Alzheimer Disease Essay Paper

Alzheimer Disease Essay Paper

Alzheimer’s disease

Alzheimer’s disease (AD) is precipitated by the impaired blood supply to the brain, causing significant cognitive dysfunction and memory loss. The standard clinical features for AD include memory problems, reduced ability to organize one’s thinking, confusion, and difficulties in concentrating and paying attention. The risk factors of AD are hypertension, hypercholesterolemia, advancement in age, and diabetes. Other risk factors are vascular diseases, obesity, positive family history, and smoking (Remp et al., 2017). In Alzheimer’s disease, the physical assessment would reveal abnormal gait and range of movements. No treatment is available for neurodegenerative disease. It is important to mention that various medications and psychoanalytic therapies can help to relieve the symptoms of AD. This paper provides an overview of a focused neurological assessment of a geriatric patient. Alzheimer Disease Essay Paper

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Focused Neurological Assessment

A focused neurological assessment is a process focused on obtaining comprehensive information from the client based on the motor, sensory, and cranial nerve tests. The focused neurological assessment is divided into eight components; motor examination, sensory examination, reflexes, coordination, station, gait, mental status, and the state of spine and meninges. A focused neurological assessment incorporates relevant examinations such as the Mini-Cog test, a three-minute tool increasing the detection and evaluation of cognitive impairment among geriatric clients. The patient in the case study is 69-years-old and could thus benefit significantly from a Mini-Cog test. The test is useful because it is easy to apply among non-specialized healthcare workers following brief training and within the community setting. The tool consists of two elements; a simply scored clock drawing test and a 3-item recall test. The mental status assessment tool also provides a 30-point tool used to assess one’s thought and mental abilities when making a diagnosis of Alzheimer’s disease. Radiological and laboratory tests can also be performed to rule out the cause of dementia. An MRI or a head CT scan can be used to rule out other causes of dementia. Laboratory tests such as lumbar puncture for CSF analysis and complete blood count tests can also be used to rule out microbial involvement. Alzheimer Disease Essay Paper

Plan of Care

Some of the preventive health screening for dementia includes a mental status assessment to establish if the patient is stressed or depressed. The patient should be encouraged to join a physical training activity or exercises, implement balanced diets, and maintain a diary to curb forgetfulness (Wang et al., 2019). Explanations and advice should be provided to the patient and family members regarding the plan of care and response to treatment. Patient education for this patient will focus on explaining the pathophysiology of the disease and the connection with clinical features. The patient will be taught about the mechanism of discharge drugs and the importance of adherence.

The education plan should also include strategies for avoiding chronic mental illness risk factors (Remp et al., 2017). The patient will also be encouraged to maintain a healthy sleep pattern and cycle and exercise regularly. The education plan should also incorporate healthy diet implementation and stress management strategies. The patient is encouraged to seek medical attention if the headache recurs and is not responding to conventional treatment and home remedies.  In such as case, the patient should visit the emergency department. The emergency department should also be visited in case the patient becomes extremely confused or develops a loss of consciousness.

The medications are preferable because they are administered once a day, a factor that is likely to enhance adherence. Patient education should focus on restating the risk factors and how to avoid them. The family should be involved in psychosocial support and help the patient with adherence to the treatment regimen. The patient should be followed up after two weeks for monitoring of medications’ effectiveness and assessment of coping skills and psychosocial support (Kaspar, 2015). The top priorities of concern for the patient with AD are to restore proper cognitive functioning, promote adequate physical activities and rest patterns, provide psychosocial support, and promote healthy nutrition. Patient education should focus on restating the risk factors and how to avoid them. The family should be involved in psychosocial support and help the patient adhere to the treatment regimen. The patient should be followed up after two weeks for monitoring of medications’ effectiveness and assessment of coping skills and psychosocial support.

Documentation

Effective documentation of a focused neurological assessment is key in developing a patient-centred care plan. Some of the factors that should be included in the documentation include the patient’s orientation to time, place and person, speech, motor and sensory coordination, gait, bilateral muscle strength, and sensations. The level of consciousness should also be determined and documented using appropriate tools such as the Glasgow coma scale. The medical record should include all the medical tests conducted and a summary of the findings. For instance, the scores obtained in the Mini-Cog test should be documented as well as the results of a mental assessment test. The medical records should include all care provided and plans for the patient.

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References

Kaspar, B. (2015). Gene delivery for treating neurological disorders. Neuromuscular Disorders, 25, S311. https://doi.org/10.1016/j.nmd.2015.06.445

Remp, R., FQ, P., Mavago, R., MM, O., MLS, G., NAC, S., & M, T. (2017). Treating Refractory Myasthenia Gravis with Rituximab – Case Report. Journal Of Neurology And Neurological Disorders, 3(2). https://doi.org/10.15744/2454-4981.3.202

Salimpour, Y., & Anderson, W. (2019). Cross-Frequency Coupling Based Neuromodulation for Treating Neurological Disorders. Frontiers In Neuroscience, 13. https://doi.org/10.3389/fnins.2019.00125

Wang, C., Haas, M., Yang, F., Yeo, S., Okamoto, T., & Chen, S. et al. (2019). Autophagic lipid metabolism sustains mTORC1 activity in TSC-deficient neural stem cells. Nature Metabolism, 1(11), 1127-1140. https://doi.org/10.1038/s42255-019-0137-5 Alzheimer Disease Essay Paper

Focused Assessment of the Neurologic System Objectives Develop a plan of care for the neurologic system Explain how to conduct a physical assessment of the neurologic system Demonstrate documentation of the neurologic system assessment findings Assignment Overview In this writing assignment, you will review a case scenario and submit an assignment providing information on how you would conduct a focused physical assessment of the client based on the presenting complaints. You will document your findings from the focused history and physical assessment data elicited and develop a nursing plan of care for this client. You can access the grading rubric for this assignment here: Writing Rubric. download Deliverables A three-page (750-word) paper Step 1 Review the case scenario. Lydia Ocampo is a 69-year-old female who is brought in to the clinic today by her husband, Dr. Danillo Ocampo. She has had a mild decline in her mental status over the past several years, but recently things have progressed. Her husband is concerned that she might have Alzheimer’s disease. She was hospitalized two weeks ago with pneumonia and a urinary tract infection and was on intravenous antibiotics. Onset: You ask Mrs. Ocampo to explain what brings her here today. She tells you she is not really sure. She tells you her husband wanted her to come because she has been forgetting things. She tells you that she does forget things sometimes, but that is because she is “getting old.” You ask Dr. Ocampo to tell you when he noticed things were getting worse with her cognitive status. He tells you that since she was discharged from the hospital, he has noticed that Lydia doesn’t want to go out with their friends or go for walks, and she seems confused more often. Duration: You ask Dr. Ocampo how long her periods of confusion are. He tells you that she used to start talking about their son (who died at age 22) like he was still living. He would remind her that Emillo was killed in a car accident, and she would remember he had died. Now she continues to talk about Emillo as if he were alive and gets angry when he tries to tell her that Emilio died. She also gets frustrated more easily when she can’t remember how to turn the TV on or start the dishwasher. Characteristics: You ask Dr. Ocampo to describe Lydia’s current day and her ability to carry out her daily activities. He tells you that Lydia used to be able to take a shower and get dressed in the morning. She would go for walks with him during the day and out to dinner with friends. She would read, watch TV, and work in her garden in the backyard. She had periods of forgetfulness and confusion but could be redirected. Now, he cannot trust her to be outside by herself; she wandered out of the backyard and into a neighbor’s house last week. She wakes up at night, gets confused, and doesn’t remember where she is. When he tries to reorient her, she becomes angry. She has also stopped reading and working in the garden and has more difficulty getting dressed in the morning by herself. Aggravating or alleviating factors: Redirecting or reorienting Lydia used to help, but now that seems to frustrate her more. Alzheimer Disease Essay Paper

Distractions in the environment and strange places also make her dementia worse. Other background information: Lydia Ocampo was born and raised in the Philippines and came to this country when she was 18. She has no living relatives in the United States and has a niece and nephew in the Philippines. Dr. Ocampo is a retired pathologist and has class II heart failure and hypertension. He is Lydia’s primary care giver and was very distressed when she was recently hospitalized. Neurological exam: You decide to perform the Mini Cog Test. She scores 0 on the word recall, and her clock drawing is incomplete. Her mood during the exam is irritable, and she argues with her husband as he responds to questions. Her reflexes and motor strength are normal and her gait is normal. Her swallowing reflex is normal. Alzheimer Disease Essay Paper

Diagnosis and treatment: You suspect her dementia is worsening and that she is in the early stages of Alzheimer’s disease. She undergoes brain imaging studies and neuropsychological testing, and a diagnosis of Alzheimer’s is made. Step 2 Provide answers for the items below. You are precepting a student nurse today who is taking her assessment class. She is learning about focused history and assessment skills. In your paper, discuss the following items: Write a detailed explanation describing what you would say to the student when explaining the assessment conducted and the findings. Discuss any additional assessments you would also perform such as the mini-mental exam. What are other potential factors related to the probable diagnosis you would be concerned about with this client? Explain how you would document your findings in the medical record. Develop your plan of care. Identify one to two nursing diagnoses and one to two nursing interventions related to those diagnoses. These interventions should include evidence based practices from the Hartford Institute for Geriatric Nursing. Cite the references used in your plan in correct format. Identify what client education should be done for Lydia and her husband, given her background and presenting concerns. Describe your teaching strategy and how you will evaluate the effectiveness of the educational intervention. Explain how you would determine care giver strain on Dr. Ocampo. Alzheimer Disease Essay Paper