Critical Thinking Essay on the Mr. M Case Study

Critical Thinking Essay on the Mr. M Case Study

A 70-year-old Mr. M is a patient with a deteriorating health condition living at an assisted living facility. He has limited physical activity related to an unsteady gait and difficulty ambulating. Previously, he suffered from hypertension, which was controlled by angiotensin-converting enzyme inhibitors. He also had status post appendectomy, hypercholesterolemia, and tibial fracture status postsurgical repair with no signs of complications. Currently, he has problems with memory since he cannot recall simple things like his room number. He also quickly becomes agitated and aggressive and appears fearful and afraid when aggressive. His rapid deterioration is shown by his inability to dress, bathe, or feed himself. The test results show that he has a blood pressure of 123/78mmHg, a heart rate of 93 beats per minute, and a respiratory rate of 22 breaths per minute. On urinalysis, his urine is cloudy, and there is a moderate number of leukocytes in his urine. Liver function tests show his AST and ALT serum levels to be 32 U/L and 29 U/L, respectively. This paper critically analyzes Mr. M’s health condition to determine the most appropriate interventions to support him.

Based on Mr. M’s clinical manifestations, the primary diagnosis for his condition is Alzheimer’s disease. Alzheimer’s disease is an irreversible neurological disorder associated with dementia (Bejanin et al., 2017). It causes the loss of cognitive functioning, and the behavioral abilities of a patient suffering from Alzheimer’s disease are significantly affected such that patients fail to carry on with their daily life. Patients experience memory loss and other cognitive difficulties in the early stages of the disease. Problems experienced include personality and behavior changes, wandering and getting lost, difficulty repeating questions, and trouble remembering the names of people. In the later stages, dementia associated with Alzheimer’s Disease makes one dependent on others to carry out routine activities such as bathing and feeding. Therefore, Mr. M is suffering from Alzheimer’s disease since he is experiencing problems associated with memory loss, such as trouble remembering the names of his family members and his room number. The fact that he has to depend on others for routine activities such as dressing, feeding, and bathing shows the disease has progressed into a more severe stage.

One of the most likely secondary diagnoses for Mr. M’s health condition is urinary tract infection. Urinary tract infections are mainly caused by bacteria such as Escherichia coli (Dadzie et al., 2019). These bacteria in the kidney cause the body to produce leukocytes to fight the infection. The produced leukocytes are often excreted in the urine. They make urine appear cloudy when they mix with it. Therefore, Mr. M is likely to be suffering from a urinary tract infection, given a moderate number of leukocytes in his urine, and the urine appeared cloudy.

Since Mr. M has Alzheimer’s disease, several abnormalities are expected during his assessment. For instance, during his mental status examination, he is likely to have problems with responding to questions and organizing his thoughts. He is also likely to look confused and disoriented. A magnetic resonance imaging (MRI) and computed tomography scan will likely reveal the presence of beta-amyloid deposits in his brain. Patients with Alzheimer’s disease often present with extracellular deposits of beta-amyloid proteins in their neurons(Joe & Ringman, 2019). Such abnormalities would confirm that Mr. M is suffering from Alzheimer’s disease.

Mr. M’s health condition may affect him physically, psychologically, and emotionally. The damage to his brain will limit his participation in physical activities. Lack of movement will make him physically unfit, predisposing him to other health conditions. Psychologically, he might experience hallucinations and depression. The complex changes in the brain make patients with Alzheimer’s’ disease hear or see unreal things. He might develop depression due to low self-esteem resulting from his inability to care for himself. Emotionally, Mr. M may experience a broad range of emotions, including fear, shock, anger, grief, and even relief. Family caregivers may find it difficult to handle the patients, especially when they cannot control their emotions. This may make them stressed. Therefore, both an Alzheimer’s patient and their family caregivers are affected by this health condition.

Several interventions can be used to support Mr. M and his family. To help adjust to the altered cognitive abilities, it is important to develop an effective communication system with the family and the patient. Since the patient may forget to take the recommended medications, it is important to administer the medications to the patient at scheduled times. The family members should be advised on crushing the tablets for the patient if he has difficulty swallowing them. They should be encouraged about patient reorientation by being taught how to orient the patient to circumstances, place, person, and time.

Given Mr. M’s current condition, he faces problems such as forgetfulness. He can easily forget to take the prescribed medications. Suffering from dementia implies Mr. M cannot engage in an activity that would earn him income. He has to depend on his family members for survival. Besides, he is likely to suffer from injuries due to an unsteady gait. Since he cannot care for himself, he is likely to suffer from infections that result from poor personal hygiene. For instance, he may suffer from skin infections, gastroenteritis, and food poisoning.

Overall, Mr. M is suffering from Alzheimer’s disease, which has been gradually progressing over time. The disease has made him develop dementia since he cannot remember simple things such as his room number and the names of his family members. He is forced to depend on family members since he cannot care for himself. Since his family members are also affected by his health condition, they should also be involved in the care plan for Mr. M.

References

Bejanin, A., Schonhaut, D. R., La Joie, R., Kramer, J. H., Baker, S. L., Sosa, N., Ayakta, N., Cantwell, A., Janabi, M., Lauriola, M., O’Neil, J. P., Gorno-Tempini, M. L., Miller, Z. A., Rosen, H. J., Miller, B. L., Jagust, W. J., & Rabinovici, G. D. (2017). Tau pathology and neurodegeneration contribute to cognitive impairment in Alzheimer’s disease. A Journal of Neurology, 140(12), 3286–3300. https://doi.org/10.1093/brain/awx243

Dadzie, I., Quansah, E., Puopelle Dakorah, M., Abiade, V., Takyi-Amuah, E., & Adusei, R. (2019). The Effectiveness of Dipstick for the Detection of Urinary Tract Infection. Canadian Journal of Infectious Diseases and Medical Microbiology, 2019. https://doi.org/10.1155/2019/8642628

Joe, E., & Ringman, J. M. (2019). Cognitive symptoms of Alzheimer’s disease: Clinical management and prevention. The BMJ, 367, 1–14. https://doi.org/10.1136/bmj.l6217

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Critical Thinking Essay on the Mr. M Case Study

Case Study: Mr. M.
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. 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:

1. Describe the clinical manifestations present in Mr. M.
2. 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.
3. When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
4. 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.
5. Discuss what interventions can be put into place to support Mr. M. and his family.
6. 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.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.