NRSG 266 Context of Aging- well-being and cognitive state

Answer the following seven (7) questions. Use evidence based literature to support answers where appropriate. All information not your own original thought must be referenced. For each answer you must demonstrate person centred care by including reference to Edith’s circumstances where required. 

Question 1

 

Edith requires a physical assessment in the ED. Provide evidence based person centred (ie Edith) rationales for each assessment provided below. 
ECG 
Respiratory Ax 
Skin Ax 
Mini cognitive assessment

 

Question 2

Edith has presented with dementia, most likely in the context of Alzheimer’s Disease. List six 6 signs and symptoms of early Alzheimer’s disease which Edith is experiencing. For each sign and symptom provide detailed data from scenario to support your answer. Provide your answer.

Question 3

 

The medical team perform further testing to rule out any potentially reversible cause of Edith’s dementia. Edith undergoes various tests to exclude other possible contributing pathology. The medical team send Edith for a brain perfusion scan, also called a SPECT (single-photon emission computerised topography). These results confirm that a diagnosis of Alzheimer’s disease is most probably the cause of Edith’s dementia. Why is it important for Edith and her family to have a definitive diagnosis? Use literature to support your discussion. 

Question 4

 

Edith is transferred to the ward. The medical team commence Edith on an initial 4 weeks dose of 5mg BD of Donepezil (TN Aricept) with a view to monitoring Edith for effects and incrementally increasing the dose over time. Explain to mode of action of Donepezil with respect to the pathophysiology of Alzheimer’s Disease?

Question 5

Alzheimer’s disease is associated with progressive memory loss. Outline why Edith is experiencing progressive memory loss.

Question 6

The following nursing problems are relevant for Edith: 
1. Potential for decreased nutritional status impacting well-being and cognitive state

Question 7

 

Edith is still driving a car but admits she occasionally gets lost and is losing confidence. What duty of care do the health care professionals have to Edith with respect to her driving a car now that she has a formal diagnosis of Alzheimer’s Disease? You may include reference to your State authorities eg. Police or Road authority.