Case study of Mary Mueni

Published: 2021-07-07 00:22:46
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A 79 year old lady Mrs. Mary Mueni with mild Asthma lives in the North London. As a group member of the Catholic Church she is responsible for running the church activities and she was also responsible for seeing the co-coordinating activities for the resident association in the block of flat where she used to live, it was the time when she was not well. She has been admitted to the hospital because of having a minor stroke attack; hence she got discharged having a speedy recovery. It has been observed that over the past years she had been victim of the few residual difficulties, but faces some minor imbalance in leg so she used to walk by the help of tripod walking stick and easily got tired if she had to stay in queue for the long time period. She finds difficulty in having healthy foods. It is due to the reason that she faced difficulties in kitchen and she is not able to cook good food. Due to this cause she tends to eat the healthy food that progressively turning into the sever urine infection.She has a daughter Annie, who is used to visit her once at the weekend in order to help Mary to have bath and to let her shopping done. Moreover, carer also visits her on every Tuesday and Thursday to help he in washing. However, both of the care taker and Mary daughter is worried about her Mary as she is not participating actively and refused to participate properly in her daily activities. She used to spend all of her time on siting on the Chair as she is losing hope in her. Thus, general physician visited Mary at her home and diagnosed Vascular Dementia and suggest her to bring a nurse for care taking and to assess her need.The last Recorded Observation The last recorded observations of Mary were stated in the given table:Particular Observation Blood Pressure160/70mm/HgPulse Rate111 beats/minPain Score9/10Temperature38.9o CSats91% on 15 liters of OxygenRespiratory Rate31 breaths/minuteBlood Sugar6.8 mmolCapillary Refill Time5 secondMary got a Minor stork attack but gets a speedy recovery. She has been facing the issue of imbalance in legs which do not let her to stay stand for the long period of time. Due to having this terrible pain she is not able to work properly and cooks foods. Hence, she has been diagnosed with the issue of urine infection. She is not participating actively and refused to participate properly in her daily activities and she has been diagnosed having an issue of Vascular Dementia and asked for the district nursing to assess her needs.Medical Prescription:Prescription: 75 mg Aspirin orally once daily; Omeprazole 20 mg orally once daily; Salbutamol 100mcg 2 puffs twice a day; Beclametasone Diproprionate 200 mcg 2 puffs twice a day.Case Study Hostile Nursing Care By being diagnosed having an issue of Vascular Dementia and asked for the district nursing to assess her needs. She had been serving from having and issue of minor stroke, leg imbalance, urine infection, and vascular dementia. The role of a nurse is assisting the patients and makes them relax and content. In the case of Mary the distinct nurse has spent time with Mary and her daughter and discusses things with them in order to find out the issue. However, nurse discovered some further issue in Mary as she often attempted by diarrhoea and sometimes she gets tied with the constipating issue because of not eating healthy. Mary used to spend most of his time in spending chair and its increasingly becoming comfortable for both Mary and her daughter. Due to continuous sitting on chair her bottom area that sacral and is red and full of rash but have no sores. Moreover, the nurse has noticed the two small abrasions to her leg of normal size but it is no so disturbing to her but are seems to be scabbed and are healing. Her daughter continues by defining that it occur rarely and heal very easily and quickly without getting any issue. Henceforth, nurse seems satisfied and happy that those wounds are not leg ulcer and are just simple bruises and cuts and nothing else, but she had clearly ensured that such wound required full care and need so such few injuries many not be turn into nay risky deterioration as she have a few veins varicose issue analyzed. On a second visit of nurse at the Mary homes she come to conclude that Mary has been going through the issue of stress incontinence and she sometimes founds to be moody but it is a general thing about getting older. She often found in a condition of more breathless than normal as she goes around any populated area.Practices and Interventions of Nursing However, the paper is critically discussing about the symptoms and signs between the final diagnoses of vascular dementia in Mary. The analysis of the study is based on the case of Mary who have been facing many of the issues that is counting down the light of hope in Mary. A 79 year old lady Mrs. Mary Mueni with mild Asthma lives in the North London. By being diagnosed having an issue of Vascular Dementia and asked for the district nursing to assess her needs. She had been serving from having and issue of minor stroke, leg imbalance, urine infection, and vascular dementia. The disease process of vascular dementia and the psychological behavior is analyzed that may become one of the major reasons for influencing the behavior of patient. Therefore, such issues are essential to take under the full consideration. Hence, in this paper the exploration has been critically done in order to define the way to manage patient. It is done by considering the critical nursing intervention and assessment in order to ensure the best practices and interventions.Urine InfectionIt is one of the issues found in the case of Myra as she has been facing this issue due to unhealthy food. she faced difficulties in kitchen and she is not able to cook good food. Due to this cause she tends to eat the healthy food that progressively turning into the sever urine infection. It is cited in the study of (Urden, 2015) that urine infection is cause in the digestive system due to the excess amount of the bacteria caused by the (E. coli) bacterium Escherichia. However, this particular behavior is usually found in the digestive system. This infection may directly affect the bladder, kidneys, and tubes. The risk of having such infection is high in women as they have been facing the issue having such infection rate risk is about 50%. Some of its common issue may include the frequent urge to urinate, burning sensation when urinating, painful sensation when urinating. In addition to this, it is stated that this problems needs to be treated at specific time duration and it can be cured with the treatment of two to three days.Vascular DementiaIt is denoted in the study of (Park, 2014) that the vascular dementia is a very general term that uses to describe the issue with planning, reasoning, judgment, memory and many of the other thought process caused as a result of the brain damage due to impaired flow of blood to the brain. It can be develop after having stroke block in the brain but it is not necessary that the cause of vascular dementia is due to the stroke. The effect of strokes on the thinking and reasoning is dependable to the location and severity of the stroke. Vascular dementia is also due to the reason of brain being deprived of nutrients and vital oxygen, reduce circulation and blood vessels. 1 however, the risk of stroke and heart disease is increased due to having high blood pressure, smoking and high cholesterol also increase the risk of having vascular dementia. Hence, the controlling of such factors may lead into the lower chance of having the vascular dementiaIt is cited in the study of Butcher, (2018), that the symptoms of the vascular dementia is depends on the brain part where the blood flow have been impaired. The symptoms might defined the most clear cut when the happened suddenly by following a stroke. In addition to this if the reasoning and thinking is changed in the mind it clearly linked to the condition of stroke and might be represent as the post-stroke dementia. Moreover, one of the other characteristics that represent the vascular dementia symptoms might follows by the mini or series of stroke. In this aspect the changes in the stroke is notice downward from the previous function level. It has been analyzed from the several of studies that the symptoms of vascular dementia are usually due to having a brain change issues. In addition to this, sometime such situation may call by the doctors as the condition of mixed dementiaIn this below stated list several of the major symptoms of having vascular dementiaHaving issue and trouble in paying concentration and attentionThe rate of confusion increasesIt reduces the ability of organize action and thoughtsIt declines the ability to analyze a situation and the ability to develop and plan an effective communicationIt decereas the abilty to decide what to done nextThe problems with memory startedThe issue of agitation and restlessnessHigh rate of depressionThe frequent and sudden urge to urinate and inability control on passing urineIn the case of Mary she has been facing the same issue of vascular dementia and she has been facing issue of memory. She has been facing the issue vascular dementia due to having a brain change issue. However the process of vascular dementia and the psychological behavior is analyzed as one of the major reasons for influencing the behavior of Mary. she used to spend most of his time in spending chair and its increasingly becoming factor of having memory problem that defines the condition of Vascular Dementia in Mary.Physical Examination The diagnosis of Mary started with the physical examination. Hence, it has been analyse that the issue of vascular dementia needs to be cover at the earlier basis in order to have a speedy recovery of Mary. The symptoms of Vascular dementia has been diagnosed in Mary and it is causing the sever imbalance in life. The vascular dementia system needs to be monitor specifically in order to raise hope in Mary. It declines the ability to analyze a situation and the ability to develop and plan an effective communication for Mary, It reduces the ability of organize action and thoughts in Mary. She has been facing issue and trouble in paying concentration and attention. Due to this consideration, it is essential to deliver a proper treatment to marry in order to minimize this issue. The proper implication is needed to deliver by the nurses to Mary to bring her out from this terrifying situation. It would be conducive to minimize the issue of vascular dementia so it could enable Mary to thin effectively and concisely.The finding of Mary began with the physical examination. Subsequently, it has been examine that the issue of vascular dementia should be cover at the prior premise keeping in mind the end goal to have a fast recuperation of Mary. The indications of Vascular dementia has been analyzed in Mary and it is causing the separate irregularity throughout everyday life. The vascular dementia framework should be screen particularly keeping in mind the end goal to bring trust up in Mary. It decreases the capacity to break down a circumstance and the capacity to create and design a powerful correspondence for Mary; it diminishes the capacity of sort out activity and contemplations in Mary. She has been confronting issue and inconvenience in giving careful consideration. Because of this thought, it is fundamental to convey an appropriate treatment to wed keeping in mind the end goal to limit this issue. The correct ramifications is expected to convey by the medical attendants to Mary to bring her out from this unnerving circumstance. It is helpful for limit the issue of vascular dementia so it could empowers Mary to thin adequately and briefly.Vascular Dementia Affecting MaryThe finding of vascular dementia in Mary is affecting her mood badly as it is clearly diagnosed by the nurse. It is referred to in the examination of* Basch (2015), that the manifestations of the vascular dementia is relies upon the cerebrum part where the blood stream have been debilitated. The side effects may characterized the most obvious when the happened all of a sudden by following a stroke. What’s more if the thinking and believing is changed in the mind it plainly connected to the state of stroke and may be speak to as the post-stroke dementia. In addition, one of alternate attributes that speak to the vascular dementia side effects may takes after by the smaller than usual or arrangement of stroke. In this viewpoint the adjustments in the stroke is see descending from the past capacity level. It has been broke down from the few of concentrates that the side effects of vascular dementia are ordinarily due to having a mind change issues. Moreover, at some point such circumstance may call by the specialists as the state of blended dementiaLooking at Mary, she has been analyze under the borderline hypotensive. The BP reading of 160/70 mm/Hg and it is clearly define as the fluid volume trigger of having high BP. Therefore, the BP rate is need to be monitored accurately in order to reassure her. Moving towards the pulse rate of Mary that is recorded 122 beats per minutes since, it shows the indication of the dehydration as it indicated that he heart is attempts to have the less volume of blood that causing into the harder and faster pumping. Hence, it is the reason for having the high increased heart rate (Clarke, 2017).The creator has utilized The Roper, Logan and Tierney Model (1980) to devise a customized medicinal services for Mary as his condition may make him remain in the doctor’s facility for an any longer length. The medical caretaker likewise should assume a key part in building up his care design (Standing, 2017). This model receives an all-encompassing methodology suits the effect of Mary s morbidities on beadily exercises. This model can distinguish upwards of twelve exercises: correspondence, disposal, washing and dressing, eating and drinking, working and playing, dozing, breathing, articulation of sexuality, versatility held in connection to the life expectancy and the reliance or freedom continuum. As per (Crowen, 2008), brought up the structure is oversimplified; notwithstanding, it gives a methods for building up a coherent methodical care in view of cooperation and shared coordination. It takes into consideration methodical gathering of data from a patient in horde points of view, for example, organic, mental, social, ecological and political-economic. However, the nursing procedure is an efficient strategy for outlining and conveying nursing care which includes the accumulation of data, tolerant appraisal, arranging consideration and characterizing targets for nursing care, and additionally executing intercessions and assessing comes about.It is denoted in the study of Conrad (2017) that an evaluation ought to be performed consistently, which is considered as an essential period of the nursing procedure that must be done over and again. On account of Mary, the RLT Model in light of Activities of Living is favored. This model empowers human services experts to create an appropriate care arrange for that is adjusted to his needs. Creator of this contextual analysis observes this structure to be a perfect model in surveying understanding completely. It is additionally valuable for human services experts as it keeps them from passing up a major opportunity for any part of care (Roper et al, 2000).Shortcoming of RLT Model, it must be yielded that the evaluation is a long-drawn process and it requires investment to cover each of the twelve viewpoints. The creator opines that despite the fact that it is a perfect fit for the ward where Mary will be conceded, alert must be practiced before utilizing it for all patients since it could be conceivable that Mary is conceded in a bustling ward; in the event that they evaluate all patients routinely utilizing this model, a few parts of nursing procedure may be disregarded, causing extra work for the approaching staff.Fever likewise identified with lack of hydration has been known to bring about unfavorable results including hypotension, tachycardia and tachypnoeic and shortcoming (Ostland, 2018). Different side effects incorporate expanded narrow refill time, and dry/broke lips. Mary. Flowing volume demonstrates that he needs a nearby checking of liquid contribution and additionally yield alongside hemodynamic.Mary condition of cognizance (consciousness) has been assessed through CURB-65 and a score of 3, which shows that he is cognizant and is threat of incapacity relating to awareness (Resuscitation Guidelines, 2015). Moreover, his psychological readiness ought to likewise be checked. Medical attendants ought to guarantee that he can convey sufficiently, since pneumonia can influence mental status. Notwithstanding, British Thoracic Society (B.T.S) (2009) states that variables like the seriousness of pneumonia and term of healing facility stay – cause 30 day and 1-year mortality of grown-ups who are 60 years old or higher.Mary has been given a dose of 75 mg Aspirin orally once daily. However the use of Aspirin is done in the high fever, flue, toothache and headache. It is given to reduce the pain. It is also used to minimize the swelling. Mary have been facing the issue of swelling and pain in the leg idue to the imbalance. This helps Mary in pain relief and swelling. However, it is denoted in the study of (Basch, 2015) that use of the Aspirin is not an effective one for the cure of the vascular dementia. In addition to this the issue of vascular dementia is reduced by the proper caring. In such situation it is essential to take care of the patients and provide them love and satisfaction.Mary has been given a dose of Omeprazole 20 mg orally once daily; as this medicine is useful in the relief of the certain stomach problems. It is directed by the physician to Mary in order to have relief from the stomach problems. As being directed by the nurse she has been facing this issue number of time and the main reason for this is that the nurse has analyzed that as she often attempted by diarrhea and sometimes she gets tied with the constipating issue because of not eating healthy. However there has been a certain side effect analyzed for the use of the Omeprazole including severe headache and abdominal pain etc.Mary has been given a dose of Salbutamol 100mcg 2 puffs twice a day as she is been a victim of the Asthma. It is one of the best cure and relief from Asthma. It is inhaler puffer and directed by the physician to use a twice a day in order to stay save from the asthma attack. However, the continuous use of Salbutamol leads in to the sever allergy and dryness. In addition to this, most of its attack visualize in the dry and cold session, therefore, the appropriate amount of puffs are required to inhale in such session as directed by the physician.Mary has been given a dose of Beclametasone Diproprionate 200 mcg 2 puffs twice a day. It is also giving to her to get relief from the short breath as a result of the asthma. It is inhaler puffer and directed by the physician to use a twice a day in order to stay save from the asthma attack. However there has been a certain side effect analyzed for the use of the Beclametasone Diproprionate such as dryness.Conclusion However, the paper is critically discussing about the symptoms and signs between the final diagnoses of vascular dementia in Mary. The analysis of the study is based on the case of Mary who have been facing many of the issues that is counting down the light of hope in Mary. A 79 year old lady Mrs. Mary Mueni with mild Asthma lives in the North London. By being diagnosed having an issue of Vascular Dementia and asked for the district nursing to assess her needs. She had been serving from having and issue of minor stroke, leg imbalance, urine infection, and vascular dementia. She has been treated by such issue by having the medicine Prescription of 75 mg Aspirin orally once daily; Omeprazole 20 mg orally once daily; Salbutamol 100mcg 2 puffs twice a day; Beclametasone Diproprionate 200 mcg 2 puffs twice a day. In addition to this she is properly visualized under the nursing monitoring in order to deliver proper care to her. It is due to the reason that along with the proper medical prescription a proper care and love is highly needed.ReferencesBasch, E., Deal, A. M., Kris, M. G., Scher, H. I., Hudis, C. A., Sabbatini, P., … & Chou, J. F. (2015). Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. Journal of Clinical Oncology, 34(6), 557-565.Butcher, H. K., Bulechek, G. M., Dochterman, J. M. M., & Wagner, C. (2018). Nursing Interventions classification (NIC)-E-Book. Elsevier Health Sciences.Clarke, D., & Malecki-Ketchell, A. (2016) Nursing the Acutely Ill Adult: Priorities in Assessment & Management. London: Macmillan Education Palgrave.Conrad, K, (2017). Clinical Approaches to Hospital Medicine. New Orleans, LA: SpringerCorwin, E. (2008). Handbook of Pathophysiology. New York: Wolters Kluwer.Östlund, U., & Persson, C. (2014). Examining family responses to Family Systems Nursing interventions: An integrative review. Journal of Family Nursing, 20(3), 259-286.Park, H. (2014). Identifying Core NANDA‐I Nursing Diagnoses, NIC Interventions, NOC Outcomes, and NNN Linkages for Heart Failure. International journal of nursing knowledge, 25(1), 30-38.Urden, L. D., Stacy, K. M., & Lough, M. E. (2015). Priorities in critical care nursing. Elsevier Health Sciences.

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