Fundamentals of Nursing: Caring and Clinical Judgement - Essay Example

In nursing, the practitioner is obligated to carry out comprehensive assessment of the patients under their care before they can administer any kind of medical measure or recommend them for a particular form of medical attention. Assessment is often done in a number of ways to ensure that in the end, the right prescription can be given and patient is relieved of the pains they had initially. The assessment should be holistic and helps to identify the patient’s nursing problems, which can either be actual or potential. The actual assessment is based on what the nurse can readily see in a client, while a potential assessment is based on what, in the forecasting ability of the nurse, could turn out to be a serious problem in some future time if precautions are not taken. We have the Glasgow Coma Scale (GCS) assessment tool that is often used for people who got unconscious out of their medical condition. Tom was got by his wife Mary in the bathroom in an unconscious condition. It is not immediately very easy to tell the exact problem he has. He is definitely going to be admitted to the intensive care unit to recover from his coma. The Glasgow coma scale will be used to test his recovery rate from the unconscious state. It is based on scores obtained from the eye response, verbal response and the motor response. The sum of the three response score will lead to the conclusion that Tom’s condition is severe, moderate or minor. An assessment could also be based on the interview with the patient or the person closest to them and who probably understands what they had been going through in the periods preceding their present situation. It would be possible for the nurse to infer the problem of the patient by understanding the preceding symptoms and the kind of drugs that they had got over the counter. History or background information of the patient could also prove resourceful the nurse investigating the condition of the client. Mary for instance says that Tom’s father died of something they had every reason to believe was a heart related problem. These are some hereditary conditions that people over the age of 65 years are always prone to. This condition can also be passed from one parent to child, making it possible for the condition to circulate within the family. Mary says that when she got Tom in his unconscious condition, one side of his body was flaccid, which means that his one side may have gone numb. This is a condition that often leads to strokes which impair the patient permanently in an irreversible way. Besides, he wasn’t able to talk well. This is a common characteristic of diabetics and people with heart conditions. Tom could be suffering in any of the two conditions, i.e. diabetes or other heart conditions. Under such situations, the nurse who cares for Tom should be concerned with Tom’s diet while he remains in hospital and even after he is discharged. Once the symptoms lead one to think that a patient could be diabetic, there are food materials that they are then supposed to abstain from lest their condition worsen. The heart problem could be the high blood pressure, which is the most common condition among people over the age of 65years. These two conditions go together in very many cases. They are two conditions that require strict balances and any kind of imbalance leads to serious medical problem. A nurse will prescribe the right way to handle Tom in case those are the two conditions that ail him. Goals As a nurse, one would want to see Tom abstain from the foodstuffs that lead to the rise or fall in the level of blood sugar. Any rise or fall in the blood sugar level leads to serious health problems that could lead to death. High blood pressure is a lifestyle medical condition that would call for a change in lifestyle. One is supposed to avoid stressing conditions to ensure that the blood pressure remains normal, because any rise could prove deadly if no urgent care is given. The nurse should ensure that as Tom stays in the hospital and even after he is discharged, he has the best conditions of feeding with the prescribed food and lifestyle that is devoid of stressing conditions. He needs to maintain a healthy living so that no imbalances in the blood sugar level and in the blood pressure are experienced often. Interventions for the goals One of the goals is to make sure that Tom can have a healthy feeding lifestyle. Poor feeding practices often lead to worsening of medical conditions and in the case of diabetes, one never has choice but to engage in healthy feeding practices. Being the lifestyle disease that it has proved to be, it calls for a lifestyle change. Certain foods lead to increased sugar in the blood which may lead to regular hospitalization or even death. The foods will most likely be prescribed by the doctor and in most cases; doctors will recommend reasonable indulgence in sugary food, or total abstention from such. Continual overconsumption of sugary foods will lead to raised sugar levels in the bloodstream, which would be a very serious case. For high blood pressure, the change in lifestyle will take the dimension of regular exercising ad leading a life free from stressing conditions. Conditions such as stress will exacerbate the blood pressure condition. When the blood pressure rises above normal, it would be another serious health problem that may lead to hospitalization or death at worst. High blood pressure conditions have killed many people before they can be rushed to the hospital for urgent medical attention. To avoid such, one has to live by the doctor’s prescription of lifestyle. Tom is likely suffering from this risky medical condition and the only way to help it is to perform many exercises, play golf more in case it results in the activity threshold that the doctor will ask him to live by. Katz, S; Stroud M (1963). "Functional assessment in geriatrics: a review of progress and direction". Journal of the American Geriatrics Society 37: 267–271. Mahoney, F; Barthel D (1965). "Functional evaluation: the Barthel index". Maryland State Medical Journal 14: 61–65.. Wilkin, D; Jolley D (1979). Behavioural problems among older people in geriatric wards, psychogeriatric wards and residential homes 1976-1978. University Hospital of South Manchester. Pattie, A; Gilleard C (1979). Manual of the Clifton assessment procedures for the elderly. Essex: Hodder and Stoughton. Goldberg, D (1972). The detection of psychiatric illness by questionnaire: a technique for the identification and assessment of non-psychotic psychiatric illness. Oxford: OUP. 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