Barriers In Communication Discussion Paper

English being the second language of Eva pose barrier in communication. Therefore in order to ensure that she has a clear understanding of instruction and information that need to be communicated verbal interactions will be followed. For every information provided or instruction being directed to her, verification must be done by means of asking her to repeat what she understood or could make out of the conversation thereby allaying the possibility of arousal of any confusion or discrepancy (van Rosse et al., 2016)Barriers In Communication Discussion Paper.

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Management and documentation of Mia’s refusal to take Panadol is necessary to provide holistic treatment for her and ensure quicker recovery and recuperation from her condition in post operative states. As a nursing professional I will try to persuade Mia through my communication skills. Mia being a little girl, I will try to maintain a friendly gesture towards her so that she trusts and keeps faith in my instructions and refrains from not taking medications. I will further document this observation and behavior so that the near mss outs of medicines may be further replaced by some other medical intervention (Powell-Cope et al., 2014)Barriers In Communication Discussion Paper.

As an EN, nursing education catering to the needs of the patient through effective care strategies need to be imparted in order to allow speedy recovery. The factors that may be emphasized while educating Mia about her care must be simple and easily comprehensive to aid in efficient implementation. The necessary items must be considered and teaching must be given at appropriate time following basic principles and avoiding the medical jargons. Written handouts must be given in addition to verbal instructions to ease the process of teaching. The reception ability of Mia through assessment of her senses must be done prior to imparting education to harbor positive benefits (Bastable, 2016)Barriers In Communication Discussion Paper.

The workplace health and safety (WHS) considerations that need to be implemented while Mia’s mother is staying at the hospital will comprise of undertaking the screening protocols for any communicable disease in the mother to avoid the possibility of spreading infection. Hand hygiene must be further promoted to mitigate the risk of nosocomial infection that might pose threat to Mia who is more vulnerable to contract such pathogens due to immune-compromise in post operative stages. Thus provision for safe work premises will allow for conducting the treatment modalities concerning treatment intervention for Mia in an effective and smooth manner (Jinnett et al., 2017)Barriers In Communication Discussion Paper.

    • The pulse rate must be lowered as vital signs indicated tachycardia that might cause cardiovascular difficulties
    • Respiratory rate was found to be quite normal and hence require no intervention
    • SpO2 found to be 98% and hence needs to be improved through arrangement made for oxygenation through masks
    • Body temperature of 36.8? C was quite normal and hence demanded no specific intervention
    • Mia appeared pale even after being well perfused and that will be addressed by diets and other drugs that will improve her condition and improve the supply of oxygen and blood to the tissues (Hockenberry & Wilson, 2014)Barriers In Communication Discussion Paper.

Effective Nursing Priorities For Mia’s Recovery

Assessment  Nursing Diagnosis Planning & Goals Implementation Evaluation
Activities of Daily Living (ADLs)

Must have at least 3

 1. Increased heart rate

2. Pain in abdomen

3. Low output of urine

 1. Heart rate must be lowered by anti-arrhythmic medications comprising of beta blockers or calcium channel blockers

2. Pain abatement must be done through analgesic  to alleviate the symptoms

3. Catheter may be administered in the bladder to remove fluid

 1. Beta blocker will be given

2. Opioid drug will be given as painkiller

3. Free drainage of urine from bladder will be collected through urinary catheterization

 1. Herat rate normalized

2. Perception of pain reduced

3. Urine flow normal without requiring catheter
Nutritional Status Easy to digest food must be given in post appendectomy Heath must be restored through balanced diet Immune building and healing foods must be given comprising of carbohydrate, fat and protein, vitamins and minerals in correct proportion Client faces no difficulty in eating all types of food
Pain Abdominal pain after 2 hrs in post appendectomy stage Client will be relived from pain

Analgesics may be given

 Oral medications in the form of opiod drugs may be given

Ambulatory care may be facilitated

 Patient expressed of feeling better without experiencing grimacing pain
Sleep and Rest Client received adequate rest in post appendectomy and did not complain of having sleep problems The care for client must be properly monitored and documented to aid in guiding treatment options In case of pain problems at night, mild sedative may be given with prior consent from the attending physician Client felt better without any symptom of pain or sleeping difficulty
Discharge Planning Vital signs of the client checked

Pain perception in post operation state must be assessed

 Patient has no complaints of pain and other side effects due to side effect of medication

No report of sleeping difficulty

 Teaching regarding care and health maintenance imparted to client Client appears healthy without exhibition of any adverse side effects

Differences in Anatomy and Physiology of the aged person:

    • The bones and joints become weakened and fragile due to reduced mineral density in these structures

Nursing care: Restriction in movement preferably with assistance

  • Reduction in the number of neuronal cells in the brain in addition to reduction in the release in the amount of neurotransmitter

Nursing care: Mental support and care must be given when memory and forgetfulness or being promptly agitated is noticed Barriers In Communication Discussion Paper

Nursing care: Therapeutic intervention through consultation with doctor must be given

  • Less absorption of aerial oxygen due to decreased number of alveoli and weakening of the respiratory muscle such as diaphragm

Nursing care: Drugs may be administered based on the severity of the condition

  • Less forceful contraction of the esophageal muscles leading to slower emptying of food into stomach thereby accounting for the generation of constipation condition

Nursing care: Dietary regime should be strictly monitored to allow for holistic outcomes (Regan, Russo & Putte, 2015).

ACAT stands for Aged Care Assessment Team that aims to evaluate the needs of an aged person either at home or within the periphery of the aged care home and find out whether the concerned person is entitled to receive government subsidized aged care services. Donald may be benefited by referring to this approach through adoption of definite assistance in performing day to day activities through specific health condition consideration. Permission will be sought by the members of the ACAT to consult a physician for discussing the medical data prior to commencing any service intervention (Moye, Marson & Edelstein, 2013)Barriers In Communication Discussion Paper.

Complications associated with deep vein thrombosis (DVT) include pulmonary embolism and post-thrombotic syndrome. In pulmonary embolism, blood clot breaks off and traverses via the bloodstream to the lungs thereby blocking the blood vessel and impairing the oxygen transportation to the tissues. Chest pain, breathing difficulties are common in such instances that might culminate in heart failure and appear fatal. Blood clot appearing in the vein of the calf region is termed as post-thrombotic syndrome where diversion of blood flow to other veins increase the venous pressure and resulting in presenting symptoms like that of swelling, pain and rash. Therefore Donald’s length of stay in the hospital might be affected due to DVT causing delay in discharge to treat the ensuing symptoms (Patel & Brenner, 2014).

In condition when the medical imaging nurse has arrived to take Donald for his chest X-ray while his IV antibiotics and his S/C Enoxaparin are due, his medication administration must be prioritized considering the fact that he might have DVT in his left lower leg that appear life threatening. Lack of timely intervention might be fatal also. Therefore drug dosage should be prioritized rather than emphasizing on conducting chest X-ray (Urden, Stacy & Lough, 2015)Barriers In Communication Discussion Paper.

Donald has the appropriate documents regarding the Advanced Health Care Directive (AHCD) that might positively impact on his emergency care management under circumstance when his condition might deteriorate suddenly. AHCD has the provision of appointing an agent possessing the power of attorney and have the right to undertake care and treatment decisions on behalf of the patient who is not in a position to make decisions independently. Instructions related to health care wishes may be further communicated via this agent to the concerned authority and Donald might exercise all these benefits (Silveira, Wiitala & Piette, 2014)Barriers In Communication Discussion Paper.

Nursing Care For Elderly Patients Like Donald

Assessment Nursing Diagnosis Planning & Goals Implementation Evaluation
Activities of Daily Living (ADLs)

Must have at least four.

 1. Restricted movement

2. Skin tear leading to wound

3. Swabs positive VRE

4. Suspected of having DVT

 1. Increased mobility and physiotherapy

2. Regular wound dressing and wound healing

3. Cure of bacterial infection and use of antibiotics

4. Thrombolysis and retraction of clot through anticoagulant

 1. Analgesics for pain mitigation and physiotherapy to support movement

2. Dressing of wounds and application of topical medicine for quick healing

3. Administration of antibiotics to cure VRE

4. Anticoagulants and blood thinners applied to dissolve the clot and offer cure

 1. Patient showed improvement in movement through reduction of pain

2. Skin do not bear the wound anymore, healed completely

3. The proper healing of wound has further validated the negative VRE

4. DVT cured
Wound on Left arm Wound healing in 1-3 days and on 4-5 days signs of wound breakdown Wound care antibiotics and ACAT assessment Daily wound care as per wound chart Wound cured
Cognition Little confused at times

Repetition of same questions and forgetfulness

Agitated at times

 Cognitive tests for evaluation of cognitive functioning and diagnosis of definite problem MRI, CT scan, EEG Patient will express better cognitive functioning
Deep Vein Thrombosis (DVT) Clot in the left lower leg Thrombolysis and dissolution of clots thereby improving blood supply and oxygenation to tissues Anticoagulants and thrombolytics applied No visible clot formation in left lower leg
Discharge Planning Vital parameters checked and normal

Movement improved and pain reduced

VRE cured

DVT treated

 Patient will express satisfaction performing activities of daily living without any interference Adequate care facilities and treatment modalities provided Patient has been cured of VRE and DVT

Movement has been improved without requiring medication

Evaluation is important in the delivery of nursing care in rendering improved model of nursing care by virtue of empirical findings and evidence based research. Resource utilization coupled with improved cost effectiveness may be further enhanced for transition towards more person-centered care approach rather than task oriented approach (Keating, 2014).

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VRE refers to Vancomycin Resistant Enterococci that constitutes a type of bacteria that has eventually developed resistance against m,any antibiotics particularly vancomycin. VRE is likely to spread through casual contact or via contaminated articles or through a hospital setting via hand contact with the healthcare professionals. Patients having weakened immune system are more prone to contract VRE.

Nosocomial infection means the hospital acquired infection and is likely to be caused by bacterial, viral or fungal pathogens. Bacteria are mostly responsible for this and results in harboring blood stream infection, surgical site infection, ventilator associated pneumonia and urinary tract infection (McCracken et al., 2013)Barriers In Communication Discussion Paper