Question

Please help

Please help

Below is patient assessment

The patient is 70 years old. She is suffering from dementia. The woman is currently undergoing depression as well as anxiety. She is confused. She has decided to relocate from t plaza (where she has been for three months) to our place because of the deterioration of her medical condition. She has undergone unusual mental alteration. She had moved to new place so as to receive care as she wasn’t able to look after herself while in her apartment. The woman reveals to me that she has experienced intermittent diarrhea over the past one week. In addition, she has had chills. She experienced neither fever nor abdominal pain however. Whenever she urinates, there is tingling. The patient doesn’t however have hematuria. Not even the urinary frequency. It unfolds to me that the patient‘s PO intake has considerably declined as she has been occasionally nauseous too, once including vomiting. The conjunctiva are non-injected, with pupils equal and round. The patient is not hard of hearing, ears and nose have a normal external appearance, oropharynx is clear and mucus membranes appear dry. The neck is supple, has no masses. The heart has a regular rate and rhythm, there are no pathologic abdominal aortic pulsations and there is no jugular venous distention. Normal effort for respiration and the lungs are clear to auscultation bilaterally. The abdomen is soft, nontender, non-distended, and there are no palpable masses and no pathological hepatosplenomegaly. Bowel sounds were present. There is no clubbing, cyanosis or ischemia. There are no bony deformities pathologic asymmetry or masses. These is trace lower extremity edema. Patient can ambulate with a walker. The skin has no rashes pathologic indurations/nodules/tightening on the exposed areas. She has also had insomnia, GERD, IBS, kidney stones and acute kidney injury, and small bowel obstruction (resolved without surgery).

Base on the patient assessment please help me to write care plan with three patient problem and please help

Patient Problem #1: Anxiety and depression related to prolonged hospitalization as evidenced by crying during the examination and being unhappy with her living conditions.

Patient Problem includes:
1. Nursing diagnosis 

2. Supporting evidence (subjective and objective data) 3. One SMART* goal. 

4. Minimum of 3 EB* interventions.

What lab need to do for this patient

Please type not handwriting

Answer 1

1,Nursing Diagnosis:
-Ineffective coping(dementia,anxiety,depression)
-Electrolyte Imbalance (due to diarrhea)
- Fluid volume deficit(diarrhea)
-Hypothermia(chills and fever)
-Insomnia( history)
- knowledge deficit (due to dementia and confusion)
- Diarrhea
-Dysfunctional gastrointestinal mobility(GERD)
-Impaired urinary elimination (acute kidney injury and kidney stone)
2, Supportive evidence:
Subjective data:
-patient is confused,depression and anxiety
-Intermittent diarrhea for past week
-she experienced fever,chills and abdominal pain
Objective data:
-Having history of GERD,IBS,kidney stones and acute kidney injury and small bowel obstruction(resolved without surgery)
3, One SMART goal:
S- Specific
Improving knowledge,eliminate anxiety and depression and associate symptoms
M-Measurable
Patient need skills to handle the problem..psychological symptoms should be solved to do follow up with other symptoms.
A- achievable
Patient need communication and therapy involvement rather than pharmacological intervention..patient should undergo for some investigation to find out the present illness..
R- Relevant
Patient need follow up with rehabilitation program to recover from her disability
T-time -bound
Elderly patient need assistance with their daily needs..patient should be educated with choosing her right place for living.
4, EB intervention:
- Non-pharmacological intervention like cognitive stimulation Therapy(CST) to support with mild to moderate dementia
- Nurse-patient relationship can eliminate their suffering from anxiety and depression
-patient should be treated for IBS,to avoid fluid volume deficit
-Do kidney function Test to findout the present symptoms of tingling sensation..
-plan small frequent diet for her daily calorie requirement.
Lab test:
-kidney function test
-serum electrolyte
-Ambulatory acid probe test to measure the acid in stomach over 24 hours
- complete blood count
- c-reactive protein
-ESR
-Blood glucose test
-thyroid -stimulating hormone level(to find the hormonal imbalance)
-Vitamin B12 level