Elaborate Assessment of David King - Assignment Example

Case study Introduction The studied case concerns David King whose wife found fallen on in the showers upstairs, broughtand admitted to Accident and Emergency (A&E) department. The purpose of the report is to present an elaborate assessment, care and discharge plan for David King. The plan to be in the report is to ensure and guarantee comprehensive care for the patient. The plan will ensure safety of the patient during stay and even after discharge from the hospital until achieving significant recover. The structure of the report outlines assessment, provision of the actual care and discharge procedures from the hospital. Nursing assessment tools The nursing assessment tools relevant for the situation of David Kings are Crichton Royal behavior scale and the Barthel Index. Barthel Index encompasses ten items for measuring daily functioning of patients and particularly mobility and daily living (Gallao 2006, pg. 201). The tool helps in investigating items such as moving, feeding, transferring to toilet and back, bathing, walking, dressing, grooming, up and downstairs movement and continence of bladder. The Barthel Index is important here considering that the situation of avid King disenables him practicing self-care or operating independent of a caretaker. His hands are weak, he cannot communicate and has incontinent bladder that makes the tool the best for offering comprehensive care. Crichton Royal behavior scale measures patient’s ability in ten dimensions or items that include mobility, memory, self-care, social disturbances, communication and orientation (Schachter 2011, pg. 181). This toll is relevant considering that it guides in accurate assessment on issues that directly affect David Kings. For instance, the tool cab help a nurse assess and scale communication, coordination and memory capability of the patient. Health problems likely in David Kings From the description of the case study, David Kings seems to be suffering from three health problems that include heart attack, body injuries and impaired memory. Body injuries resulting from the slump that necessitated admission of David Kings in the hospital is the most urgent health care problem that nurses need to attend. Impaired memory and cognition is the second most urgent healthcare need about David Kings and which requires quick attention. Heart attack that could be due blood pressure requires the least urgent medical care. The reason for making manifest and hidden body injuries as urgent healthcare problems facing David Kings relates to the magnitude of the pain that the problem is likely to cause to the patient. Managing and reducing the pain suffered by David Kings on admission into the hospital will help reduce the strain of blood vessels on the injured parts (Schachter 2011, pg. 183). Since the suspicious cause of the fall relates to heart problem likely caused by high blood pressure as attributed to be the cause for father’s death, continued inflammation and soreness of blood vessels will work to worsen the condition. Impaired memory and cognition is identifiable health problem considering that considering the inability of David Kings to speak or communicate clearly. Impaired memory also manifests through the incontinent of urine that is perhaps due to unresponsiveness of the sphincter muscles that control flow of urine. This condition prioritizes second considering it could be a resultant effect of the pains experienced due to body injuries. David Kings can restore from the condition upon elimination of the body pains. Heart problem prioritizes last considering that it is a suspect cause of the fall and entire health condition that of David Kings. It is most likely that the condition happened at that particular moment of falling either through high blood pressure and would recur later. This means that treatment of the condition may not be immediate, but requires continuous care to help the patient regulate lifestyle and avoid reoccurrence of high blood pressure. In addition, the reason for last prioritization of the heart problem relates to uncertainty that it led David into the current health condition. Certainty about the suspicion of heart problem as the cause may become possible after David recovers from the pains due body injuries, regains conscious and explain what made him slump in the shower. Goals for the most urgent health problem Body injuries constitute the health problem requiring the most urgent treatment. One of the goals is to reduce and stop any inflammations on the body. Body inflammations have great ability to cause serious and unbearable pains for the patient (Rubin & Tamaoki 2005, pg. 219). If unchecked and left to continue after a long time, the body inflammation may develop into serious sores that may lead to permanent inflammation of blood vessels to cause improper physical appearances. Another goal regarding attendance to bodily injuries is to treat and ensue that any open wounds heal. Open wounds are susceptible to viral and bacterial infections. Treatment in this case means covering the wounds and applying antibacterial and antiviral elements. As argued by Rubin and Tamaoki (2005, pg. 221). Treatment of the open wounds will also prevent development of purse that may cause expansion of the wound to cover greater part of the affected region. Treating inflammations and open wounds within the quickest time possible will help prevent development of serious conditions and pains that may worsen health condition of David Kings. Interventions Treating wounds is actually the best and direct way to end pains and strains in the body of an individual patient. In the case of David Kings, two intervention strategies to reduce effects of or handle wounds will apply. One of the strategies is dressing that requires great care and diligence on the part of a healthcare practitioner. When dressing wounds, healthcare practitioners need to use disinfectant liquids to clean the wound surface (Sussman & Bates-Jensen 2007, pg. 78). Cleaning ensures removal of any dirt, stones or damaged skins that may cover particular cells from disinfection. Sometimes, cleaning may involve use of warm water to kill germs that may be present in the wound to cause extended damage on the body cells in the wounded region. After thorough cleaning and disinfection, healthcare practitioner then needs to identify a disinfected fabric to wrap or cover the wound to provide a moist effect to facilitate healing process. Another intervention may involve injection with or administration of antibiotic drugs to kill any bacteria that might have penetrated to cause further damage (Sussman & Bates-Jensen 2007, pg. 81). Inflammations on body parts can present a serious condition to the individual patient. In the case of David Kings, the best intervention strategies to tackle inflammations may involve messaging on the swollen parts with warm water to spur open of the surrounding blood vessels to allow easily flow of blood. Another intervention strategy to tackle inflammation can involve use of anti-inflammatory oil and elements on the swollen parts to suppress COX enzyme usually attributed to cause inflammations. The oils and elements applied on swollen parts should be COX inhibitors to suppress activities of COX enzymes to cause inflammations (Rubin & Tamaoki 2005, pg. 220). Applying of COX inhibitor oils and related anti-inflammatory elements can also take the form of messaging. Messaging in this case means rubbing smoothly on the damaged and swollen body parts to press and eventually make inflammations disappear. Issues likely to face client after discharge and solutions David Kings condition exposes him to various health issues that may live with him even after discharge from the hospital. One of the issues relates to likelihood that there will be reoccurrence of heart problems suspected to have caused him the slump that led him to the hospital. There is no actual treatment for heart attacks or high blood pressure. This means that if it had began manifesting in the life of David, the condition will continue to present considering the old age of David of 71 years (Kahn & Meyer 2003, pg. 144). Intervention strategy to this condition can involve recommendation of change of diet and adoption of easy lifestyle to reduce causes and avoid circumstances that escalate heart attack or high blood pressure claimed to have killed David’s parents. Since David lives with a Mary who is also aged, discharging the patients to go back home may not assure him best care that can limit his access to physical features that can cause him serious injuries when in isolation (Blumenthal, Rogers & M.D 2007, pg. 133). For the reason, it will be proper to refer David to elderly home for advanced care that will enable service providers to monitor him closely and ensure that prevention of serious harm if he faces any heart attack. Another health issue that David may face is soreness of joints that might have sustained harm during the slump. Intervention may still involve referral to elderly home for advanced care that may involve messaging of the joints. Upon discharge, David may also suffer from depression due to inability to engage in physical activities as he did before the slump. Intervention may involve subjection to thorough guidance and counseling to help in restoring his condition and enforcing acceptance. Furthermore, David is also likely to develop mobility difficulties that may be due to effects of join dislocation or numbness of injured body parts. Intervention can involve regular visitations of David to identify such a problem and provide walking sticks or wheel chair when deemed necessary. Conclusion The report outlines frameworks and processes to ensure provision of maximum quality and safe healthcare to David Kings who got admission in the hospital after slump in the upstairs shower of his house. David is 71 years who prior to injury was physically active and mostly health except for headaches that ended through self-administration of drugs. Even though healthy, David has a family history of heart problems and high blood pressure that might have led to his fall. To provide best care, nursing assessment tools that include Crichton Royal behavior Index and Barthel Index will be applicable. From the condition of David, it likely that he suffers from three health problems that include body injuries, impaired memory and heart problem. References BLUMENTHAL, ROGER S., M.D. (2007). 2007 Johns Hopkins White Papers: Heart Attack Prevention. Medletter Assoc. GALLO, J. J. (2006). Handbook of geriatric assessment. Sudbury, Mass, Jones and Bartlett Publishers. KAHN, A. P., & MEYER, D. H. (2003). The Encyclopedia of Work-Related Illnesses, Injuries and Health Issues. New York, Infobase Pub. http://public.eblib.com/EBLPublic/PublicView.do?ptiID=291158. RUBIN, B. K., & TAMAOKI, J. (2005). Antibiotics as anti-inflammatory and immunomodulatory agents. Basel, Birkhäuser. SCHACHTER, S. C. (2010). Evidence-based management of epilepsy. http://search.ebscohost.com/login.aspx?direct=true&scope=site&db=nlebk&db=nlabk&AN=685409. SUSSMAN, C., & BATES-JENSEN, B. M. (2007). Wound care a collaborative practice manual. Philadelphia, Wolters Kluwer Health / Lippincott Williams & Wilkins. http://www.r2library.com/public/ResourceDetail.aspx?authCheck=true&resid=608. Read More