: A Patient with Altered Mental Status - Case Study Example

Case Study: A Patient with Altered Mental Status The essay aims to address a two-fold objective to wit: (1) to describe the patient condition through history, examination, and procedure ordered; and (2) to select 3 course concepts that recommends best practice in patients with altered mental status.Case Study: A Patient with Altered Mental Status Mental processing time decreases with age, memory, and language but the judgment capacities remain intact as well as the mental status of a patient; thus, any change in the mental status of an aging client should never be viewed as normal (Brunner, Smeltzer, Bare, Hinkle & Cheever, 2009, 1850).

For instance, Patient X who was 70 years old was found confused and lethargic at bed time by her daughter. They had attended a relative’s birthday party and Patient X was in her usual state of good health when they left 2 hours before. Patient X took her usual medications when they arrived home which were set up in a weekly pill box including Metformin, Metoprolol, and Plavix. Previous medical history revealed positive Type 2 Diabetes Mellitus and hypertension prior to transient ischemic attack.

Upon initial examination, Patient X is disoriented, confused, and a lethargic woman in pajamas. There were no evidence of trauma and focal signs or symptoms, vital signs are stable, and oxygen saturation is good. Fingerstick glucose was ordered followed by the administration of 1 ampule of D50. Fingerstick glucose testing is the most commonly used method to determine blood glucose readings thus, are indicated for emergency instances requiring immediate determination of blood glucose (Medifocus.com, Inc., 2011, 24).

Meanwhile, the administration of D50 intends to provide higher levels and substrates to combat possible nutritional deficit and hypoglycemia (Ahrens, Prentice & Kleinpell, 2007, 493). After a few minutes, Patient X became alert and oriented. Medical practitioners advised her to be transported to the nearby hospital for further examination but decided to refuse transport after feeling well. The outcome of Patient X’s health status is good, care has been delivered effectively, and the only critique to the interventions done was the lack of education regarding possible complications of not being seen by a specialist nor was the possible reason for altered mental status.

As part of the case study, I chose 3 course concepts that would recommend the best practice in caring for elderly patients with altered mental status and history of diabetes and hypertension. Course concepts include patient assessment, patient-centered care, and special needs elderly of patient. In patient assessment, clinical case scenarios often find the AEIOUTIPS helpful. AEIOUTIPS stands for alcohol, epilepsy, infection, overdose, uremia, trauma, insulin, psychosis, and stroke and are viewed as the most possible causes why people experienced altered mental state (Elling & Elling, 2003, 172).

Applying the AEIOUTIPS assessment, possible causes of Patient X’s altered mental status were due to alcohol because they had attended a party, possible uremia due to hypertension, and insulin-related cause such as occurrence of hypoglycemia. However, although Patient X is taking hypoglycemic agents, it was not hypoglycemia that was found out during the assessment but the hypotensive effect of ethanol (found in alcohol) when combined with these agents. Meanwhile, patient-centered care involves preparation of Patient X during each intervention.

This can be done by teaching her about the procedures to be done. In addition, a patient-centered care also demonstrates respect for client’s right to refuse treatment or transport to other health facilities and the right to receive individualized, holistic, and population-focused care (Brunner, Smeltzer, Bare, Hinkle & Cheever, 2009, 1850). As care is patient-centered, so as the special needs of the patient must be met. Elderly population experiencing altered mental status has age-specific considerations.

Elderly patients airway must be checked for displace dentures for it may cause airway obstruction, supine position is not recommended because of poor tolerance and risk for respiratory distress, capillary refill time is not a reliable indicator of systemic perfusion because it increases as one ages, and altered mental status in elderly patients should be assumed to be a new finding unless a history of prior dementia is known (Proehl, 2009, n.p.). Failure to address the special needs of the elderly may result to the worsening of the condition.

ReferencesAhrens, T., Prentice, D. & Kleinpell, R.M. (2007). Anatomy and Physiology of the Gastrointestinal System. Critical Care Nursing Certification: Preparation, Review, & Practice Exams (5th ed.) (p. 473-494). New York: McGraw-Hill Companies, Inc.Brunner, L.S., Smeltzer, S.C., Bare, B.G., Hinkle, J.L. & Cheever, K.H. (2009). Assessment of Neurologic Function. Brunner and Suddarths Textbook of Medical-Surgical Nursing (12th ed.) (p. 1830-1856). Philadelphia: Lippincott Williams & Wilkins.Elling, B.

& Elling, K.M. (2003). History and Physical Examination of the Patient with a Neurological Problem. Principles of Patient Assessment in EMS (p. 171-181). New York: Delmar Learning.Medifocus.com. (2011). The Intelligent Patient Overview. Medifocus Guidebook On: Type 1 Diabetes Mellitus (p. 15-44). Maryland: Medifocus.com Inc.Proehl, J.A. (2009). Emergency Nursing Procedures (4th ed.) (n.p.). Massachusetts: Elsevier Inc.