Nursing Care Priorities for Resources Availability -myassignmenthelp

Question: Write about theNursing Care Priorities for Resources Availability. Answer: Introduction Priority setting is very important in nursing and lack of it can lead to serious consequences for patients. Nurses must be aware of important international, local and national healthcare trends in nursing (IOM, 2011). Recent studies show that priority setting as a tough skill for new nurses to acquire and is not given sufficient time in nursing education. Priority setting id described as ordering of nursing problems using notions of importance so that a sequential order for nursing actions can be established. Priority setting is influenced by a number of factors, for example nursing expertise, condition of the patient, resources availability, organization of the ward, care philosophies or models, relationship between nurses and patient and cognitive used which is used by nurses in priority setting (Brown et al, 2015). There is a need for nurses to approach care in an accountable manner so that the future of nursing is strong. Accountable care is known as a team of healthcare provider s holding shared responsibility for quality and cost of healthcare that they provide to communities with an aim of improving healthcare values (CMS, 2009). The main strategy is to provide effective healthcare, involve the patients in making decisions and reduction of illnesses that can be prevented. This paper will look at nursing care priorities of Mr Rhatin Bhai, an 87-year-old patient with Parkinson's disease. An analysis will be made of whether the patient has problems managing his medication using the Levett-Jones clinical reasoning cycle. Two theories, which can be used to explain nursing priorities, are the Millers functional consequences theory and the Levett-Jones clinical reasoning cycle. The Miller functional consequences theory was invented by Miller and it states that older adults get to feel functional consequences due to age related changes and other risk factors (Johnson Chang, 2014). When there are no interventions, functional consequences become negative but with interventions, they can be positive. A nurses role is to identify factors, which lead to negative functional consequences and initiate the relevant interventions that will lead to positive consequences. Normal changes related with age can negatively interfere with the activity and quality of life of a patient (Martini, Nath Bartholomew, 2015). The nurse has to differentiate between changes caused by age that can be reversed and risk factors, which can be modified. The clinical reasoning cycle is a reference to judgments and clinical decision-making through a logical process. It was developed by Levett-Jones and is an eight-stage process that nurses or medics use to collect signals, process information, understand a patient's problem, plan interventions and do an evaluation of outcomes after which they reflect again on the whole process (Levett-Jones et al, 2010). The Clinical Reasoning Cycle by Levett-Jones The situation of Mr Bhai will be analysed using the clinical reasoning cycle, which has eight processes (Levett-Jones, 2013). Mr Bhai is a patient who suffers from Parkinson's disease and currently has a tremor in both hands, which is becoming worse. Due to this, he is having difficulty in performing activities of daily living like cooking and doing his shoelaces. His finances just enable him to meet his expenses and this may be affecting the purchase of medication. Consider the patient's situation Parkinson's disease is a chronic disorder that affects the central nervous system and has a direct impact on the motor system of a person. It is characterized by shaking of the body, rigidity, slow movement and increased dependency on other for basic activities with growing age. The patient, in this case, is Mr Ratin Bhai who is 87 years old who lives independently as he lost his wife and they did not have any children. His mobility has been altered and he now had a slight tremor in the hands, which is making simple tasks difficult to do. He has relatives close by but does not want to bother them. He is currently on the following medication. Thyroxine 100 micrograms daily Carbidopa/Levodopa 25/100 q8h Entacapone 200 mg q8h Due to the tremor on his hands and the difficulty in performing some basic tasks, Ratin may be having some difficulty in managing his medication. Collect cues/information In the collection of information, the nurse must focus on the biopsychosocial context of Parkinsons disease and operate on ethical, legal and operational assumptions to prevent the complications of the disease and put in place the necessary treatment and rehabilitation procedures. The nurse will look at the pathophysiology of the disease and consult other professionals on the team. The symptoms of Parkinsons disease are divided into motor and non-motor and each of these has different symptoms (Postuma et al, 2015). The nurse will interview Mr Bhai to get to know his age, his living situation, his feeding habits and how he takes his medicine. She will also ask him symptoms, which lead him to believe that his sickness is getting worse. Through the information collected, an appropriate diagnosis will be made. Process information The nurse will process the information that has been given by Mr Bhai by looking at the effects of Parkinsons disease and comparing it to the symptoms, which he is suffering from (Galter, Nieto Baroto, 2016). One of the symptoms of Parkinson's is tremors and Mr Bhai has tremors on his hands (Hunter, 2016). Another symptom is social isolation, which is also affecting Mr Bhai as he has no children and is a widower. He also does not want help from his relatives. Financial worry also stresses Mr Bhai as he is retired and whatever he earns barely meets his expenses. Patients with Parkinson's disease also suffer from decreased mobility. Mr Bhai's mobility has decreased due to old age and hypothyroidism, which causes weakness of the muscles. The nurse will assess Mr Bhai's case and see where his symptoms fit to know how to give him the appropriate care. Identify problems/issues Three nursing priorities that will be identified are dealing with the tremors, restoring performance of activities of daily living and dealing with the uncertainty about the future. One of the motor symptoms of Parkinsons disease is tremors. Pin-rolling tremors occur in the hands and the symptom is back-and-forth rubbing of the thumb and forefinger. When the hands are at rest, they also tremble. There is also difficulty in doing activities of daily living. Parkinsons can make it harder and less safe to perform normal activities that were previously done. In this case, Mr Bhai is unable to tie shoelaces and make a cup of tea and this can lead to health deterioration as he lives alone and cannot do basic activities. There is also an uncertainty about the future of Mr Bhai. One of the symptoms of Parkinson's is Hypothyroidism, which can lead to depression and social isolation. Mr Bhai seems to be suffering from this as he prefers to be alone and does not want the help of his relatives. The top care priority, in this case, will be dealing with the tremors. It is imperative that the tremors are managed so that Mr Bhai is able to do basic activities, which are very important to enable him to get better. Establish goal/s The nurse will establish goals so that Mr Bhai's symptoms are managed for a positive outcome. In this case, the goal will be to manage the motor symptoms, non-motor symptoms and principles of rehabilitation symptoms. The current drugs that the patient is using will be reviewed to see whether they are an adequate part of the treatment and if the dosage is sufficient for the current symptoms, which the patient has developed. The general practitioner of Mr Bhai seems to suspect that Mr Bhai may not be managing his medicine regimen as required hence the escalation of symptoms. The focus should be on how to ensure that Mr Bhai takes all the medication, which is required and does not skip any dose. This will include any additional medicines that will be administered (Miller, 2014). The nurse, therefore, has to get down to the bottom of why Mr. Bhai may not be taking his medicine faithfully as it may be intentional as he feels they are not working or unintentional as his finances may not be sufficient for purchasing the medicine. The main goals will, therefore, be to manage Mr Bhai's tremors by putting in measures to ensure that the tremors in both hands reduce in two weeks. In one month, he should be able to tie shoelaces and make a cup of coffee (Pont-Sunyer et al, 2015). The nurse also has to make sure that Mr Bhai has a realistic progression of his disease in a week. Take action The nurse will take action on managing Mr Bhai's symptoms. The action that will be taken is to review and manage medication that Mr Bhai is currently taking, as he should not be having tremors if the medications are working. The current medication may also be leading to the negative side effects. Tests will be done and if medication is not working, it will be changed. Mr Bhai will also be referred to occupational therapy for assessment so that it can be determined how much he is able to do for himself. This will help him to maintain self-independence and pride. Mr Bhai will also be referred to a physiotherapist to make an assessment of if he needs mobility aid that will help to make him more independent. A social worker will also be involved so that Mr Bhai gets assistance in organizing his meals and doing other basic activities. The social worker will assist in arranging for home care so that Mr Bhai's quality of life is improved. A fall risk of assessment is also required so that falls and subsequent injuries are prevented (Wu Hallet, 2013). Evaluate outcomes The nurse must ensure that Mr Bhai is monitored and progress documented (Bryant Knights, 2015). In an evaluation of the outcomes, the nurse will do an evaluation of whether the tremor has decreased on Mr Bhai's arms. An evaluation will also be done on whether he can now tie his shoes and make a cup of tea. It is also important that Mr Bhai is asked questions to determine whether he now has an understanding of his disease. Reflect on process and new learning The nurse will reflect on the whole process to confirm if everything has been done correctly so that the patient gets a positive outcome. All the processes will be reflected upon and reviewed together with the general practitioner. Anything new that has been learnt in regards to managing the disease must be noted so as to be applied to any future patients (Schrag et al, 2015). Constant monitoring of Mr Bhai will occur so that he is helped to manage his disease appropriately. Conclusion As demonstrated, the important role of nurses in the care of patients with Parkinson's disease is quite obvious and training of new nurses to meet growing demands is important. Nurses have to prioritise what to handle when a patient comes into their facility. Through this, the right diagnosis is made and the patient gets quality healthcare as whatever is most serious is handled first. Mr Bhai's case also emphasizes the importance of a support system for patients who are suffering from conditions brought about by age (Kitson, 2009). The nurse plays an important role by ensuring that the family becomes aware and is involved in the patient treatment process. Different tools should be developed to enhance nursing care as nurses play a key part in ensuring that patients get well. References Brown, D., Edwards, H., Seaton, L Buckley, T. (2015). 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