Nursing Care Plan for Nutritional Deficit and Mobility Risk Assignment Sample

Managing Malnutrition and Fall Risk in Elderly Patients

Nursing care plan 1: Managing nutritional deficit within the patient

As per the case study it can be seen that Mrs. Atkinson has lost 5kg weight in the last three months and along with that she has refused meals and has a poor appetite. These have led to nutritional deficits within the body. As opined by Tamura et al. (2020), elderly patients mainly when are in hospitals for a long time have an increased risk of malnutrition. This leads to health complications more often which may decrease the wound healing, cause muscle wasting and the immune system can be weakened.

Goal:

The goal of this nursing care plan is to improve the nutritional intake of Mrs. Atkinson and in that way stabilising her weight within the upcoming 4 weeks. It is aimed by the care givers to ensure that she is consuming 75% of her meals minimum and gaining at least 1 kg of weight by the end of the session.

Interventions for the care plan

1. Nutritional assessment: This is one of the key interventions where the eating pattern of the patient will be assessed along with their dietary history. Clinical testing can help in identification of the malnutrition level. For example, the albumin test can help in this case. This can help in developing a proper care plan as well. In case of elderly patients, it is quite common that malnutrition remains undetected and for them early interventions are important.
2. Providing supplement: Since the patient is unable to take meals for her nutritional fulfilment, the caregivers can provide her nutritional supplements to manage her nutritional deficit. Protein shakes can cause high calorie intake (based on the discussion of Dominique et al. 2021). These supplements can be chosen as per her pReferences and dietary restrictions.
3. Customising the meals: Since the patient is unable to consume a large portion at a time, she can be offered with smaller but frequent meals. Along with that snacks like fruits, yoghurt or cheese can be given to her for fulfilling her nutrition. While giving her smaller meals, it should be taken into account that the choice of foods should be proper to meet the nutritional requirement of the patient. In this regard, a dietician can be consulted by the caregivers. This can help them to develop a proper plan for the patient (based on the discussion of Αntoniadou & Varzakas, 2021).
4. Proper monitoring and reporting: The dietary intake of the patient should be monitored properly for better results. A healthcare team should be appointed which can track the progress of the patient regarding the food intake and make the diet plan accordingly. Monitoring this food intake can make sure that the patient is taking the proper portion of nutrition, the timing is proper and the food preference is followed (as per the discussion of Αntoniadou & Varzakas, 2021).

Expected outcomes

1. It is expected that Mrs. Atkinson will gain at least 1 Kg weight within 4 weeks and she will be stabilised. In this regard, routine checkup of her weight will be done and care plan will be improvised accordingly
2. She will intake at least 75% of her meals daily. In this case, her consumption of meals will be checked as well. If she is not taking enough food, alternative strategies will be taken like providing supplements. Also, her food can be replaced with other meals and she can be provided with more snacks as stated before. In such cases the protein shake is a good protein. Caregivers will consult with the dieticians regarding this (Ang, Low & How, 2020).

Nursing care plan 2: Managing the impaired mobility and risk of falls

The key problem in this case is that Mrs. Atkinson is experiencing impaired mobility as she is not steady on her feet. She is taking support of a walking frame and she has mentioned pain in her left hip. Due to her mobility issues, she has a high risk of fall and that can lead to fractures, and increased chance of mortality.

Goal

The goal in this case is to improve the mobility of the patient and reduce the risk of her falls. This goal is to develop strength and balance within the patient. Also, it is to look after that the patient is taking less assistance in case of mobilising and the chances of falls are reduced.

Nursing interventions

1. Physiotherapy: This is one of the most effective processes to improve the mobility and overall stability of the patient. This can help in increasing the muscle strengths and providing balance and more flexible joints. These can help in increasing the mobility among the patient and thus the chances of falls can be reduced as well (based on the discussion of Shao et al. 2020). Physiotherapists can help in designing exercise by targeting the specific areas like the hip muscles. This will gradually reduce her pain giving her improved mobility.
2. Fall prevention program: This is included with guiding the patient to use the walking frame properly. Ensuring that she is mobilising in a place where there are no obstacles, and so she must have support from the caregivers all the time. Increasing self management techniques and environmental modifications can help to reduce the risk of fall from the premise of the patient (Freiberger, Sieber & Kob, 2020).
3. Pain management: One of the biggest reasons for the immobility of the patient is the pain she is suffering from. Pain management therapy will help to reduce the pain in her left hip. Along with therapies, medications are also included within this process and this can help in increasing her mobility.
4. Using mobility aids: This is designed to provide support to the patient. She is already using the walking frame. It will be ensured that she is using that properly for avoiding any risk of falls and making a smooth mobility. Alternative devices can be suggested here as well.
5. Educating the patient and the family: This is one of the major interventions. The patient and the family members must be aware of the risk of falls and the factors which can contribute. Based on that proper fall management education can be provided to them to avoid any such occurrence in future (Freiberger, Sieber & Kob, 2020)

Expected outcomes

1. The first expected outcome is that the patient will improve her mobility within the upcoming 4 weeks and she will require less assistance to walk. This is aimed to increase her level of independence from her daily activities (Αntoniadou & Varzakas, 2021). In this regard, daily assessment and weekly reporting of her mobility will be done to ensure that the intervention is working properly. Improvement will be ensured that she is requiring less assistance to walk and can mobilise independently.
2. Reducing the chances of falls is another major expected outcome in this case. It is expected that within the upcoming four weeks, the patient will have a lesser risk of falls. This is directly related to her mobilisation process (based on the discussion of Beck Jepsen et al. 2022). Once the patient is more mobilised her chances of falls will be decreased. In this regard, it will ensure that there are no obstacles in the premise where she will walk or move. Also, regular monitoring of her progress will be done and the physiotherapist will ensure that she is free to move in the selected area. In case of any risk of fall the family members must take necessary steps and along with that the treatment plan should be reviewed by the caregivers to ensure ultimate safety of the patient.