It can also be established from the case history that the patient is depressed, confused and drowsy which suggests that the patient needs immediate care with respect to her mental health and a suicide risk assessment should also be performed. Apart from this, it is essential for the nursing staff to treat her with patience, look after her meals and medication and to maintain a silent environment around her. Urinary incontinence seems to be harmless in the shorter duration and can be give less importance due to other critical conditions, however, it is potentially life-threatening (Foreman, 2009). It is vital to look after urinary incontinence and prevent the soiling of the patient’s bed. The patient is also at an increased risk of cross-infection as Mrs. Djokic was residing at an aged care home. Hence, the hygiene of the patient should be scrutinized, wounds and skin tears to be looked for and a wash and change clothes should be provided to the patient.
General management of the chronic conditions is also of great significance and needs attention. For type-1 diabetes the management may include monitoring the blood glucose levels, monitoring closely for the signs of hypoglycemia, monitoring the anion gap, monitoring the fluid balance, administration of a prescribed dosage of insulin and medications (Wood, 2012). For dementia the management may include provision of a quiet environment with minimal stimuli, assisting the patient in daily activities, talking and dealing with the patient calmly and patiently, using simple and short sentences, assisting the patient in taking medications, meals and hygiene care, maintaining a schedule for toileting and avoiding mechanical restraints (Cruz et al., 2012).
The nursing staff should try to maintain a sleeping schedule, a diet chart and a toileting schedule. Medication administration of the patient should be strictly maintained and followed. There are increased chances of fall as the patient has dementia hence adequate lighting should be maintained and the patient should be assisted while walking and in daily activities such as changing clothes, washing etc. As the patient is prone to violent outbursts because of mental health status it is essential to keep any dangerous or harmful items and medicines out of the patient’s reach. Since the patient is diabetic there are increased chances of infections and ulcers. To prevent infections, the patient should be examined for any wounds or signs of infection and to prevent ulcers such as pressure ulcers, the patient should be made to get up from the bed at frequent intervals and made to change the posture of lying on the bed after some intervals.
Cruz, C., Fisher, A.S., Lussier-Cushing, M. & Repper-DeLisi, J. (2012). Dementia. In Buttaro, T.M. Nursing Care of the Hospitalized Older Patient. Wiley: Hoboken.
Foreman, M.D. (2009). Critical Care Nursing of Older Adults Best Practices (3rd ed). Springer Publishing Company: New York.
Institute for Quality and Efficiency in Health Care. (2017). Hyperglycemia and hypoglycemia in type 1 diabetes. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK279340/
Wood, S.L. (2012). Diabetes. In Buttaro, T.M. Nursing Care of the Hospitalized Older Patient. Wiley: Hoboken.
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