Question

Please help

Below is another people post. Please help to write some responds to this post (For example, what do you think about this post. How do you think about this post, does it clear. What do you learn from this. something like that)

1. Paragraph #1: Patient’s age, sex, brief PMHx, explanation of current medical situation

JG is a 66 year old male who is on hospice comfort care. His previous and current comorbidities include: Obsessive compulsive disorder, schizophrenia, Parkinson’s disease, alcoholism, hypoproteinemia and anemia. His current hospice status is based on his failure to thrive. He refuses basic care such as eating, drinking, bed bath, oral care, perineum care. Mentally, there is little indication of understanding, and besides the word, “no,” the patient is non-verbal. He responds to touch by moving his arms quickly over his head, scratching at his arms or attempting to strike staff.

2. Paragraphs #2: Clearly describes application of medical surgical concepts discussed in class thus far.

This patient’s refusal of care worsens his medical circumstances. Yelling, saying no and even striking out at staff if attempting to perform care creates an environment where JG does not always get the care his body really needs. Skin breakdown is a serious issue due to the incontinence, cachexia, and lack of movement. At the time of this assessment, the patient had three stage one pressure injuries as well as a reddened but blanchable coccyx.

3. Paragraph #3: Clearly describes application of pharmacology to clinical practice.

Due to comfort care status, this patient’s medications are all PRN, but the patient does not take medications, though they may cause less pain or suffering. Refusal of medications means that the patient’s cognitive state suffers as well for a number of reasons. Firstly, JG is anemic due to liver and bone damage. He is also highly malnourished. Nutrients, like Vitamin B12 or protein, are needed for red blood cell production and are not available due to the patient’s refusals. He also refuses to wear oxygen, though his oxygen saturation is 86%.This leaves the body tissues in a general state of lower than standard oxygen profusion and could be causing some of the confusion. In addition to nutrient deficiencies, the damage done by the patient’s former alcoholism on the brain could have caused a number of cognitive deficits. Parkinson’s disease eventually affects the brain and to make matters more complicated, this patient has schizophrenia. It is difficult to say where the patient is cognitively, since he has been refusing his anti-psychotics and anxiety drugs such as Haldol or LORaxepam. It is possible that this patient is more aware than healthcare workers realize, but his schizophrenic symptoms such as delusions or hallucinations are influencing his behaviors. Certainly the patient striking himself and scratching his arms is a visible indication that the schizophrenic symptoms are actively present in the patient.

Answer 1

In the present scenario, JG is a 66-year-old male who is on hospice comfort care. His previous and current comorbidities include Obsessive-compulsive disorder, schizophrenia, Parkinson’s disease, alcoholism, hypoproteinemia, and anemia. The patient is non-compliance of his basic care. He is not responding as verbally and not he is not moving his extremities as normally, but tries to strike her staff.

Here we can see the patient is more aware but due to the schizophrenic symptoms such as delusions or hallucinations results in fading of this awareness.

Here we can see the refusal or the compliance character of the patient and the present medical conditions result in the worsening of his conditions. He is not aware of caring for his body and his little movement, weakness of his present condition and incontinence results in pressure ulcer formation.

Here a more movement to his body is needed this body, But the fact is that he is having misbehavior, that is striking against the staff and I think he needs a restraint.

For the treating of his pressure ulcers, there is much body care needed as a professional nurse we have to do the basic care to his body such as bed bath and powdering of the body with talcum powder and if needed to prevent the infection at the pressure areas by pouring an antiseptic powder to the breakdown area of the skin.

And the other fact is that he is having a low saturation of oxygen that is 86% and he refuses to wear the mask, this again leads to the confusion stage to him.

The whole reason for his chronic condition is his alcoholism during his past years.

At last, the patient striking himself and scratching his arms is a visible indication that the schizophrenic symptoms are actively present in the patient. This indicates that surely we need to restrain him as medically with orders. Otherwise, nay is having misbehavior such as striking over the staff and as well as the scratching behavior results in the worsening of skin break down and may result in more suspecting infection. We have to prevent it that anyway by restraint.