Asynchronous Oral Video Presentation On Geriatric Care Assignment Sample

Introduction: Nursing Case Review of Complex Geriatric Medical Care

• This patient is a 70-year-old male with a history of type 2 diabetes and hypertension. He has also complained of the presence of symptoms such as abdominal distension and jaundice, which may be due to complications of these chronic conditions.
• In this presentation, this patient’s clinical characteristics and possible aetiologies will be discussed as well as the appropriate treatment plan. The relevance is based on the fact that studies presented highlight the importance of nursing interventions and use research findings to enhance clients’ outcomes.
• The key components of the presentation will include the patient’s demographics, acute admission diagnosis, pathophysiology of any identified conditions, medication review, discharge planning, and teaching points. The rationale for each section is to combine clinical reasoning with knowledge of patients’ needs and pReferences.

Speaker's Note:

The presentation covers a detailed report of a 70-year-old male patient. We also will focus on demographic data, health problems, medications, and discharge plans, stating main nursing interventions and decisions.

Patient Demographics and History

• The patient is a man of 70 years old with type 2 diabetes mellitus and arterial hypertension.
• Signs and symptoms are gastralgia, ascites, jaundice, and oedema.
• The patient has a chronic history of noncompliance with medications that have been prescribed to him.

Speaker Notes:

Several aspects of patient profiling are paramount in deliberating on the complexity of the case. These chronic illnesses, diabetes and hypertension, along with the noncompliance to medications, pose a critical possibility to his current acute state and hence mandate an evaluation.

Reasons for Acute Admission

• The patient was admitted because of the acute onset of dizziness and loss of consciousness.
• A severe hypoglycemic episode was observed, and the blood glucose was at 1.5 mmol/L.
• Hepatotoxicity was inferred from jaundice and raised liver enzymes (Francis & Navarro, 2020).

Speaker Notes:

Due to acute hepatic dysfunction, the patient had a recent admission for a severe hypoglycaemia event. These aspects point to the dire need to seek urgent and appropriate treatment for his condition from a qualified medical person.

Pathophysiology of Identified Conditions

• Metformin-stimulated hypoglycemia resulted in bad critical conditions due to low blood sugar (Nakhleh & Shehadeh, 2021).
• High bilirubin and liver enzymes indicate the presence of hepatic problems, which could be cirrhotic (Kalas et al., 2021).
• Pulmonary oedema falls under cardiovascular diseases, and it is associated with fluid retention and high blood pressure (Iqbal & Gupta, 2023).

Speaker Notes:

The hypoglycaemia of the patient might be due to the wrong administration of metformin. At the same time, increased activity of liver enzymes shows that the liver is affected and, coupled with cardiovascular disease, adds to the patient’s pathophysiological profile.

Increased Abdominal Girth

• This increased measurement indicates an increase in the perimeter due to fluid, most probably ascites.
• Decreased serum albumin levels are possible for liver cirrhosis or other advanced liver diseases (Jagdish et al., 2021).
• In particular, the presence of ascites and pitting oedema demonstrates severe fluid overload in the patient’s body.

Speaker Notes:

Abdominal enlargement is another manifestation of ascites, a complication most often seen in patients with liver cirrhosis. The low albumin levels of the patient also support the conclusion about further severe hepatic impairment which causes ascites.

Medication: Furosemide

• Frusemide is a loop diuretic that can be used to treat overhydration and promote diuresis (Khan et al., 2023).
• The manifestations include electrolyte disturbances, although less frequently hypokalemia and dehydration (Gędek et al., 2023).
• Nursing considerations include serial measurement of potassium levels, renal function and the patient’s hydration status.

Speaker Notes:

Frusemide is useful for managing the patient’s fluid overload. However, for its efficacy, it presents a high risk of causing complications like an imbalance in electrolytes, with particular reference to potassium in the human body.

Critical Medication Analysis

• Paracetamol was omitted from the order due to the consideration that it may worsen liver injury (Rotundo & Pyrsopoulos, 2020).
• Metoprolol was then used to treat cardiovascular problems to regulate the heart rate and blood pressure (Morris et al., 2024).
• This will trigger dosage modifications before discharge with particular reference to efficacy and safety.

Speaker Notes:

The decision not to be given paracetamol was due to the propensity to liver-related problems as a side effect of the drug. Inotropic and chronotropic effects of the cardiovascular system were maintained by using metoprolol. Proper evaluation of the necessity for continued medication or change of doses is important before discharge of a patient.

Discharge Medication Plan

• Metformin should be continued with proper supervision of blood glucose and renal functions.
• The administration of furosemide may therefore be based on fluid levels and balance of electrolytes (Felker et al., 2020).
• To ensure no further liver damage, it is advisable to stop the use of paracetamol and seek alternative pain relief.

Speaker Notes:

The discharge medication plan will cover glycaemic balance more so to avoid fluid overload. To reduce complication rates in patients after direct discharge, closer observation and appropriate alteration of dosage will be crucial.

Discharge Teaching Points

• It is important to teach the patient personally about blood glucose monitoring to avoid incidences of hypoglycaemia (DeSai et al., 2021).
• Counseling the patient that he should avoid taking salty foods, as this will assist in controlling the swelling and keeping off ascites.
• Teaching the patient about signs of impending fluid overload, including an increase in weight or worsened oedema.

Speaker Notes:

Teaching will be critical during discharge so that the patient will be in a position to manage the condition at home. A proper understanding of blood glucose monitoring, changes in diet, and signs that are there with a relapse will assist with not getting readmitted.

Conclusion

• Interventions include maintaining metformin, monitoring the client, adjusting the Frusemide according to the fluid volume, and avoiding paracetamol as it is dangerous to the liver.
• Patient education will encompass the importance of blood glucose monitoring, changes in the diet, and signs of fluid retention.
• This case involved a patient with hypoglycaemia, hepatic dysfunction, and cardiovascular issues.

Speaker Notes:

Medical-surgical Critical care interventions were aimed at maintaining his clinical status; medication administration, and anticipatory care.