Case Study of Leonard-Free-Samples for Students-Myassignmenthelp

Question: Identify, using the clinical reasoning cycle, three of Leonards health risk factors. Critically evaluate three best-practice assessment tools appropriate for this case. Identify and discuss interventions that will support Leonard via a person-centred approach and critically analyse how these relate to your obligations as a health professional. Answer: Introduction: Clinical reasoning cycle helps professionals to identify the condition of the patients, their symptoms and thereby process the information to identify the care priorities. Accordingly, interventions are set for peeving bets quality care to patients helping them to come back to their normal lives (Vanderberg et al. 2017). In this assignment, clinical reasoning cycle and assessment tools would be used identify the care priorities of the patient named Leonardo and interventions would be given to them accordingly. Clinical reasoning cycle and identification of three health risk factors: Considering the patient situation: Leoonard is a 73-year-old man who is admitted to the emergency department in the acute care ward after he had a fall in the local shops. The presenting symptoms that were noticed were bruises on face and hip region, low body weight, mild confusion and low body weight. He is unable to cope with his present condition and is seen by a social worker at home. Collecting cues and information: When medical history of Leonard is documented, it is seen that he has mild cognitive impairment that is secondary to Alzheimers disease. It is also seen that he has a decubitus ulcer on his left leg, arthritis in his back, anaemia, mild hypotension and industrial deafness. He also has urinary incontinence. He has already fallen twice in the last six months and he is also facing huge issues in coping up with the situations. He is unable to conduct his daily activities like cooking, cleaning, self-care and other activities. Processing the information: With gradual aging, his mobility has degraded and this had exposed him to risks of falling. He had already fallen twice although severe fractures had not taken place before the last fall at the shop. Secondly, he has been suffering from mild cognitive impairment secondary to Alzheimers that might aggravate if not treated properly resulting him in complete loss of cognitive ability and hence may result him to live poor quality life. Moreover, he is also seen to have issues with coping with his home chore activities and activities of daily life. Researchers are of the opinion that mild cognitive development affects the self care activities of human beings making them more dependent on others for their personal hygiene and regular activities of life (Stam et al. 2016). He is not being able to clean, cook, self-care, not being able to perform his favourite activities like gardening and many others. Moreover, he is anaemic and decreased body weight. This is actually making him tired, he i s not feeling to work, and therefore he is sleeping throughout the day. All these had resulted in very poor quality life. Identification of the problems and issues: From the above analysis, different important risk factors are identified in case of Leonardo. The first one is that he is highly prone to fall due to loss of motor functioning due to aging procedures. The second risk factor is that he has mild cognitive impairment where he is exposed at the risk of noticeable as well as measurable decline in memory and thinking skills that would affect his daily life (Webster et al. 2016). The third health risk factor that is identified is his anaemic conditions and low body weight that is making him lethargic and sleepy throughout the day. This would make him suffer from shortness of breath, dizziness, headaches, and coldness in feet, weakness and fatigue. The heart has to pump faster and work harder to carry more oxygen rich blood throughout the body that may expose the patient to heart failure. Establishment of goals: Fall risk assessment should be done at his house to reduce chances of fall and develop his motor skills so that he can walk effectively reducing chances of fall. Therapy for cognitive development of the patient should be ensured. Diet management and caring for his activities of daily lives should be ensured. Actions steps: Community registered nurses should be assigned for him who would be taking effective interventions for his motor skill development and diet management. Physiotherapists can be allocated to make him develop his mobility. Moreover, effective therapy for cognitive development should also be proposed to help him develop his memory and thinking skills. Evaluation of outcomes: Positive outcomes need to be monitored after the application of the interventions. The better his mobility, cognitive status and body weight, the better would be his quality life. Reflection: After allocation of the interventions and evaluating the results, the nursing individuals would reflect on the practices and their experiences so that they can develop their knowledge and skills for the future. Three (3) best-practice assessment tools appropriate for this case: The patient is already identified with wild cognitive impairment that in course of time will affect his thinking capability and memory. The nursing individuals in such condition will be mainly using the Mini Mental State Examination (MMSE) to assess his present mental health status. It is mainly an 11 questionnaire set that will help to test Leonardos ability to test five areas of cognitive functioning. These are orientation, registration, attention, calculation, recalling power as well as language (Ginter et al. 2018). The maximum score is 30 and the score of 23 is the lowest. When an individual is scoring less than 23, then poor cognitive capability is ensured. Based on the score that Leonardo receives in this assessment tool of cognitive ability, suitable interventions would be developed by the professional. Leonardo is highly vulnerable to fall due to his motor disabilities. He has already fallen thrice and there is also high chance of him falling in the near future that may or may not accompany severe potential harm to him. Therefore, in order to be cautious and preventive of the situation of fall. Therefore, healthcare professionals are often seen to use of the Hendrich II Fall Risk Model. This tool is very quick to administer and successfully provides determination of risk for falling based on different factors that are gender, mental health and emotional status, known categories for medication increasing risk, symptoms of dizziness and others. (Petersen et al. 2014) This tool is found to be suitable for fall risk assessment and even for post fall assessment for secondary prevention of fall. The instrument is found to be sensitive to a degree of about 74.9% and specific as if that to about 74% with inter reliability that measures to around 100%. The use of this tool may help the pati ent named Leonardo to prevent secondary fall in the future. Leonardo is seen to have low body weight and he is also a suffering from anaemia. A non-communicable disorder mainly occurs due to deficiency of iron in diet. Moreover, his low body weight may be due to improper diet management that may be either due to his lack of knowledge of the important of specific diet on his health or his inability to cook food properly. Recently, he has become unable to take care of himself and conduct cooking as well. Therefore, with the help of the subjective Global assessment, nursing professionals will be able to take data on his nutrition intake, weight symptoms, functional capacity, metabolic requirements and many others. The tool also helps the individuals to assess the patients physical examination, SGA rating, contributing factors and many others (Cooper et al. 2015). This would help them to develop ideas about his health condition depending on the nutritional intakes and would help them to take effective interventions are diet management. Interventions that will support Leonard: Patient centred care helps nursing professionals to keep the patient in the centre of the care plan allowing them to participate in the decision making and respecting their dignity as well as autonomy to the best extent (Strohle et al. 2015). Nursing professionals should ensure that they are providing safe and competent care services and work in accordance with that of the standards of professional and broader health system. The nursing professionals need to support Leonard and his well-being by incorporating him into informed decision-making (Code of conduct, NMBA 2017). This would help him to feel that his dignity and autonomy is respected. The professionals should also be promoting and preserving trust as well as privilege of the patient by developing effective therapeutic relationship. Shared decision making, effective communication with the patient, culturally safe practice, effective partnership and others should also be maintained (For registered health practitioners Code of c onduct, APHRA 2018). As Leonardo is not ready to shift to residential care, the nursing professionals should arrange for community nurses who would be conducting his treatment procedures in his home only. For preventing falls, interventions like maintaining bed position is important. It should be kept adjacent to floor reducing risk of fall. Hand bars in the washrooms and other places can be used to provide a support to him while he is mobilising. Moreover, heavy furniture should be kept and light furniture should be removed so that chances of tumbling are reduced. Loose clothes should be avoided and clutters on the pathways of his walking should be removed to reduce chances of fall. To develop his motor skills, the community nurse should fix appointments with the physiotherapists who would be helping to develop his gait and motor skills. This would help to develop his mobility and reduce chances of fall (Langa et al. 2014). In order to develop his condition of mild cognitive impair ment, the nursing professionals should help the patient to undertake a number of lifestyle interventions. The professionals would communicate effectively with him with the interventions that would be helping him to develop his cognitive abilities (Booth et al. 2015). The professionals should respect his discussions and should not put upon the intervention plan on him. Rather they should educate him about the rationale of the interventions so that the patient feel that he is included in the treatment procedures. Regular physical exercise, a diet low in fat, rich fruits and vegetables, incorporation of omega 3 fatty acids, intellectual stimulation, social engagement and memory training should be ensured to improve his cognitive ability (Dobner and Kaser 2018). The nursing professionals should also allocate a dietician for him to develop his diet chart and educate him about the importance of nutrients and diet he should follow. All these would not only improve better quality life of th e patient but would also ensure patient satisfaction due to patient centred care (Kader and Peera 2014). Conclusion: From the above discussion, it is seen that clinical reasoning cycle had helped to identify the health risk factors of the patient named Leonardo. Moreover, appropriate tools had been used to assess the above mentioned three health issues so that his present status of heal can be identified and accordingly interventions are planned. 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