Evaluation of Nursing Care

Evaluation of Nursing Care Introduction It is the prime role of health care professionals to provide adequate health services to their patients. Nursing care requires them to handle patients form different ages and health backgrounds. Medical nurses should consider the particular needs of their patients. Different age groups need special medical treatment. Children and elderly patient sometimes are neglected and not been given enough medical attention. Providing immediate medical attention to the patients is very important to ensure the health safety and chances for survival. There are times when medical nurse or a care giver should learn to handle complex situations. Sometime there is a need to deal with multiple or complicated health issues. Providing the necessary nursing care means being patient and responsive to the specific medical needs of the patient. To identify their needs one must understand the medical history of the patient after making an accurate diagnosis. Patient management is an important aspect of medical services. The nurse should have complete knowledge of the health condition, treatment and medication the patients need. Nursing care covers a wide scope of concern which has to be carefully assessed and efficiently provided. The different issues regarding the patient should be properly addressed and monitor. There should be cooperation between the doctor and the medical staff to give appropriate medical assistance to a patient in need. In evaluating nursing care one must consider the factors like the need for monitoring devices, oxygenation and ventilation, nutritional need of the patient, elimination processes and problems like renal failure, colostomy etc., environmental impact or hospital acquired infection, environmental management and also special care for dying patient. Analysis and Discussion An 83 year old male patient was admitted to the ward via emergency department. He was brought after vomiting dark colored brown fluids with blood clots. The patient has medical history of Parkinson�s disease, community acquired MRSA, depression, renal calculi, osteoporosis, recurrent UTI, constipation, dysphagia, depression, multiple skin tear and conjunctivitis. The patient�s UTI led to renal calculi. Parkinson�s disease Parkinson�s disease is a disease of the basal ganglia characterized by slowing down in the initiation and execution of movement (bradykinesia), increased muscle tone (rigidity), tremor at rest and impaired postural reflexes. It is the most common form of Parkinsonism (a syndrome characterized by similar symptoms).� The pathological process of Parkinson�s disease involves degeneration of the dopamine producing neurons in the substantial nigra of the midbrain which in turn disrupts the normal balance between dopamine and acetylcholine Ach in the basal of ganglia. DA is a neurotransmitter essential for normal functioning of the extra pyramidal motor system including control of posture, support and voluntary motion. Symptoms of PD do not occur until 80% of neurons in the substantial nigra are lost. Many complications of Parkinson�s disease are caused by the progressive deterioration and loss of spontaneity of movement, Swallowing may become very difficulty (dysphagia) in severe cases like in this patient, leading to malnutrition or aspiration. General debilitation may lead to pneumonia, urinary tract infections and skin breakdown. Mobility is greatly decreased. The gait usually consists of rapid, shuffling ministeps. The posture is that of the old man image, with head and trunk bent forward and the legs constantly flexed. The lack of mobility can lead to constipation, ankle oedema and more seriously, contractures. Orthostatic hypotension may occur in some patients along with loss of postural reflexes, may result in falls or other injury. Troublesome complications include seborrhea (increased oily secretion of the sebaceous glands of the skin), dandruff, excessive sweating, conjunctivitis, difficulty reading, insomnia, incontinence and depression. Due to dsyphagia in this patient, he was on PEG feeds. Dysphagia is associated with a wide range of