Report Health of Older Adults
This assignment will be presented in a report format 1375 words excludes references.
Please use the template provided to structure your report. The template can be found in ‘Assessments’ under ‘Course Menu’ on the NURS 2024 home page.

Case study 1
At 1600 Mrs Bonnici was admitted to the Emergency Department (ED). The paramedic informs you that Mrs Bonnici is an 84 year old lady who was walking home from her weekly grocery shopping when two people attempted to take her hand-bag from her. Mrs Bonnici did not let go of her hand-bag and was subsequently thrown to the ground. Mrs Bonnici’s neighbour found her and helped her walk back home. An ambulance was called because Mrs Bonnici was “not feeling well” and was “out of breath”. Mrs Bonnici has a deep cut to her left knee and abrasions to the palms of her hands.

Mrs Bonnici was born in Malta and has been a widow for 2 years. She lives alone in the family home in metropolitan Adelaide. She has one daughter and two sons living locally, who visit her regularly.

Mrs Bonnici?�s health history reveals that she has had three previous heart attacks, has congestive cardiac heart failure and is currently under the care of a physician at the hospital. Mrs Bonnici’s vital signs are: heart rate (HR) 130 b/min and irregular; blood pressure (BP) 90/50; respiratory rate (RR) 26 /min; oxygen saturation (SaO2) 89% on air; temperature 36.7 degrees. Your assessment also reveals shortness of breath, the visible use of accessory muscles, she appears agitated and requires frequent repetition of assessment questions.

Case study 2
At 1500 Mr Kapoor has been admitted to the ED with abdominal pain on the right side just below the rib cage and central upper abdomen. Mr Kapoor’s son, Sachin informs you that his father has been in discomfort for about a week and that the pain is “now constant”. He also states that in the last two days his father has not eaten any food or has taken any fluids. This morning Mr Kapoor was very unwell and his son called an ambulance to bring him to hospital. Your initial assessment of Mr Kapoor reveals that he is feverish, anxious, and his son states that he had been nauseated and vomited four times today. Mr Kapoor is 85 years old, was born in Varanasi, India and lives with his son and extended family. His English is poor and Sachin has requested to stay and act as a translator, particular as Mr Kapoor is refusing treatment. Sachin also informs you that his father is finding it increasingly difficult to manage normal activities of daily living at home and he is at times becoming forgetful and confused.

Mr Kapoor’s health history reveals that he has lost a lot of weight over the last year, and now weighs 53kgs. Mr Kapoor’s vital signs are heart rate (HR) 110 b/min and regular; blood pressure (BP) 90/50; respiratory rate (RR) 28 /min; oxygen saturation (SaO2) 98% on air; temperature 39.3 degrees.

Identify two nursing assessment tools that you would use to develop a current profile of your client’s health status. Briefly explain your choices. Provide a rationale for your choices using evidence based literature to support your choices.

Diagnosing
State 2 actual nursing diagnostic statements to describe your client’s major presenting health problems. (using correct nursing diagnosis format)

State 1 potential nursing diagnostic statement to describe your client’s major presenting health problems. (using correct nursing diagnosis format)
Assign priorities to the actual and potential nursing diagnostic statements and provide a rationale, using evidence based literature, to support your decision.

Planning
1. Goals/Desired Outcomes : Based on your first prioritised nursing diagnosis, identify 4 goals/desired outcomes your client.

2. Nursing Interventions : Identify two nursing interventions for each goal/desired outcome and provide a rationale, using evidence based literature, to support your decision.

Implementing and evaluating
During your evaluation of the client you identify that there is no advance directive in your client’s clinical notes. You have decided to commence discussions on advance directive planning with your client. Explain what an advance directive is and what factors need to be considered prior to commencing discussions with your client.