NURSING QUESTION Scenario: Susan is a 65-year-old school nurse who has recently
ID: 122654 • Letter: N
Question
NURSING QUESTION
Scenario:
Susan is a 65-year-old school nurse who has recently retired from an elementary school. She is beginning to feel rather lonely now that she is no longer working. She is a widow with adult children living out of the area. Her children have suggested that she may want to move to their city and be closer to her grandchildren. She has been avoiding these discussions with her family and tells them all is fine. Moving seems like a major upheaval to her. Although she has been in fair health physically, at her last visit to the health care provider, she had lost 10 pounds and is just below her desired weight.
Nursing Concern and Nursing Interventions:
Nursing Concern: Adult failure to Thrive related to depression.
Nursing Interventions:
1. Monitor patient using geriatric depression scale
2. Monitor weight loss and food intake.
3. Help the patient identify and practice activities that promote usefulness
In 100 words or more and based on the above scneario and the above nursing concern and nursing interventions, please do the following (providing support for your answers):
A. Identify and state any concerns associated with the proposed nursing interventions.
B. State how each of the above nursing interventions can be enhanced to be more patient centered.
C. Provide at least 3 additional nursing interventions for this patient.
Thank you.
Explanation / Answer
According to The Institute of Medicine failure to thrive is defined as “Weight loss of more than 5%, decreased appetite, poor nutrition, and physical inactivity.” Failure to thrive in older adults is not just one medical condition. It is a deep seated disorder that can include physical and mental components. Very often it is accompanied by depression, dehydration, and low cholesterol. Unlike depression, malnutrition is an autonomous forecaster to failure to thrive in older adults and mortality. A dietary history including caloric intake and body weight, needs to be taken and monitored on an ongoing basis.
According to this situation susan is a 65-year-old school nurse who has recently retired from an elementary school. Susan does not want to be dependent on anyone. At now she is no longer working and also susan loss her partner, so she is beginning to feel lonely. It leads susan in to depression and in turn it leads to her weight loss.
Nursing Interventions:
1. Monitor patient using geriatric depression scale
The Geriatric Depression Scale and the Cornell Scale for Depression in Dementia are useful tools for assessing this dynamic in patients with failure to thrive. The scale consists of 30 yes/no questions. Each question is scored as either 0 or 1 point. The following general cutoff may be used to qualify the severity: Normal 0-9, Mild depressives 10-19, and Severe depressives 20-30. Based on this scale susan was present on severe depression.
2. Monitor weight loss and food intake.
Malnutrition is an independent predictor of mortality in older adults. The most accurate evidence of malnutrition in an elderly patient is hypo cholesterolemia and hypo-albuminemia. Assessment of malnutrition involves a dietary history that includes daily caloric intake, the availability of food, the use of nutritional or herbal supplements, and the adequacy of the patient’s diet as quantified through the amount of food intake, the number of meals, and the balance of nutrients.
3. Help the patient identify and practice activities that promote usefulness
Failure to thrive should focus on identifiable diseases and be limited to interventions that have few risks for these frail patients. Failure to thrive commonly occurs near the end of a person’s life, so initially, treatment involves efforts to modify possible causes. A team approach that includes a dietitian, a speech therapist, a social worker, a mental health professional, and a physical therapist may be helpful.
Additional nursing interventions:
Monitoring of daily electrolytes and fluids
Encouraging participation in activities the patient once enjoyed
Providing opportunities to exercise at the patient level of ability.
Daily weighing and tracking weight trends
Recording daily caloric intake and types of foods eaten
Related Questions
Navigate
Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.