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Nursing on Gerontology - Essay Example

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I. Truthseeking This is a case of an 82 year old female, who comes in with the chief complaint of shortness of breath. Because of this, she is already using oxygen. The patient has been smoking for 40 years already, although she is not barrel-chested. In addition, she presents with signs of depression…
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Nursing Essay on Gerontology
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"Nursing on Gerontology"

Download file to see previous pages Thus, the three main nursing diagnoses of the patient are 1) ineffective airway clearance related to pneumonia and chronic obstructive pulmonary disease (COPD), 2) impaired gas exchange related to acute and chronic lung disease, and 3) displaying symptoms of depression due to respiratory illness. It is highly possible that her respiratory condition is caused by her history of smoking. Cigarette contains noxious chemicals that irritate the respiratory lining. These protective mechanisms include the increased production of mucus layers the epithelium to prevent the chemicals from reaching the cells, causing further damage. In addition, the respiratory cells to divide in a faster rate to try to compensate for the chemical-induced tissue injury. As a result, the normally one-cell thick respiratory epithelium that is able to facilitate gas exchange between the atmosphere and blood is now converted to a thick epithelium with multiple cell layers, which decreases the amount of air passing through. This clinically presents as ineffective airway clearance, causing impaired gas exchange, thus explaining the shortness of breath experienced by the patient, and the need for supplement oxygen to meet the demands of the body (Reilly, Silverman & Shapiro, 2012, pp. 2153-2154). Addressing the first two nursing diagnoses should be prioritized because these two are the ones causing the depression. In fact, it is estimated that almost one-third of individuals suffering from a chronic medical condition present with signs of depression. When a person acquires a chronic illness, he or she must adjust both to the disease and to its treatment. Consequently, the health condition can affect a person’s independence, quality of life and perception. These changes cause significant stress that can push a person to abnormal levels of sadness, causing depression. Although a lesser priority, this nursing diagnosis should also be addressed since the loss of interest, sleep disturbance and repeated thoughts of death or suicide can adversely affect management of the concomitant respiratory disease (Cleveland Clinic, 2009). III. Open-Mindedness Again, the patient has depression resulting from the inconvenience brought by ineffective airway clearance and impaired gas exchange due to chronic airway obstruction, not elsewhere classified. Based on this statement, the measurable outcome should include 1) increased forced expiratory volume in a second (FEV1) to demonstrate improvement in airway clearance 2) increased oxygen saturation of hemoglobin to objectively measure improvement in gas exchange, and 3) better functional status (SF-36 Health Survey) score compared to before treatment. IV. Inquisitiveness Nurses have a vital role in the achievement of these outcomes. To improve FEV1 and oxygen saturation, nurses should first be familiar with the management plan of the patient. A) They ensure that the patient’s medications, bronchodilators for airway obstruction and supplemental oxygen to improve gas exchange, are being taken as per the doctors’ orders, so that homecare can become an option (Hernandez et al., 2008). B) Any questions about these medications, both by the patient and her family, should be addressed to promote compliance and adherence. By doing so, this can involve the family into the patient management (Jonsdottir, 2008). C) Also, the patient should be guided during the measurement of FEV1 using spirometer and oxygen satura ...Download file to see next pagesRead More
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