Nursing Problem: Malnutrition and Poor Appetite

QUESTION

For this task you need to create TWO nursing care plans (NCP) for Mrs. Fatima Ahmed (see case study below). Instructions Examine the following case study, and with reference to appropriate scholarly literature: 1. Identify TWO (2) actual or potential nursing problems relevant to Mrs. Fatima Ahmed. For each problem, justify your choice of the problem (e.g., by referring to the patient’s assessment data in the case study). The two (2) problems form the basis for the two (2) care plans, i.e., one problem for each care plan. 2. For EACH nursing problem, identify ONE (1) SMART goal for care for Mrs. Fatima Ahmed (total 2 goals). Remember a SMART goal is specific, measurable, attainable, realistic and timely. 3. For EACH goal, describe TWO (2) nursing interventions you would implement to meet the goal (total 4 interventions). For each nursing intervention, provide a rationale by referring to appropriate literature. 4. For each intervention, describe the expected outcome and how you will evaluate the effectiveness of the intervention (i.e., how you will know that the intervention has/has not worked, by referring to appropriate scholarly literature. How to Structure your assignment Address one Nursing Care Plan at a time. Complete one nursing care plan relating to one identified actual or potential nursing problem, and then complete the second one. For this assessment item, use headings to ensure each Nursing care plan is clear. The headings should be: • Nursing Problem • Goal • Nursing Interventions • Expected Outcomes and Evaluation These headings should be repeated for each Nursing Care Plan. Case Study Mrs. Fatima Ahmed is a 78-year-old woman who recently moved to Edgewater Residential Aged Care Facility in Brisbane, Queensland. She is a widower with three adult-aged daughters. Prior to coming to the residential aged care facility, Mrs Ahmed lived independently in her home, which was located in Brisbane where she grew up. Two daughters live nearby to the residential aged care facility and visit frequently. She has one daughter who lives in Sydney who she sees occasionally, they are in constant contact, but this daughter has five children to care for. Mrs Ahmed recently gave up her volunteer role at the local Islamic youth community centre, and she also misses attending the mosque and seeing her friends. Since arriving at the residential care facility, Mrs. Ahmed’s appetite has been poor. She refuses meals regularly and says that she does not like the food at the facility. She must be encouraged by staff to drink water regularly. The staff at the facility are worried about her recent weight loss (5kgs in 2 months). Mrs Ahmed is unsteady on her feet and requires ‘one on standby assist’. She uses a walking frame when mobilising. Since arriving at the facility, Mrs Ahmed has been wanting to spend inc

ANSWER

Nursing Care Plan 1

Nursing Problem: Malnutrition and Poor Appetite
Justification: Mrs. Fatima Ahmed’s poor appetite, refusal of meals, and recent weight loss (5kgs in 2 months) indicate malnutrition and potential nutritional deficiencies. This can further lead to compromised immunity, muscle wasting, and increased risk of falls due to weakness.

Goal: By the end of two weeks, Mrs. Ahmed will have improved her nutritional intake and gained at least 1 kg of weight.

Nursing Interventions

Assess Nutritional Needs: Conduct a comprehensive nutritional assessment, including dietary habits, preferences, food allergies, and religious/cultural considerations. Collaborate with a registered dietitian to develop a personalized meal plan based on her preferences and dietary requirements. (Holst et al., 2017)
Rationale: Understanding Mrs. Ahmed’s specific nutritional needs will help tailor the meal plan to her preferences, promoting better compliance and improved intake.

Encourage Small, Frequent Meals: Offer Mrs. Ahmed small and nutrient-dense meals/snacks at regular intervals throughout the day. Provide her with culturally familiar foods that she enjoys, ensuring they meet her dietary requirements. (Keller et al., 2019)
Rationale: Frequent, smaller meals are easier to consume and digest, reducing feelings of fullness and discomfort that may be discouraging her from eating.

Expected Outcomes and Evaluation:
Mrs. Ahmed will consume at least 75% of her prescribed meals and snacks within two weeks.
The dietitian will assess Mrs. Ahmed’s weight gain progress after two weeks to determine if she has gained at least 1 kg.

Nursing Care Plan 2

Nursing Problem: Social Isolation and Lack of Engagement
Justification: Mrs. Ahmed’s recent move to the residential aged care facility has disrupted her social connections, leading to feelings of isolation and sadness. Her withdrawal from social activities and missing her friends indicate a need for intervention to improve her emotional well-being.

Goal: Within one month, Mrs. Ahmed will actively participate in social activities and engage with peers at the facility, demonstrating improved emotional well-being.

Nursing Interventions

Conduct a Psychosocial Assessment: Engage in therapeutic communication with Mrs. Ahmed to understand her feelings, interests, and past social activities. Collaborate with the facility’s social worker to identify suitable social groups or activities aligned with her cultural background. (Chen et al., 2020)
Rationale: A thorough psychosocial assessment will help identify Mrs. Ahmed’s emotional needs and enable tailored interventions to promote engagement.

Encourage Participation in Group Activities: Encourage Mrs. Ahmed to participate in group activities such as games, crafts, or religious gatherings, based on her preferences and cultural background. Assign a staff member to accompany her and provide support as needed. (Rizzuto et al., 2012)
Rationale: Engaging in group activities can foster social connections and reduce feelings of loneliness, enhancing Mrs. Ahmed’s emotional well-being.

Expected Outcomes and Evaluation:
Mrs. Ahmed will actively participate in at least two group activities per week within one month.
Observe her interactions and expressions during activities to assess her level of engagement and emotional well-being.

Conclusion

Through the implementation of evidence-based nursing interventions, Mrs. Fatima Ahmed’s health and well-being can be improved. By addressing her malnutrition and social isolation, the care plans aim to enhance her quality of life and ensure a holistic approach to her care in the residential aged care facility.