Possibilities that Mrs. Smith can Change from the Current Mental Status
Mrs.Smith may not be able to have a positive change in the mental status particularly because of her age and the other health conditions that she faces. According to McCance and Huether (2015), when one is aging, the nervous system undergoes a significant change in the cellular, structural, functional and cerebrovascular components. Some of the changes which can worsen the mental problem include the rampant decrease in the number of neurons, development of intracellular neurofibrillary tangles and subsequent imbalance of neurotransmitters. Arterial atherosclerosis changes, the decrease in vascular density as well as increased permeability decreases the hopes for improvement in Mrs.Smith’s case.
Differential Diagnosis and Reasons
Due to the cases and details presented, my view is that Mrs. Smith is suffering from delirium. She is old and the fact that the sleep cycle is impaired can be confirmed to be depressed and changing from reality to confusion (McCance & Huether, 2015). The sickness which can cause dry cough and crackles may have increased the chances of Mrs.Smith contracting delirium. Also with the dry cough and crackles, she might be sick which could affect a person at this age to become delirious.
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Depression, Dementia, and Delirium
Depression causes prolonged sadness and a feeling of despair. Some of the other characteristics are insomnia, reduced interests and lack of appetite. Dementia, on the other hand, is the increased failure rate of the cerebral functions including language, memory, attention and behavior changes . Depression can also cause very bad thoughts in a person such as suicidal thinking and thinking that he or she might be having no reason to live. Mayo Clinic (2017) claims that dementia can improve with treatment and can respond to some medications. The memory of a person who is suffering from dementia worsens slowly over the years. The slow worsening of the condition might be due to the slow death of brain cells and neurons (Mayo Clinic, 2017). Lastly, delirium is a condition which is always associated with hypoxia, fluid-electrolyte imbalanced hypoglycemia and UT (McCance & Huether, 2015). Delirium affects sleep, causes attention loss and disorganized thoughts and causes delusions.
Explanation to Mrs. Smith’s Daughter on the Treatment Needed Prognosis
Mrs. Smith’s daughter should understand the procedures which will be undertaken to take care of her mother. I will ensure that she understands that we are going to do follow up and work upon the mother to get a complete history of the problems that she is facing currently including the issue of the other conditions such as hypertension, diabetes, and dementia. I will also explain to her the need to have a full laboratory test for some of the other issues which we might not have done in reaching at the dementia conclusion during the first diagnosis. The laboratory tests which will be applied include ECG, urine, blood and radiology tests (McCance & Huether, 2015). The aims of all these follow up tests are to establish the real issue and to get to know the cause of delirium. At the same time, the next stage will be to ensure that other issues such as primary disorders are well checked and treated as well to avoid worsening the conditions. I will also ensure that the daughter agrees to make regular visits to the doctor for checkups and to see if any improvements are made with keeping records for future references.
References
Mayo Clinic. (2017, August 02). Dementia. Retrieved August 8, 2018, from https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013
Mayo Clinic. (2018, June 13). Seizures. Retrieved August 8, 2018, from https://www.mayoclinic.org/diseases-conditions/seizure/diagnosis-treatment/drc-20365730
McCance, K. L., & Huether, S. E. (2015). Pathophysiology: The Biologic Basis for Disease in Adults and Children (7th ed.). St. Louis, MO: Mosby.
