Perform a nursing history review/collection and health assessment on two (2) aged care clients, preferably one with cognitive impairment and one with physical frailty. Based on the clinical presentation, discuss with RN regarding nursing goals and nursing interventions for the client. Formulate care plan using Best Practice Guidelines. If the facility allows, students are encouraged to use facility care plan templates. If facility documents are not accessible, students should use the format provided here:

CLIENT 1

• Develop a nursing care plan based on a comprehensive health assessment of a client. The nursing care plan should include the management of behaviors of concern or cognitive impairment. Report to RN as needed. Please de-identify your patient.
• Take care of these clients and evaluate your care plan to see what you could have done better.
• Make sure you act within your own scope of practice.
• Write at least 3 nursing goals per client and 3 interventions for each goal.

In Client 1, give one (1) example of how you promoted the client’s capacity to self-care 

Give one (1) example of how you advocated for client and their carers. 

Give one (1) example of how you included the client’s cultural preferences and social inclusiveness in your care. 

CLIENT 2

• Develop a nursing care plan based on a comprehensive health assessment of a client. The nursing care plan should include the management of behaviors of concern or cognitive impairment. Report to RN as needed. Please de-identify your patient.
• Take care of these clients and evaluate your care plan to see what you could have done better.
• Make sure you act within your own scope of practice.
• Write at least 3 nursing goals per client and 3 interventions for each goal.

In Client 2, give one (1) example of how you promoted the client’s capacity to self-care

Give one (1) example of how you advocated for client and their carers.

Give one (1) example of how you included the client’s cultural preferences and social inclusiveness in your care.

ANSWER

Client 1: Nursing Care Plan for Cognitive Impairment

Health Assessment

Client 1 is an 80-year-old female with a diagnosis of Alzheimer’s disease. She presents with memory deficits, confusion, difficulty in performing daily tasks, and behavioral changes including aggression and agitation. Her Mini-Mental State Examination (MMSE) score is 15, indicating severe cognitive impairment.

Nursing Goals

Enhance Safety: Ensure the client’s physical safety and prevent harm due to cognitive deficits and wandering behavior.
Promote Self-Care: Support the client’s ability to engage in basic self-care activities, such as eating, dressing, and grooming.
Manage Behavioral Symptoms: Minimize aggressive and agitated behaviors to improve the client’s quality of life.

Nursing Interventions

Enhance Safety
Implement door alarms and locks to prevent wandering and ensure a safe environment.
Provide supervision during ambulation and transfers to reduce fall risk.
Label personal items and maintain consistency in the placement of furniture to minimize confusion.

Promote Self-Care
Use visual cues, such as pictures or step-by-step instructions, to guide the client through self-care routines.
Provide verbal prompts and physical assistance as needed to ensure adequate nutrition and hygiene.
Allow the client to participate in self-care activities at her own pace to maintain a sense of autonomy.

Manage Behavioral Symptoms

Employ redirection techniques and distraction strategies to redirect the client’s focus away from aggressive behaviors.
Implement a consistent daily routine to provide structure and minimize confusion, which can contribute to agitation.
Collaborate with the healthcare team to assess the need for pharmacological interventions to manage severe behavioral symptoms.

Promoting Capacity to Self-Care

Client 1 was encouraged to participate in her self-care activities by using visual cues and step-by-step instructions. This approach allowed her to retain a sense of independence and control over her daily routines.

Advocacy for Client and Carers

Regular communication with the client’s family members and caregivers ensured that they were aware of her condition, needs, and challenges. This facilitated informed decision-making and enhanced the client’s overall care and support system.

Inclusion of Cultural Preferences and Social Inclusiveness

The care plan was tailored to incorporate the client’s cultural preferences and background. By understanding her cultural values, traditions, and preferences, interventions were aligned to ensure her comfort and sense of belonging within the care environment.

Client 2: Nursing Care Plan for Physical Frailty

Health Assessment

Client 2 is a 75-year-old male with multiple chronic conditions and physical frailty. He experiences difficulty in performing activities of daily living, such as mobility, transferring, and bathing. He presents with reduced muscle strength, balance problems, and increased risk of falls.

Nursing Goals

Enhance Mobility:Improve the client’s ability to move independently and safely to promote overall physical well-being.
Prevent Falls: Minimize the risk of falls by implementing measures that enhance the client’s stability and reduce environmental hazards.
Optimize Self-Care: Assist the client in maintaining personal hygiene and grooming to promote dignity and self-esteem.

Nursing Interventions

Enhance Mobility
Develop a personalized exercise program, including strength training and balance exercises, to improve muscle strength and stability.
Utilize assistive devices, such as walkers or canes, to provide support during ambulation and transfers.
Encourage regular physical activity and engagement in light exercises to improve overall functional capacity.

Prevent Falls
Conduct a thorough assessment of the client’s living environment to identify and address potential fall hazards.
Educate the client and family members about fall prevention strategies, including proper footwear and safe movement techniques.
Implement a fall prevention plan that includes regular monitoring, risk assessment, and adjustments to the environment as needed.

Optimize Self-Care
Provide adaptive equipment, such as shower chairs or long-handled brushes, to facilitate independent bathing and grooming.
Offer physical assistance or verbal cues as necessary to promote safe and effective self-care activities.
Foster a supportive and nonjudgmental environment that respects the client’s autonomy and preferences.

Promoting Capacity to Self-Care

Client 2 was empowered to participate in self-care activities by providing adaptive equipment and appropriate assistance. This approach aimed to maintain his sense of dignity and promote his ability to perform personal hygiene tasks.

Advocacy for Client and Carers

Collaboration with the client’s family members and caregivers was essential to ensure a holistic approach to care. Regular communication allowed for the sharing of information, concerns, and preferences, enabling informed decision-making for the client’s well-being.

Inclusion of Cultural Preferences and Social Inclusiveness

The care plan incorporated the client’s cultural background and preferences to ensure that interventions were aligned with his values and beliefs. This approach supported his sense of identity and ensured culturally sensitive care.