Geriatric Care Plan

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Geriatric Teaching Plan
Bryant and Stratton College
Nursing 222 Geriatrics

Geriatric Teaching Plan
Mr. R.D. is an eighty-year-old male. He currently resides at the Manor Care Rehabilitation/Nursing Center. Mr. D was admitted on January 5, 2010 for pneumonia. Mr. D has other medical history problems, which include leukocytosis, headache, hypertension, depressions, postural insufficiencies, arteriosclerotic heart disease and dementia Parkinson’s. Mr. D does not currently have any food or drug allergies. Mr. D has a wife, three children, two girls and one boy. Mr. D has four grandchildren. He has at least one person visiting him every day, and you can tell by his expression he is very happy when they are visiting. Mr. D is a very pleasant quiet patient that is very helpful at answering questions to nursing students and the center staff. Mr. D is on a mechanical soft diet but uses honey-thickening liquids to ease his swallowing of fluids and has no added salt. Mr. D does not have a history of drinking or smoking. Mr. D’s current medications

ØAcidophilus Capsule- two capsules twice a day to regulate good bacteria in intestine ØCarbidopa-Levo 25-100mg 1 tablet every six hours for the treatment of parkinsons disease ØComtan 200mg 1 tablet every six hours for the treatment of Parkinson’s disease ØFlomax 0.4 mg cap 1daily for the treatment of urinary urgency and nocturia ØFludrocortisone 0.1 mg tab 1 twice a day a synthetic adrenocortical steroid possessing very potent mineralocorticoid properties and high glucocorticoid activity; it is used only for its mineralocorticoid effects. ØGuaifenesin 200 mg tab 1 tab four times a day- an expectorant ØLovastatin 20mg 1 daily- a statin for cholesterol control ØMidodrine HCL 2.5mg three times a day with meals used as a vasoconstrictor used to treat dizziness from orthostatic hypotension ØNamenda 10 mg tablet 1 twice a day for moderate to severe Alzheimer’s dementia ØSenna 10mg laxative tab

ØAcetaminophen pain medication used as needed for pain

Potential Learning Needs:
2.Fall precautions
3.Occupational and physical therapy
4.Safety concerning medication administration and side effects

Nursing Diagnosis: At risk for aspiration related to difficulty swallowing Goal: Client will maintain patent airway and clear lung sounds during the stay at Manor Rehab/Nursing Center (Ackley, 2006, pg 151) 

Nursing Diagnosis: At risk for falls related to impaired physical mobility Goal: Client will remain free from falls while at Manor Rehab/Nursing Center 

Nursing Diagnosis: Impaired verbal communication related to Parkinson’s dementia Goal: Demonstrate congruency of verbal and non-verbal behaviors

Nursing Diagnosis One: At risk for aspiration related to swallowing difficulty Mr. D is at risk for aspiration related to swallowing difficulty because of his Parkinson’s dementia. SHORT TERM GOAL: Mr. D will remain free of aspiration while at Manor Rehab/Nursing during my shift. Nursing Interventions:

ØMonitor respiratory rate, depth and effort
ØNote any signs of aspiration such as dyspnea, cyanosis, wheezing or fever ØTake vital signs frequently noting onset of temperature
LONG TERM GOAL: Client will remain free of aspiration using the following precautions during his duration at Manor Rehab/Nursing Center Nursing Interventions:
ØClient needs to be fed slowly and allow adequate time for chewing and swallowing ØKeep head above bed elevated when feeding and at least one hour afterwards ØNote any are onset abdominal distention or increased rigidity of the abdomen ØIf client shows side symptoms of nausea and vomiting position on side ØWhen feeding client watch for signs of impaired swallowing or aspiration, including coughing choking or spitting food. EVALUATION: Mr. D has not had any episodes of aspiration during my shift or his stay at Manor. The client verbally states an understanding of the precautions to prevent future...
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