ASSESSMENT INFORMATION Assessment Title Written assessment Purpose The purpose of this written task...

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ASSESSMENT INFORMATION Assessment Title Written assessment Purpose  The purpose of this written task is to engage students with the application of theory  into practice and how this needs to be flexible to meet the needs of the person  requiring health care assistance. Due Date 4 th October 2023 Time Due 1400 hrs AEDT Weighting 40% Length 1500 words +/- 10% (includes in-text citations, excludes reference list)  Assessment Rubric Refer to Extended Unit Outline Appendix 2 LOs Assessed LO1, LO3, LO5 Task Students will assess, prioritise and plan the care of the guided case study patient using a  clinical reasoning framework in hospital and community setting. Introduction and  conclusion not needed. Case study Mr. Johnson is a 75-year-old man, was brought to the emergency department (ED) by his  daughter with concerns about his increasing levels of pain, intermittent periods of acute confusion and deteriorating overall general health.  Initial Assessment Mr. Johnson is alert but disorientated to time and place. He appears dishevelled and  malnourished, with a strong odour of urine. He was brought in a wheelchair and was  guarding his L knee. Daughter stated Mr. Johnson took two (2) Ibuprofen (neurofen) tablets couple of hours ago with minimal effect. BP - 140/93  HR - 96 bpm and regular  Peripheral pulses - Present  RR - 18 rpm  Temp - 37.0C (tympanic)  Sa02 - 98% RA  BGL – 9 mmol/L Height -170 cm  Weight - 74 kg (weighed 80 kgs six months ago) ECG - NAD  NRSG266: Principles of Nursing: Contexts of Ageing NRSG266 _ Assessment 2: Written Assessment _ © Australian Catholic University 2023 _ Page 2 of 5 MMSE – 23/30 L Knee Xray- NAD Urinalysis - dark concentrated yellow, clear urine, SG 1.010, pH 7, Leukocytes and  nitrite- positive. Medical history Mr. Johnson has a history of multiple chronic medical conditions, including  osteoarthritis, osteoporosis, hypertension, and diabetes. He is on several medications and  has regular visits with his primary care physician.  Medications Ibuprofen Panadol osteo Alendronate (Fosamax) Norvasc Cholecalciferol Calcium supplements Metformin Hydrochloride Gliclazide Hydrochlorothiazide Patient history Mr. Johnson lives independently in his own home and usually cooks his own meals at  home. His daughter visits him couple of times each week. Mr. Johnson walks for an hour  daily and catches up with his friends at the nearby park once a week. He enjoys spending  time with his grandchildren. He never smoked and drinks a bottle of beer after dinner  while watching TV. He wears glasses for long distance and bilateral hearing aids. Recently the daughter noticed Mr. Johnson increasingly neglecting his personal hygiene,  nutrition, and household upkeep. Mr. Johnson has been socially isolated. and had  multiple falls at home recently.  Admitting diagnosis: Early signs of dementia.  You are the registered nurse looking after Mr. Johnson, and you are required to plan her  care guided by a clinical reasoning framework and the provided case study information.  Sections you need to respond to include: 1. Patient assessment (500 words) • Provide an initial impression by identifying relevant and significant features from Mr.  Johnson’s current ED presentation. • Discuss the possible causes for Mr. Johnson’s intermittent cognitive impairment.  NRSG266: Principles of Nursing: Contexts of Ageing NRSG266 _ Assessment 2: Written Assessment _ © Australian Catholic University 2023 _ Page 3 of 5 Do you agree or disagree with Mr. Johnson’s diagnosis of an early onset of  dementia. Justify your opinion and support your discussion with evidence from  the case study. • Evaluate the impact a misdiagnosis may have on the care provided for Mr.  Johnson. Mr. Johnson’s intermittent confusion resolved after 3 days. He was assessed by the Aged  Care Assessment Team (ACAT) and was eligible for a community care package. Mr.  Johnson was discharged home with regular codeine for his chronic pain. 2. Physiological changes of ageing and identify patient issues (500 words) • Discuss how the normal physiological changes of ageing may increase Mr.  Johnson’s risk of falls. Identify three (3) evidence-based nursing interventions with rationales that should be implemented for Mr. Johnson to reduce the risk of  falls. (Do not include referrals in your answer).  • Evaluate how Mr. Johnson’s chronic pain would impact on his capacity to  complete two of his activities of daily living (ADL’s) ensuring you have  justified your choice of ADL’s. 3. Pharmacological management and nursing considerations (500 words) • Discuss why Mr. Johnson, as an older adult, is more vulnerable to adverse drug  effects. Ensure you include factors related to the anatomical, physiological and  behavioural considerations associated with ageing.  • Identify with rationale two (2) nursing interventions you would consider when  caring for Mr. Johnson who takes multiple medications (polypharmacy). (Do not  include referrals in your answer.) References APA 7th. Minimum 13 references . Provide URL for the references.

Dipali · Accepted Answer

WRITTEN ASSIGNMENT		4
WRITTEN ASSIGNMENT
Table of contents
Introduction	3
Patient Assessment	3
Physiological Changes of Aging and Patient Issues	4
Physiological Changes and Fall Risk	5
Evidence-Based Nursing Interventions to Reduce Fall Risk	5
Impact of Chronic Pain on ADLs	6
Pharmacological Management and Nursing Considerations	7
Vulnerability to Adverse Drug Effects	7
Nursing Interventions for Polypharmacy	7
Considerations for Anatomical, Physiological, and Behavioral Factors	8
Conclusion	8
References	10
Introduction
The nursing care plan for Mr. Johnson, a 75-year-old man who visited the ED with worries about pain, sporadic disorientation, and declining overall health, is described in this report. With a clinical reasoning framework, the paper focuses on patient evaluation, physiological changes associated with ageing, and pharmaceutical therapy.
Patient Assessment 
His daughter took Mr. Johnson, a 75-year-old man, to the emergency room (ED) because she was worried about his declining general health, escalating pain, and sporadic disorientation. To comprehend his condition and establish the best course of action for therapy, a thorough first examination is essential. Mr. Johnson showed up looking awake but out of place and time. His appearance suggested that he may have had problems with personal hygiene and nutrition because he was underweight, dishevelled, and had a strong urine odour. Notably, he was protecting his left knee, a sign of localised discomfort. He had taken two Ibuprofen tablets a few hours before, according to his daughter, but the pain alleviation was just marginal. Vital signs were within normal ranges; however, several noteworthy discoveries were present. Mr. Johnson's heart rate was 96 bpm with a steady rhythm, and his blood pressure was a slightly higher 140/93 mm Hg. His tympanic temperature was 37.0°C, and his respiration rate was 18 rpm. His blood glucose level was 9 mmol/L, and the oxygen saturation in room air was 98%. His weight has dropped from 80 kg to 74 kg in the past six months, raising significant nutritional problems that require additional investigation (Brixner et al., 2019).
The diagnosis of early onset dementia was made when the patient had a Mini-Mental State Examination (MMSE) score of 23/30, which indicated cognitive impairment. Given the possibility of other explanations for his sporadic bewilderment, it is crucial to rigorously evaluate this diagnosis (Warner et al., 2020). His disorientation may have been caused by a urinary tract infection (UTI), which is strongly suggested by the findings of the urinalysis, which revealed dark concentrated yellow urine, clear urine, a specific gravity (SG) of 1.010, a pH of 7, and positive leukocytes and nitrite levels. In older people, UTIs can cause cognitive symptoms known as "delirium." A complicated array of chronic illnesses, such as osteoarthritis, osteoporosis, hypertension, and diabetes, were discovered in Mr. Johnson's medical history (Schwerzmann et al., 2020). Ibuprofen, Panadol Osteo, Alendronate (Fosamax), Norvasc, Cholecalciferol, calcium supplements, Metformin Hydrochloride, and Gliclazide Hydrochlorothiazide are just a few of the meds he is taking. The risk of harmful medication effects and interactions is increased by polypharmacy, which is frequent in older persons (Park et al., 2021). It is crucial to assess his drug regimen for any potential interactions and negative effects. According to his daughter, Mr. Johnson leads an independent lifestyle but has been lax with regard to diet, personal cleanliness, and domestic maintenance. His recent social seclusion as well as several domestic slips and falls are worrying. For the purpose of designing effective treatments, it is crucial to determine the underlying reasons of these behavioural changes.
In conclusion, Mr. Johnson's first evaluation uncovers a number of important facts, including cognitive impairment, dietary issues, localised discomfort, polypharmacy, and strong indications of a urinary tract infection.
Physiological Changes of Aging and Patient Issues 
In order to provide Mr. Johnson, a 75-year-old man who has presented with a variety of health conditions, with holistic treatment, it is essential to comprehend the physiological changes associated with ageing. A number of natural changes brought on by ageing may exacerbate his present health conditions, notably his risk of falls and difficulties performing activities of daily living (ADLs).
Physiological Changes and Fall Risk
People age and undergo a number of physiological changes that may make them more prone to falling. Sarcopenia,

ASSESSMENT INFORMATION Assessment Title Written assessment Purpose The purpose of this written task is to engage students with the application of theory into practice and how this needs to be...

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