Diagnosis Of Mental State Impairment Discussion Paper
Mr. M is a 70-year-old man currently living in an assisted living facility. His diagnoses are hypercholesterolemia and hypertension. A drastic deterioration in Mr. M’s functional capabilities and cognitive functioning has emerged in recent times. The clinical symptoms of Mr. M suggest a primary diagnosis of mental state impairment and can signify dementia. The clinical manifestations of Mr. M comprise unsteady gait, weakness, wandering, anxiety, confusion, and loss of memory. It is necessary to take into consideration that the symptoms of Mr. M could be as a result of another health problem, like an infection. Infections of the urinary tract may lead to confusion or reduced ability to focus. In the case of Mr. M, his memory loss started abruptly, and his condition worsened rapidly. This sudden deterioration in his health gets in the way of his capacity to perform his everyday activities and shows that there is a more significant issue. Urinary tract infection is a secondary diagnosis to be taken into account for Mr. M. Certain things like illness, inflammation, and infection may be indicated by a high WBC count. Infection, autoimmune condition, and cancer, and more may be evidenced by increased lymphocyte production Diagnosis Of Mental State Impairment Discussion Paper.
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When dementia is suspected, a head CT is often requested. Ischemia, strokes, brain atrophy, and other complications can be detected by CT scans (Rayment et al., 2016). A head CT is an essential move since there has been a significant change in Mr. M’s mental state, and it will display anomalies and changes. Obstruction or Infection in the bladder or urinary tract might lead to an increased leukocyte count. Several risk factors trigger residents of long-term care to develop urinary tract infections. Patients are vulnerable to UTIs as a result of cumulative physiological changes in aging and co-morbidity accumulation (Haaijman et al., 2018). Mr. M lives in an assisted living facility and risks acquiring urinary tract infections. Mr. M’s gradual deterioration in health could be caused by an infection, as he already has changes in his mental state and abnormal lab results. Mr. M’s other vital signs and lab results are within normal ranges, apart from increased leukocytes, lymphocytes, and white blood cell count. A diagnosis of infection is supported by these increased laboratory results Diagnosis Of Mental State Impairment Discussion Paper.
One would anticipate discovering anomalies like sleeping pattern changes, speech problems, and confusion when examining Mr. M. Most possibly, this client would be withdrawn, uncoordinated, and have difficulty planning or organizing. The genitourinary system should also be focused on during the nursing assessment because Mr. M’s urine is cloudy and the urine test found increased leukocytes. It is crucial to take into account the likelihood of renal insufficiency, based on his history of hypertension. The present health condition of Mr. M may have a big effect on his life and his family. When one has dementia, their family gets affected significantly. The reality that Mr. M cannot perform daily tasks independently as he used to can be hard to deal with. A series of emotions like sadness, loss, shock, anger, anxiety, and denial can be experienced by those recently diagnosed with dementia (Jutkowitz et al., 2017). In his psychological and emotional reactions, Mr. M has undergone transitions and easily becomes irritated, hostile, and scared, and can seem to be distant or disinterested. Additionally, during the night, Mr. M wanders and displays repetitive habits. Physical changes including lack of coordination or balance, exhaustion and weakness, and sleep problems have arisen in Mr. M. Diagnosis Of Mental State Impairment Discussion Paper
Both pharmacological and non-pharmacological approaches can be used to support and treat individuals suffering from dementia, even though dementia has no proven cure. Mr. M’s coping interventions comprise treatment that focuses on delaying functional deterioration. Some strategies to better control dementia symptoms include maintaining a comfortable atmosphere, promote exercise, adopt a fixed everyday schedule, and offer simple, calm reasons for any routine changes (Livingston et al., 2017). The family of Mr. M should be informed about what changes to anticipate and ways of dealing with them. The patient’s family can find it difficult to adapt to behavior patterns seen in Mr. M as they can be stressful. Behaviors seen in people with dementia can be extremely difficult to adapt to for the family.
Due to Mr. M’s present situation, the existing and likely issues he may experience should be considered. Since Mr. M has a high risk of having a fall incident, the patient’s safety is one of the major concerns. Mr. M has been on several medications, has unsteady gait, has minimal physical exercise linked to ambulatory difficulties, wanders at night, and appears. He has also not been independent on several daily living activities. Mr. M could have feeding disorders and is at risk of malnutrition. People with dementia can have no appetite, forget how to eat, and lose their abilities to chew or swallow. In order to know what to include in his diet, it would necessary to discover the kind of foods Mr. M likes. Bowel and bladder issues are a typical problem that affects people with dementia. The sense of having to use the toilet may not be recognized by people with dementia. These patients often find it challenging to quickly respond to impulses. This may result in skin breakdown, UTI’s and other problems. Depression is another potential problem that Mr. M could experience. Symptoms of depression include withdrawal from family and friends, mood changes, and sleeping disorders (Higuera, 2016). All these symptoms are consistent with the patient’s diagnosis Diagnosis Of Mental State Impairment Discussion Paper
References
Haaijman, J., Stobberingh, E. E., van Buul, L. W., Hertogh, C. M. P. M., & Horninge, H. (2018). Urine cultures in a long-term care facility (LTCF): time for improvement. BMC geriatrics, 18(1), 221.
Higuera, V. (2016, August 16). Complications of Alzheimer’s Disease (AD). Retrieved from
https://www.healthline.com/health/alzheimers-disease-complications
Jutkowitz, E., MacLehose, R. F., Gaugler, J. E., Dowd, B., Kuntz, K. M., & Kane, R. L. (2017). Risk factors associated with cognitive, functional, and behavioral trajectories of newly diagnosed dementia patients. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 72(2), 251-258.
Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., … & Cooper, C. (2017). Dementia prevention, intervention, and care. The Lancet, 390(10113), 2673-2734.
Rayment, D., Biju, M., Zheng, R., & Kuruvilla, T. (2016). Neuroimaging in dementia: an update for the general clinician. Progress in Neurology and Psychiatry, 20(2), 16-20. Diagnosis Of Mental State Impairment Discussion Paper
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span. Evaluate the Health History and Medical Information for Mr. M., presented below. Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below. Health History and Medical Information Health History Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN. Case Scenario Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself Diagnosis Of Mental State Impairment Discussion Paper.
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The assisted living facility is concerned with his rapid decline and has decided to order testing. Objective Data Temperature: 37.1 degrees C BP 123/78 HR 93 RR 22 Pox 99% Denies pain Height: 69.5 inches; Weight 87 kg Laboratory Results WBC: 19.2 (1,000/uL) Lymphocytes 6700 (cells/uL) CT Head shows no changes since previous scan Urinalysis positive for moderate amount of leukocytes and cloudy Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L Critical Thinking Essay In 750-1,000 words, critically evaluate Mr. M.\’s situation. Include the following: Describe the clinical manifestations present in Mr. M. Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support. When performing your nursing assessment, discuss what abnormalities would you expect to find and why. Describe the physical, psychological, and emotional effects Mr. M.\’s current health status may have on him. Discuss the impact it can have on his family. Discuss what interventions can be put into place to support Mr. M. and his family. Given Mr. M.\’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each. You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. Diagnosis Of Mental State Impairment Discussion Paper