Question

For a 98 YO male who is admitted to the hospital for hematuria following a cystoscopy with continuous bladder irrigation, answer the following in a way that the geriatric patient would likely answer (be creative):

What do you do to stay healthy?

Health Perception / Health Management: Client's perceived pattern of health and well - being and how health is managed. Example: Compliance with medication regimen, use of health - promotion activities such as regular exercise, annual check ups.

Nutritional - Metabolic: Pattern of food and fluid consumption relative to metabolic need and pattern; indicators of local nutrient supply. Example: Condition of skin, teeth, hair, nails, mucous membranes; height and weight.

Elimination:

Patterns of excretory function (bowel, bladder and skin). Includes client's perception of normal function. Example: Frequency of bowel movements, voiding pattern, pain of urination, appearance of urine and stool.

Activity: Patterns of exercise, activity, leisure, and recreation. Example: Exercise, hobbies. May include cardiovascular and respiratory status, mobility, and activities of daily living.

Cognitive/Perceptual: Sensory - perceptual and cognitive patterns. Example: Vision, hearing, taste, touch, smell, pain, perception and management; cognitive functions such as language, memory and decision making.

Sleep/rest:

Patterns of sleep, rest, and relaxation. Example: Client's perception of quality and quantity of sleep and energy, sleep aids, routines client uses.

Self - Perception / Self Concept: Client's self - concept pattern and perceptions of self. Example: Body comfort, body image, feeling state, attitudes about self, perception of abilities, objective data such as body posture, eye contact, voice tone.

Role Relationship: Client's pattern of role engagements and relationships. Example: Perception of current major roles and responsibilities (e.g father, husband, salesperson); satisfaction with family, work or social relationships.

Sexuality - Reproductive

Patterns of satisfaction and dissatisfaction with sexuality pattern; reproductive pattern. Example: Number and histories of pregnancy and childbirth; difficulties with sexual functioning; satisfaction with sexual relationship.

Coping / Stress Tolerance

General coping pattern and effective of the pattern in terms of stress tolerance. Example's: Client's usual manner of handling stress, available support systems, perceived ability to control or manage situations.

Answer 1

• HEALTH MANAGEMENT

1. EXERCISE: It is not advised to do exercises especially strenous exercises, which includes heavy jumping,weight lifting and so on, as it can cause blood to appear in urine for elderly patients who experience hematuria after colonoscopy along with continous bladder irrigation. However, it can be prevented by staying hydrated and not allowing the bladder to be empty.
2. DIET:A low sodium diet is suggested. It is recommended to include more fruits and vegetables in diet. It is adviced to drink cranberry juice or pomegranate juice as well as to increase the intake of bitter gourd, drumsticks, green bananas and coconut water along with spinach juice. Please note, try to limit the intake of refined and processed foods, salt and fatty foods as well as caffeinated drinks.
3. MEDICATIONS: Antibiotics,blood thinners such as aspirin are commonly associated with the onset of hematuria.Penicillin is the most common medicine that leads to hematuria. Adherence to the prescribed drugs are important along with taking medication at specified time. Do not take overdose or without the order of doctor.
4. ANNUAL CHECK UPS- If a person is taking medicine or have any other disease condition, it is important to do health check up periodically.
5. ELIMINATION: The urine output voume per void is approximately 250-450ml/hour and minimum urine output is 30 ml/hr and it depends on the state of hydration,medication and so on.in elderly they mainly experience bowel and bladder incontinence, where they cannot hold urine and feces for long time. The normal colour is light yellow+amber which may vary as well as the urine is transparent without any sediments with the odour of ammonia. The normal bowel pattern can be once a day, twice a day or once in a three day. It actually varies according to individual condition. In elderly the frequency of bowel and batter pattern is usually increased. A few amount of waste is also removed through skin.
6. SLEEP PATTERN: The sleeping hours are generally increased in elderly. Though the sleeping hours are increased, monitor for any sleeping disorders as sometimes this can be a cause for any undelying disease. They also get easily disturbed in sleep, so provide a proper calm environment for sleeping.​​​​​​​
7. STRESS TOLERANCE: Stress in elderly is common. Hence it can be manged by: ​​​​​​​The elderly can share their difficulties and feelings in facing stress, and their way of coping, with those they can confide (e.g. relatives and friends). This helps to ventilate emotions and facilitate the learning of different strategies of coping with stress. An active social life, healthy lifestyle and relaxation exercises are all useful ways to handle stress. Engaging in volunteer work is a means to help those who are less fortunate. It also helps to boost self-confidence and broaden one's outlook in life. Positive thinking, such as appreciating one's achievements and strengths, can help to enhance self-confidence and to cope with stress. The elderly can seek help from professionals in case of need. Smoking, drinking and substance abuse are harmful and should never be used as ways to cope with stress.
8. SEXUAL FUNCTONING:The reproductive age of a woman is limited and ends at menopause.It is frequently assumed that elder persons lose their sexual desires or that they are physically unable to perform. For the elders, the ability to remain sexually active is a major concern in their lives. Fear about the loss of sexual prowess in older males is common. Older women also express sexual desire, but may fear their interest is undignified and disgraceful. Some elder persons may even freely accept their interests in sex, but their children or grandchildren may disapprove, making them feel guilty. The elder often view sexuality as an expression of passion, affection, admiration, and loyalty, a renewal of romance, a general affirmation of life, especially the expression of joy and a continuing opportunity for growth and experience. In addition, sexual activity is a means for the elder to affirm physical functioning, to maintain a strong sense of identity and establish self-confidence, and to prevent anxiety. It remains a mode of pure physical pleasure as well. However, not all elder persons have positive attitudes about sexuality. Like all persons, elders may experience sexual dysfunction due to boredom, fear, fatigue, grief, or other factors (e.g., intrinsically low sexual desire, physical disability). Sexuality in the elder is particularly affected by problems that are common in this age group, for example, depression, medical disorders, or incapacitation or death of a partner.
9. COGNITIVE ABILITIES:The cognitive ability of a olg age may or may not dimnish.It varies individually and depends on many factors such as ruling out disease condition, medication statistics and so on. For a healthy person, his cognitive abilities are sharp and rarely dimnish depending on age.