Nursing: Discussion Reply to Javelin
The 82-year-old Male patient returns to the nursing home with chief complaints such as incontinence, restlessness, and foul-smelling urine and has a mild to moderate dementia and a known history of Urinary Tract Infection (UTI). UTI entails infections that encompass disorders in the urinary system, including Urethra, Kidney, ureters, and bladder. UTI can result in serious health issues such as acute and chronic kidney infections among aged people (Kennedy-Malone, Martin-Plank & Duffy, 2018). Additionally, it essential to note that an MMSE of 18 indicates the patient has a moderate cognitive impairment.
Besides the reported additional subjective data on seeking whether the patient feels hugely overwhelmed in understanding instructions, making decisions, and planning steps to accomplish tasks reported in the discussion, the practitioner may also try to know concerns regarding cognition change from the patient, past clinical observations and knowledgeable informant to diagnose mild cognitive impairment. Further, he may seek to know the patient’s experience in burning sensation when urinating; pain bellows his lower back or his ribs, fatigue, as well as the evidence of significant impairment in occupational or social functioning.
The additional patient observation may include the lack of Visual hallucinations and Parkinsonism to test dementia with Lewy bodies, progressive decline in cognition (very rapid decline suggest metabolic disorder, neoplasm, or prion disease), and lack of language or prominent behavioral disorders for suggestive front temporal lobar degeneration (Donaghy et al., 2018). Furthermore, objective evidence of cognitive impairment from cognitive disorders in one or more cognitive domains such as executive function, language, memory, attention, or visuospatial skills. Although individuals may make more errors and be less efficient in performing ADLs than in the past, preservation and independence of functional abilities also may be conducted.
References
Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2018). Advanced practice nursing in the care of older adults. FA Davis.
Donaghy, P. C., Taylor, J. P., T O’Brien, J., Barnett, N., Olsen, K., Colloby, S. J., … & Thomas, A. J. (2018). Neuropsychiatric symptoms and cognitive profile in mild cognitive impairment with Lewy bodies. Psychological medicine, 48(14), 2384-2390.