read NS 110 SP17 Case Study for Presentation CASE #2 Karl Sveinsdóttir is a 60 y
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read NS 110 SP17 Case Study for Presentation CASE #2 Karl Sveinsdóttir is a 60 yr. old male from Iceland, who speaks only a little English. He recently moved to the US to live with his adult daughter and her family in Connecticut after his wife of 40 years died of cancer last year. He was admitted to the hospital 3 days ago after suffering third degree burns of his left hand and forearm. Ile received this after attempting to light a gas stove burner. A careful history taken by an ER nurse revealed that the patient had not smelled any gas fumes and had assumed the burner was off; when he lit the burner the gas exploded and his left arm caught on fire. His daughter stated that she was upstairs at the time and had sinelled the gas fumes about 40 seconds before she heard the loud explosion and her father's cry for help. A neurological work up of the patient was done after he was admitted; a slight resting tremor waS was noted. The daughter states that her father has also been complaining of unusual fatigue and an overall feeling of "stiffiess" when walking for the past 3 months; she had attributed these symptoms to his age and his relocating to the US. The patient and his daughter were just told by the consulting neurologist that he has Parkinson disease (PD). In Iceland there are many peopie with PD, but no one in their family has had it; both the daughter and patient are very upset over the diagnosis. The daughter feels terrible about not bringing her father to see a doctor earlier, and both she and the patient are afraid of how disabled Mr Sveinsdôttir may become EOS/KHS revised Sp 2015Explanation / Answer
According to situation the two problems are found one is 3rd Degree Burn and another is Parkinson's Disease
The Burns are caused by a transfer of energy from a heat source to the body. The depth of the injury depends on the temperature of the burning agent and the duration of contact with it.
Burns disrupt the skin, which leads to increased ?uid loss, infection,hypothermia, scarring, compromised immunity, and changes in function, appearance, and body image care plan is designed for both the situations.
NCP FOR BOTH Burn and PD-
1. Nursing Diagnosis
Fluid Volume deficit related to increased capillary permeability and evaporative losses from burn wound.
Goal-To restore the fluid Volume.
INTERVENTION
2. Risk of hypothermia related to loss of skin microcirculation and open wounds.
Goal- To Maintain the adequate body temperature.
INTERVENTION
3. Impaired physical mobility (Limitation in independent, purposeful physical movement of the body or of one or more extremities.) may be related to tremors and rigidity.
Goal- The patient will maintain functional mobility as long as possible within limitations of disease process.
INTERVENTION
Instruct patient to perform daily exercise that will increase muscle strength: walking, riding a stationary bike, swimming, and gardening are helpful
Teach patient to sit in chairs with backs and arm rests; use elevated toilet seats or sidebars in the bathroom.
Instruct patient to raise head of bed and make position changes slowly. Teach patient to dangle legs a few minutes before standing. Avoid dehydration and maintain adequate dietary salt.
Teach the patient to concentrate on walking erect and use a wide-based gait.
4. Disturbed thought process (A state in which individual experiences a disruption in cognitive operations and activities.)May be related to parkinsonian and chronic illness.
Goal-Patient will identify factors that elicit depressive reactions and use techniques that will effectively reduce the amount and frequency of these episodes.
INTERVENTION
Assess patient for depressive behaviors, causative events, and orient patient to reality as warranted.
Use nonjudgmental attitude toward patient and actively listen to his feelings and concern.
Identify patient’s medications currently being taken.
Assess patient for potential for suicide and suicidal ideation.
5.Impaired verbal communication (Decreased, delayed, or absent ability to receive, process, transmit, and/or use a system of symbols.)May be related to physical barrier from hypertonicity from parkinsonism and rigidity of facial muscles
Goal-Patient will be able to have effective speech and understanding of communication, or will be able to use another method of communication and make needs known.
INTERVENTION
Assess the patient’s ability to speak, language deficit, cognitive or sensory impairment, presence of aphasia, dysarthria, aphonia, dyslalia, or apraxia. Presence of psychosis, and/or other neurologic disorders affecting speech.
Instruct patient to make a conscious effort to speak slowly, with deliberate attention to what they are speaking. Remind the patient to face the listener, exaggerate the pronunciation of words, speak in short sentences, and take a few breaths before speaking.
Use simple, direct questions requiring one-word answers. Repeat and reword questions if misunderstanding occurs.
Instruct patient and/or SO regarding need to use glasses, hearing aids, dentures.
Instruct patient and/or SO in the performance of facial muscle exercises, such as smiling, frowning, sticking tongue out, moving tongue from side to side and up and down.
This is the Nursing care plan for Burn and PD combinedly.
The person has been diagnosed as Patient of Parkinson's Disease as assessment done and use diagnostics tools.
The diagnosis is done on basis of Medical History and neurological examination.
The confirmation is done by giving levodopa. After giving levodopa the improvement in motor activity will confirm the diagnosis of PD.
Levodopa can be given with carbidopa to send in brain.
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