Introduction (Identified Aggregate Risk)
From the risk assessment, it was identified that the injury from falls is the main health risk J.L. The risk is further influenced by her obesity and osteoporosis diagnosis. On the other hand, R.L is at higher risk of injury resulting from falls because of his recent diagnosis of Parkinson’s. Besides, he is at a higher risk of stroke and heart attack, lung disease, and deep vein thrombosis events due to increased tobacco use.
Two Priority Nursing Diagnoses to Identified Risk for Aggregate
Nursing Diagnosis One
In the first case, the nurse should offer both occupational and physical therapy sessions to the patient. The therapy should aim at assisting them with gait techniques and provide the patient with assistive devices for ambulation and transfer. The aim of this approach is to foster the balance and stability of the patient through assistive tools such as walkers and canes.
Delegate your assignment to our experts and they will do the rest.
Nursing Diagnosis Two
Collaborate with other care providers to evaluate how Parkinson’s and the related medication increase the risk of fall. Reviewing the medication can help in identifying the drug interactions and side effects which increases R.L’s risk to fall. This will enable in tracking effects such as drowsiness, incontinence, and dizziness which are related to high risk of fall (Luzia, Victor, & Lucena, 214) .
Strategies to Address Nursing Diagnoses
Strategies for Nursing Diagnosis 1
Multifaceted therapy approach should be used to address and evaluate patient's influences, their daily activity routines and roles, and the surrounding environment. The hallmarks in these therapies include connecting the priorities and goals of the patient with adaptations and modifications that support and enhance their ability to take part in essential activities. Caregivers and occupational therapists should work with the client to assess the hazards around the home environment and assess the limitation of the individual that enhances the falls. Occupational therapy will include home modification, transforming the activity behaviors and patterns, and executing daily tasks. These activities should aim at improving the physical abilities of the patient and must regularly entail training of families, client, and other interdisciplinary teams on initiatives to support initiatives of preventing fall (Tinetti & Kumar, 2010) .
Strategies for Nursing Diagnosis 2
Using a multi-pronged approach which utilizes evidence-based interventions to prevent the downstream harm related to polypharmacy to the patient. The strategies should entail interdisciplinary teams to liberalize clinical targets to discontinue multiple medications that increase risks of fall. Another strategy is to place the patient under one care provider to foster communication and care coordination. Centralizing the primary care for the elderly will facilitate mitigation of the side effects related to polypharmacy. Accordingly, tools such as the Screening Tool of Older Persons Potentially Inappropriate Prescriptions and Screening Tool to Alert Doctors to the Right Treatment (STOPP/START) and Medication Appropriateness Index (MAI) should be deployed in clinical judgment (Wang, Camargo, & Veluswamy, 2013) .
Disaster Management Plan
Two Identified Potential Disaster
Failure to observe the suggested fall prevention initiatives at home can increase both non-fatal and fatal falls.
Discontinuing certain medication in the form of preventing overmedication and risks of fall can lead to heightened cases of Parkinson’s.
Discontinuing medication may increase psychiatric and psychological distress.
Disaster Management Plan for Potential Disaster 1
| Action | Intended Results |
| The nurses and care provider should implement a home safety evaluation. | The evaluation should focus on client screening to monitor their mobility and stability skills. |
| The care providers need to undertake multidimensional assessments | In order to identify and implement behavioral, environmental, and physical interventions that lower the disaster and improve safety. |
| Enhance family support | This entails creating awareness of the patient's fall and enabling the family members to offer validation therapy. |
| Orienting the patient to the environment in a thorough way | Call lights can be installed in their rooms and within their reach to enable the patient to ask for assistance in a prompt way. |
| Placing fall precautions across the house and inside sensitive rooms such as bathrooms and toilets. | High-risk fall room marker and armband are necessary as precautionary measures at this extreme. |
Disaster Management for Potential Disaster 2
| Action | Intended Outcomes |
| Enhancing intra-professional support during medications | To increase the responsiveness of the practitioners and care providers in identifying and handling severe psychiatric and psychological distress related to multiple medications. |
| Routinely assisting the patient with their medication while monitoring the side effects | This will enable the identification of medications that pose higher risks and determining other alternatives. |
| Encouraging the patients to perform daily exercises by joining the community gym | Aims at boosting the strength of their muscles and enabling the patients to remain physically active |
Recommendations
The disaster supplies kit for risk of fall should offer descriptions on how to use fall precautions, evaluate the risk of falling, screening the functional abilities of the patient, and maintaining watch and vigilance for falls.
Conclusion
The risk assessment form identified that both patients are at high risk of falling due to their age and unstable health conditions. As a result, the diagnosis should focus on boosting both occupational and physical therapy and lowering side effects related to multiple medications. Both diagnoses will require a multidisciplinary team approach and centralized care supports to enhance the functional ability of the patients.
References
Luzia, M. d., Victor, M. d., & Lucena, A. d. (214). Nursing Diagnosis Risk for falls: prevalence and clinical profile of hospitalized patients. Rev. Latino-Am. Enfermagem, 22 (2), 262-269.
Tinetti, M., & Kumar, C. (2010). The patient who falls. JAMA, 303 (3), 258-266.
Wang, K., Camargo, M., & Veluswamy, R. (2013). Evidence-based strategies to reduce polypharmacy: A review. OA Elderly Medicine, 1 (1), 6.
