criteria Description
Selects and integrates evidence to support and advance position/purpose; considers other perspectives.
1. Target

Specific and appropriate evidence is included. Relevant perspectives of others are clearly considered.

Evidence to support the thesis, position, or purpose is absent. The writing relies entirely on the perspective of the writer.
Mechanics of Writing

Criteria Description
Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc.
1. Target

No mechanical errors are present. Appropriate language choice and sentence structure are used throughout.
Format/Documentation
Criteria Description
Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline.

RESSOURCES

Pathophysiology: Clinical Applications for Client Health
Read Chapter 2 in Pathophysiology: Clinical Applications for Client Health.
View Resource

Cost-Effectiveness of Emergent MRI During Stroke Alert to Diagnose Stroke Mimics: Single-Center Experience
Read “Cost-Effectiveness of Emergent MRI During Stroke Alert to Diagnose Stroke Mimics: Single-Center Experience,” by Kapoor, Sha
… Read More
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=148381741&site=ehost-live&scope=site&custid=s8333196&groupid=main&profile=ehost

Couples Coping in the Community After the Stroke of a Spouse: A Scoping Review
Read “Couples Coping in the Community After the Stroke of a Spouse: A Scoping Review,” by Ramazanu, Alie, and Vico Chung, from
… Read More
https://lopes.idm.oclc.org/login?url=https://www-proquest-com.lopes.idm.oclc.org/scholarly-journals/couples-coping-community-after-stroke-spouse/docview/2355820530/se-2

Long-Term Effects on Survival After a 1-Year Multifactorial Vascular Risk Factor Intervention After Stroke or TIA: Secondary Analysis of a Randomized Controlled Trial, a 7-Year Follow-Up Study
Read “Long-Term Effects on Survival After a 1-Year Multifactorial Vascular Risk Factor Intervention After Stroke or TIA: Secondary An
… Read More
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=135138889&site=eds-live&scope=site

This Is Not Only About Memory: A Systematic Review on Neuropsychology Heterogeneity in Alzheimer’s Disease
Read “This Is Not Only About Memory: A Systematic Review on Neuropsychology Heterogeneity in Alzheimer’s Disease,” by Martorelli,
… Read More
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=pdh&AN=2018-47217-001&site=eds-live&scope=site

This Is Our Life Now. Our New Normal: A Qualitative Study of the Unmet Needs of Carers of Stroke Survivors
Read “‘This Is Our Life Now. Our New Normal’: A Qualitative Study of the Unmet Needs of Carers of Stroke Survivors,” by Denham et
… Read More
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=136283333&site=eds-live&scope=site

Optional- Disentangling Heterogeneity in Alzheimer’s Disease and Related Dementias Using Data-Driven Methods
For additional information, the following is recommended:
“Disentangling Heterogeneity in Alzheimer’s Disease and Relate
… Read More
https://www-sciencedirect-com.lopes.idm.oclc.org/science/article/pii/S0006322320300500

Optional- Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic Seizures
For additional information, the following is recommended:
“Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in
… Read More
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6509224/