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Review the following Case Study. Answer each question, and complete the Summary. Number your responses and be sure to address each question thoroughly:
A&P Case Study:
Patient: Oliver Moreau, 76 year old Caucasian male
Demographics: Patient relocated from his home Country of France 4 months ago. Patient lives with his daughter and teen-aged granddaughter.
Medical History: hypertension, Liver Cirrhosis, Parkinson’s Disease
Mr. Moreau has been admitted to Golden Smiles Skilled Nursing Facility, where you are an LVN. He is wheelchair bound, requires hoyr-lift for transfers, and total care. He is able to speak limited English, French is his primary language. Parkinson’s disease has caused him to be very rigid, he has tremors of the bilateral upper extremities, and he has difficulty swallowing. Diet: Pureed diet, nectar thickened liquids, must be fed
Current weight 137#, weight 12/21 was 152#
Patient is incontinent of urine and stool, and wears adult briefs.
Skin is intact, with redness noted at the coccyx, bilateral hips and heels.
Provide a thorough response to show your understanding of patient anatomy and physiology that must be considered when providing nursing care to Mr. Moreau. Each response is worth the following points:
1. Explain the role of this patient’s integumentary system on his overall health and well-being. (10 pts)
2. Explain the importance of nutrition on this patient’s condition and the impact that dysphagia has upon this patient’s nutritional status. ( 10 pts)
3. Utilizing the information provided above in the Case Study, complete the following 2 Nursing Problem/diagnosis for this patient: (10 pts)
Imbalanced Nutrition: less than the body requirements R/T ______________________ AEB _________________________________
R/T means “Related To”. This question is asking why his nutrition is less than his requirements.
AEB means “As Evidenced By”. This question is asking what evidence shows he is getting less nutrition than he needs.
Impaired Skin Integrity R/T ____________________________________________AEB _________________________________________________.
4. List each of Mr. Moreau’s risk factors for Impaired Skin Integrity. (10 pts)
5. List the Nursing Interventions that will promote the following patient goal: Mr. Moreau will gain 2-3 pounds within the next month. (10 pts)
Summary (50 points)
Summarize in 200 words or more your understanding of the integumentary system and the role that nutrition plays in the promotion of skin integrity. Summarize how the LVN will work best with the RN at the initial assessment of this patient to promote a healing environment, provide care, and support this patient and his family while he is a patient in Golden Smiles Skilled Nursing Facility. Think about Mr. Moreau’s holistic health, and how the Interdisciplinary team can meet his needs and prepare him for discharge.
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