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Hi! I unlocked a case study from this site but wondering if you could help me remove any plagiarizm fixed it in to APA style. Introduction This paper will examine the case study of Aadhna George Russo, an elderly indigenous woman residing in a care home and experiencing a multitude of health problems. She was diagnosed with hypertension, and her disease progressed until she suffered a heart attack. More recently she underwent abdominal surgery to remove a tumour from her large intestine. The goal of this paper is to identify the most pertinent areas of Aadhna’s life which could benefit from health promotion strategies. To determine the best health promotion strategies for the patient, a brief nursing assessment will be conducted for each area of concern. Based on those findings, health promotion suggestion will be presented and the proposed implementation. By the end, a number of realistic nursing recommendations will be made, which should all aim to improve the overall quality of life for Aadhna. Post-Op Disorientation As presented in the case study, Aadhna recently underwent surgery of her colon to remove a tumour. Since her return from the hospital following the surgery, the patient has been experiencing disorientation and confusion during the day. The cause of her symptoms are not clearly identified at this point, so further assessments would be required. A head to toe nursing assessment including all vital signs should be conducted in order to create a care plan surrounding these new and unusual findings for the patient. Specifically, the nurse should check the skin integrity surrounding the operative wound to check for any signs of infection which may be causing the patient’s delirium [CITATION Tut17 \l 4105 ]. A thorough cognitive assessment would also assist the nurse to establish the patient’s level of cognition to make appropriate care plan adjustments based on her findings. During the cognitive assessment, the nurse would also find it beneficial to question the patient during a time of lucidity about Aadhna’s pain level using a pain scale. Furthermore, the nurse should question her about her sleeping patterns following operation. The patient may be experiencing unnecessary pain or sleep disruption which may be contributing to her symptoms of disorientation [ CITATION May201 \l 4105 ]. Until the exact cause of the patient’s disorientation is identified by a physician, a number of interventions can be implemented to promote safety for the client. An immediate action that can be taken is to place floor mats around the patient’s bed to prevent injury if a fall were to occur during the night or while resting. Since this intervention does not require restraints and special approval from the family, an LPN can easily take this first step to promoting safety. Secondly, hip protectors may also be an option to avoid injury if a fall were to occur during ambulation. Review of the patient’s transfer method suitability and making adjustments as need may reduce the chances of a fall occurring. Nutrition Attention to the patient’s input and output are especially important following an operation of the colon, particularly considering the presents of her pre-existing conditions. Aadhna has high blood sugar currently controlled by metformin. Metformin is a medication used most commonly in patients with type 2 diabetes, taken orally with meals and fluids [CITATION Nur201 \l 4105 ]. The patient uses this medication for her otherwise uncontrolled blood sugar levels. In Aadhna’s case, a dietary assessment would help the nurse to determine if further review from a dietician would be beneficial to the patient. Adequate nutrition is essential for healing. The patient is likely already consuming a diet appropriate for high blood sugar, though the diet may require temporary changes to accommodate her additional nutritional requirements. Diet is an opportunity to involve the patient and the family in finding a balance between the dietary preferences of the resident and consulting with the dietician for a balanced diet. An assessment should include the input to determine the nutritional and fluid intake and medication suitability. Additionally, close comparison of the pre-op and post-op output characteristics (colour, odor, consistency and amount) may help the nurse identify any abnormal finding’s such as a blockage or bleeding throughout her GI tract. Leg ulcer An important aspect of the nurse’s role for this patient is positioning and mobility, in co[1]ordination with a physician for the suitability of ambulation and ROM following surgery. During recovery, Aadhna may experience some limitations until she reaches full recovery. By taking an inter-professional approach to the patient’s mobility and consulting a physical therapist and, or occupational therapist the nurse can help create a care plan that will at minimum maintain the patient’s level of mobility pre-op. Also, one of the goals of mobility exercise should be to prevent any exacerbation of her current leg ulcer and prevent the development of new ulcers. Ulcers are common in patients with diabetes and circulatory problems. Ulcers take a very long time to heal in the presents of circulatory issues, and can rapidly progress and lead to amputation if not addressed[CITATION Foo20 \l 4105 ]. There are a number of approaches to promote the health and integrity of this patient’s skin. As mentioned, proper nutrition and fluid balance will greatly impact the patient’s ability to restore their skin to a healthy state. The second aspect of caring for Aadhna’s skin is encouraging physical activity. Under the approval of the physician, the patient should be ambulating and performing ROM as soon as possible following surgery and this should be continued at the residents. This physical movement is good for heart health and circulation, reduces the chances for the patient to lose mobility and develop contractures and still, reduces chances of new ulcers forming while the patient is resting in bed or sitting for long periods of time during recovery. While in bed, the patient should be turned every 2 hours, and foot boots, pillows, trochanter rolls and wedges[ CITATION Ann20 \l 4105 ]. For the already present ulcer, proper wound care is essential and should be performed as per the wound care plan. All other skin should be kept clean, dry and barrier cream applied as necessary. Psychosocial As mentioned in the case study, Aadhna comes from indigenous origin, and has a supportive family who visits her frequently. Considering the close relationship, she has with her family, it would be beneficial for her and her family to be well informed and involved in her care. One benefit of involving the family is increased support and socialization. Additionally, the family can serve as a great resource for the nurse to obtain personalized information about the patient. This input can help the nurse construct a care plan with more consideration to Aadhna’s care preferences. Aadhna may wish to incorporate relevant activities, food or traditional healing techniques of her culture into her care. Incorporating more culturally appropriate care may assist in Aadhna’s reintegration from the hospital into her residents, and provide long term spiritual care. Conclusion A care plan is a living document that is continuously evolving just like the patient’s health and well being. If all of the health promoting interventions suggested for this patient should be implemented, their suitability may change over time. The desire is for the patient makes a full recovery without any complications such as an infection or loss of mobility. The should implement as many health promotion strategies as appropriate to ensure patient comfort and safety. References ADA. (2020, 07 29). Foot Comlications. Retrieved from American Diabetes Association: https://www.diabetes.org/diabetes/complications/foot-complications Clinic, M. (2020, 09 29). Delirium. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases[1]conditions/delirium/symptoms-causes/syc-20371386 Nursing2020 Drug Handbook. (2020). Philedelphia: Wolters Kluwer. K Kuswardhani, R. A. T., & Sugi, Y. S. (2017). Factors related to the severity of delirium in the elderly patients with infection. Clinical Medicine Insights.Geriatrics, 10, 1-5. doi:http://dx.doi.org/10.1177/1179553017723621 Pressure Injury Prevention and Care. (2020). In P. A. Anne Griffin Perry, Nursing Interventions & Clinical Skills (pp. 675-696). Elsevier.

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