Multidisciplinary Care Plan for Mrs. Grace Abbott: Addressing Mobility, Hygiene, and Nutrition Needs

QUESTION

Mrs Grace Abbott is a 72-year-old female admitted to hospital following a motor vehicle accident 1 week ago resulting in a fractured L) tibia and fractured R) radius and ulna. Both her leg and arm are currently in plaster casts. Grace also suffered a small laceration under her R) eye caused from her glasses hitting her face during the accident. The wound was dressed during her hospital stay and is no longer requiring wound dressings.

Grace is usually independent with her activities of daily living but has been requiring some assistance due to her limited mobility and right-hand dominance.  She requires glasses to correct vision impairment.

Grace has Type II diabetes and demonstrates a good understanding about managing her condition. She has been receiving a diabetic diet while in hospital which will continue in rehabilitation.

Grace today, has been transferred to the rehabilitation unit for 1 week, following which her daughter will move in with Grace for the remainder of her recovery.

The following multidisciplinary interventions were initiated while Grace was in hospital which will continue in rehabilitation

• Grace has been prescribed oral analgesia and Oral hypoglycaemic agent for diabetic medications

Grace is to remain non-weight bearing on her L) leg for 6 weeks and physiotherapy have assessed her as safe using a forearm support frame which has been provided to Grace.

CARE PLAN ENTRY

1. Looking back over last week’s theme, mobility, what aspects of Grace’s mobility will impact this week’s theme, hygiene?
2. Which nursing assessments/cues will you complete to identify Grace’s hygiene needs?
3. Identify two (2) problems associated with Grace’s hygiene needs. They can be actual (3-part) or potential (2-part) problems.
4. Plan at least 2 nursing interventions, with relevant rationales, you will implement to assist Grace with your 2 identified problems above. Remember! Nursing interventions must be supported using current best practices and references no more than 7 years old.
5. How will you evaluate the effectiveness of your care?

CARE PLAN ENTRY

1. Looking back over the last two weeks, will Grace’s mobility and hygiene needs impact her nutrition? If so, how?
2. Which nursing assessments/cues will you complete to identify Grace’s nutritional requirements?
3. Identify two (2) problems associated with Grace’s nutritional needs. They can be actual (3-part) or potential (2-part) problems.
4. Plan at least 2 nursing interventions, with relevant rationales, you will implement to assist Grace with your 2 identified problems above. Remember! Nursing interventions must be supported using current best practices and references no more than 7 years old.
5. How will you evaluate the effectiveness of your care?

ANSWER

Multidisciplinary Care Plan for Mrs. Grace Abbott: Addressing Mobility, Hygiene, and Nutrition Needs

Introduction

Mrs. Grace Abbott, a 72-year-old female, has been admitted to the hospital following a motor vehicle accident, resulting in fractures in her left leg and right arm. She is currently in rehabilitation and requires assistance with activities of daily living due to limited mobility. Grace also has Type II diabetes, and her health condition requires special attention. This care plan aims to address Grace’s mobility, hygiene, and nutritional needs through a multidisciplinary approach, ensuring her safe and effective recovery.

Mobility and Its Impact on Hygiene

Grace’s limited mobility due to her fractures will significantly impact her ability to perform personal hygiene tasks independently. She may face challenges with bathing, dressing, and maintaining her personal hygiene, particularly in the areas affected by her plaster casts.

Nursing Assessments/Cues for Hygiene Needs

Observing Grace’s ability to perform self-care activities, such as grooming and toileting.
Assessing the condition of her plaster casts and any skin irritations or infections.
Monitoring her oral hygiene routine and checking for any issues with denture care or difficulty holding a toothbrush.

Identified Problems and Interventions for Hygiene

Problem 1: Impaired Bathing and Grooming Related to Limited Mobility and Casts

Interventions:
Provide assistance with bathing using a sponge bath or shower chair to ensure safety and comfort.
Offer assistance with grooming tasks, such as hair brushing and nail care.
Encourage regular changing of clothes and bed linen to maintain cleanliness and prevent skin breakdown.

Problem 2: Risk of Infection and Skin Breakdown Under Plaster Casts

Interventions:
Regularly inspect the skin under the plaster casts for signs of redness, swelling, or pressure sores.
Keep the skin under the casts dry and clean by using moisture-absorbing powders or padding.
Educate Grace and her daughter on the signs of infection and measures to prevent skin breakdown.

Evaluation of Effectiveness

The effectiveness of the nursing interventions will be evaluated by monitoring Grace’s ability to perform hygiene tasks independently, assessing the condition of her skin under the plaster casts, and ensuring the absence of infections or pressure sores.

Impact of Mobility and Hygiene on Nutrition

Grace’s limited mobility may affect her ability to access and prepare meals independently. Additionally, her diabetic condition requires adherence to a specific diet to manage blood sugar levels effectively.

Nursing Assessments/Cues for Nutritional Requirements:

Assess Grace’s dietary preferences, food allergies, and any specific dietary restrictions due to her diabetes.
Observe her ability to feed herself, including her hand dexterity and use of assistive devices.
Monitor her blood sugar levels and assess the effectiveness of her diabetic medication.

Identified Problems and Interventions for Nutrition

Problem 1: Difficulty with Meal Preparation and Feeding Related to Limited Mobility

Interventions:
Collaborate with the hospital dietitian to create a personalized meal plan that meets Grace’s nutritional requirements and is easy to prepare.
Provide adaptive equipment, such as built-up utensils or assistive devices, to facilitate self-feeding.
Educate Grace and her daughter on meal preparation techniques that cater to Grace’s current mobility status.

Problem 2: Risk of Blood Sugar Fluctuations and Inadequate Diabetic Management

Interventions:
Monitor Grace’s blood sugar levels regularly, and adjust her diabetic medication as per the healthcare provider’s recommendations.
Encourage regular meals and snacks that adhere to the prescribed diabetic diet to maintain stable blood sugar levels.
Provide education on the signs and management of hypoglycemia and hyperglycemia.

Evaluation of Effectiveness

The effectiveness of the nursing interventions will be evaluated by monitoring Grace’s ability to prepare and eat meals independently, regular blood sugar level checks, and her adherence to the prescribed diabetic diet.

Conclusion

Mrs. Grace Abbott’s care plan involves a comprehensive approach that addresses her mobility, hygiene, and nutritional needs. By implementing evidence-based nursing interventions and closely monitoring her progress, we aim to support Grace’s recovery, ensure her safety, and optimize her overall well-being during her stay in the rehabilitation unit and while receiving care at home. Through this multidisciplinary care plan, we strive to promote Mrs. Abbott’s independence and enhance her quality of life.