NRNP 6540 Week 1 Discussion : Assessment of Older Adults

/in /by

NRNP 6540 Week 1 Discussion : Assessment of Older Adults

As patients age, they are more likely to develop health issues. While some of these health issues are normal changes due to aging, some of them are abnormal and require further evaluation. Consider a 92-year-old patient who has been diagnosed with several disorders, including obstructive sleep apnea, hypertension, mild chronic anemia, restless leg syndrome, and osteoporosis. Despite these disorders, he can independently perform all basic activities of daily living, walk a quarter mile without difficulty, and pass functional and cognitive assessments. However, he did report that he fell a few times and had lost his way while driving to a familiar location (Carr & Ott, 2010). As an advanced practice nurse caring for geriatric patients, you will likely encounter patients like this. While he can pass the basic assessments, the report of falls and confusion might indicate underlying issues of immobility, sensory deprivation, and/or cognitive dysfunction that require further attention. To identify these potential underlying issues and distinguish between normal and abnormal changes due to aging, healthcare providers use a variety of assessments. These assessments are a key tool in the care of geriatric patients.NRNP 6540 Week 1 Discussion : Assessment of Older Adults

ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

This week, you examine assessment tools and evaluation plans used to assess geriatric patients presenting with potential issues of immobility, sensory deprivation, and cognitive dysfunction.

Reference:
Carr, D. B., & Ott, B. R. (2010). The older adult driver with cognitive impairment: “It’s a very frustrating life.” Journal of the American Medical Association, 303(16), 1632–1641. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915446/

Learning Objectives

Students will:

  • Analyze assessment tools used to assess older adults
  • Design evaluation plans for patients with immobility, sensory deprivation, and/or cognitive dysfunction
  • Identify immunization requirements related to health promotion and disease prevention for older adults
NRNP 6540 Week 1 Discussion : Assessment of Older Adults

Learning Resources

Required Readings (click to expand/reduce)
Recommended Reading (click to expand/reduce)
Recommended Media (click to expand/reduce)

Discussion: Evaluation Plan

As geriatric patients age, their health and functional stability may decline resulting in the inability to perform basic activities of daily living. In your role as a nurse practitioner, you must assess whether the needs of these aging patients are being met. Comprehensive geriatric assessments are used to determine whether these patients have developed or are at risk of developing age-related changes that interfere with their functional status. Since the health status and living situation of older adult patients often differ, there are a variety of assessment tools that can be used to evaluate wellness and functional ability. For this Discussion, you will consider which assessment tools would be appropriate for a patient in a case scenario. NRNP 6540 Week 1 Discussion : Assessment of Older Adults

Photo Credit: LIGHTFIELD STUDIOS / Adobe Stock

To prepare:

  • Review this week’s Learning Resources, considering how assessment tools are used to evaluate patients.
  • Your Instructor will assign a case study to use for this Discussion. Review the case study and, based on the provided information, think about a possible patient evaluation plan. As part of your evaluation planning, consider where the evaluation would take place, whether any other professionals or family members should be present, appropriate assessment tools and guidelines, and any other relevant information you may wish to address.
  • Consider whether the assessment tool you identified was validated for use with this specific patient population and if this poses issues. Think about additional factors that might present issues when performing assessments such as language, education, prosthetics, missing limbs, etc.
  • Consider immunization requirements that may be needed for this patient. NRNP 6540 Week 1 Discussion : Assessment of Older Adults

    ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

By Day 3

Post an explanation of your evaluation plan for the patient in the case study provided, and explain which type of assessment tool you might use for the patient. Explain whether the assessment tool was validated for use with this patient’s specific patient population and whether this poses issues. Include additional factors that might present issues when performing assessments, such as language, education, prosthetics, etc. Also explain the immunization requirements related to health promotion and disease prevention for the patient.

Read a selection of your colleagues’ responses.NRNP 6540 Week 1 Discussion : Assessment of Older Adults

By Day 6

Respond to at least two of your colleagues on two different days in one or more of the following ways:

  • Suggest alternative assessment tools and explain why these tools might be appropriate for your colleagues’ patients.
  • Recommend strategies for mitigating issues related to use of the assessment tools your colleagues discussed.
  • Explain other health promotion considerations for patients in this population or with related issues.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Post to Discussion Question link, and then select Create Thread to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!NRNP 6540 Week 1 Discussion : Assessment of Older Adults

Rubric Detail

 

Select Grid View or List View to change the rubric’s layout.

Content

Name: NRNP_6540_Week1_Discussion_Rubric

Excellent
Point range: 90–100		 Good
Point range: 80–89		 Fair
Point range: 70–79		 Poor
Point range: 0–69
Main Posting: 

Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
Points Range: 40 (40%) – 44 (44%)
Thoroughly responds to the discussion question(s).
NRNP 6540 Week 1 Discussion : Assessment of Older Adults
Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. 

No less than 75% of post has exceptional depth and breadth.

Supported by at least 3 current credible sources.
Points Range: 35 (35%) – 39 (39%)
Responds to most of the discussion question(s). 

Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of the post has exceptional depth and breadth.

Supported by at least 3 credible references.
Points Range: 31 (31%) – 34 (34%)
Responds to some of the discussion question(s).
NRNP 6540 Week 1 Discussion : Assessment of Older Adults
One to two criteria are not addressed or are superficially addressed. 

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with fewer than 2 credible references.
Points Range: 0 (0%) – 30 (30%)
Does not respond to the discussion question(s). 

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only 1 or no credible references.
Main Posting: 

Writing
Points Range: 6 (6%) – 6 (6%)
Written clearly and concisely. 

Contains no grammatical or spelling errors.

Further adheres to current APA manual writing rules and style.NRNP 6540 Week 1 Discussion : Assessment of Older Adults
Points Range: 5 (5%) – 5 (5%)
Written concisely. 

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.
Points Range: 4 (4%) – 4 (4%)
Written somewhat concisely.
NRNP 6540 Week 1 Discussion : Assessment of Older Adults
May contain more than two spelling or grammatical errors. 

Contains some APA formatting errors.
Points Range: 0 (0%) – 3 (3%)
Not written clearly or concisely. 

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.
Main Posting: 

Timely and full participation
Points Range: 9 (9%) – 10 (10%)
Meets requirements for timely, full, and active participation. 

Posts main discussion by due date.
Points Range: 8 (8%) – 8 (8%)
Posts main discussion by due date. 

Meets requirements for full participation.
Points Range: 7 (7%) – 7 (7%)
Posts main discussion by due date.
Points Range: 0 (0%) – 6 (6%)
Does not meet requirements for full participation. 

Does not post main discussion by due date.
First Response: 

Post to colleague’s main post that is reflective and justified with credible sources.
Points Range: 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. 

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.NRNP 6540 Week 1 Discussion : Assessment of Older Adults
Points Range: 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.NRNP 6540 Week 1 Discussion : Assessment of Older Adults
Points Range: 7 (7%) – 7 (7%)
Response is on topic, may have some depth.
Points Range: 0 (0%) – 6 (6%)
Response may not be on topic, lacks depth.
First Response: 

Writing
Points Range: 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. 

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.NRNP 6540 Week 1 Discussion : Assessment of Older Adults
Points Range: 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. 

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.
Points Range: 4 (4%) – 4 (4%)
Response posed in the discussion may lack effective professional communication. NRNP 6540 Week 1 Discussion : Assessment of Older Adults 

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.
Points Range: 0 (0%) – 3 (3%)
Responses posted in the discussion lack effective communication. 

Response to faculty questions are missing.

No credible sources are cited.
First Response: 

Timely and full participation
Points Range: 5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. 

Posts by due date.
Points Range: 4 (4%) – 4 (4%)
Meets requirements for full participation. 

Posts by due date.NRNP 6540 Week 1 Discussion : Assessment of Older Adults
Points Range: 3 (3%) – 3 (3%)
Posts by due date.
Points Range: 0 (0%) – 2 (2%)
Does not meet requirements for full participation. 

Does not post by due date.
Second Response: 

Post to colleague’s main post that is reflective and justified with credible sources.
Points Range: 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. 

Responds to questions posed by faculty. NRNP 6540 Week 1 Discussion : Assessment of Older Adults

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
Points Range: 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
Points Range: 7 (7%) – 7 (7%)
Response is on topic, may have some depth.
Points Range: 0 (0%) – 6 (6%)
Response may not be on topic, lacks depth.NRNP 6540 Week 1 Discussion : Assessment of Older Adults
Second Response: 

Writing
Points Range: 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. 

Response to faculty questions are fully answered, if posed.
NRNP 6540 Week 1 Discussion : Assessment of Older Adults
Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.
Points Range: 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. 

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.
Points Range: 4 (4%) – 4 (4%)
Response posed in the discussion may lack effective professional communication. 

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.NRNP 6540 Week 1 Discussion : Assessment of Older Adults
Points Range: 0 (0%) – 3 (3%)
Responses posted in the discussion lack effective communication. 

Response to faculty questions are missing.

No credible sources are cited.
Second Response:
Timely and full participation
Points Range: 5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. 

Posts by due date.NRNP 6540 Week 1 Discussion : Assessment of Older Adults
Points Range: 4 (4%) – 4 (4%)
Meets requirements for full participation. 

Posts by due date.
Points Range: 3 (3%) – 3 (3%)
Posts by due date.
Points Range: 0 (0%) – 2 (2%)
Does not meet requirements for full participation. 

Does not post by due date.
Total Points: 100

Name: NRNP_6540_Week1_Discussion_Rubric

Mr. Perkins, age 81, reports for an annual physical examination. He says he is doing well. His only known problem is osteoarthritis. He also requests a flu shot. He takes no medications other than Tylenol for arthritis pain. When he walks into the exam room, you notice that he uses a straight cane in his right hand. When you ask about the cane, he says he began using the cane because the pain in his right hip had increased significantly over the past six months. NRNP 6540 Week 1 Discussion : Assessment of Older Adults

ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

Pain Can have a devastating effect on patients with older chronic conditions, and common geriatric ailments can be painful.  Pain can affect a patient’s quality of life of a patient. According to Keela (2010), pain assessment tools can be used to establish reliability, validity, and sensitivity to changes from treatment. The International Association for the Study of Pain (IASP) defined pain as an “unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage (Breivik, H. 2002). There is no single diagnostic test for pain.  But a comprehensive history and physical and neurological examination is performed when evaluating and identifying the best treatment plan for pain associated with chronic medical conditions such as Mr. Perkins osteoarthritis NRNP 6540 Week 1 Discussion : Assessment of Older Adults

In the case of Mr. Perkins, the assessment and diagnosis of pain can be complicated by psychological and behavioral factors such as anxiety due to payment associated with medical services, distress, depression, anger, and cognitive functional decline. Mr. Perkin’s clinician has to reassure him and provide as many resources as possible when answering questions.  Historical assessment should be done with the involvement of the spouse.  Pertinent information may be missing from the patient’s narrative. For a more comprehensive historical assessment, the patient’s live-in partner or family, or caregiver should be involved in the questionnaire.  Effective treatment of pain in the elderly is impeded by the patients’ unwillingness to take pain seriously, stoicism, and the assumption that pain is part of “growing old.”  Despite having increased pain for the last six months, Mr Perkins has not been to his doctor for treatment. NRNP 6540 Week 1 Discussion : Assessment of Older Adults

Chronic pain causes stress on the body.  A patient experiencing pain daily affects performance in activities of daily living (ADLs), decreased appetite, and energy. Chronic pain affects emotional and physiological changes such as depression, anger, anxiety, and fear of reinjury, leading to disability or maladaptive behavior. NRNP 6540 Week 1 Discussion : Assessment of Older Adults

Mr. Perkins is 81 years old, with osteoarthritis.  Several vaccinations are recommended due to his age. These vaccines are the flu vaccine annually.  Two doses of Zoster or varicella for shingles.  One dose of the pneumococcal conjugate or pneumococcal polysaccharide.

NRNP 6540 Week 1 Discussion : Assessment of Older Adults

References

American Pain Society. The ACPA. (n.d.). https://www.theacpa.org/acpa_maze/american-pain-society.

Breivik, H. (2002). International Association for the Study of Pain: Update on WHO-IASP Activities. Journal of Pain and Symptom Management, 24(2), 97–101. https://doi-org.ezp.waldenulibrary.org/10.1016/S0885-3924(02)00465-7

Michael R. Clark, M. D. (n.d.). Guide to Chronic Pain Assessment Tools. Practical Pain Management. https://www.practicalpainmanagement.com/resources/diagnostic-tests/guide-chronic-pain-assessment-tools.NRNP 6540 Week 1 Discussion : Assessment of Older Adults

You make an interesting point about some accepting pain as part of growing older. I agree it is the responsibility of the clinician to performs a detailed assessment and provide education. Chronic pain in the elderly associates with falls, depression, sleep disturbances and decreased satisfaction of quality of life (Schofield & Abdulla, 2018).  This puts his safety at risk and by finding the cause of the problem he may be able to receive proper treatment to increase his quality of life. Given the potential for cognitive decline in the elderly, the use of pain assessment tools is a useful additive to the assessment. Generally, a numeric scale is used to rate pain, but the addition of the face pain scale revised (FSP-R) can help give additional detail to fully understand the patient’s perspective of the pain (Flaherty, 2020). Finding the root cause of the pain can be challenging, therefore making it all the more important to be accurately assessed and treated.NRNP 6540 Week 1 Discussion : Assessment of Older Adults

Flaherty, E. (2020). Pain assessment for older adults. https://hign.org/consultgeri/try-this-series/pain-assessment-older-adults

Schofield, P. & Abdulla, A. (2018). Pain assessment in the older population: What the literature says. https://academic.oup.com/ageing/article/47/3/324/4951960

I agree with you on using the right pain assessment tools to treat the patient.  I will just add that besides the pain assessment, paying attention to changes in patient behavior is extremely important when dealing with cognitively impaired or non-verbal patients.  A paradigm of inadequate pain management exists and includes negative effects on physical function, psychological morbidity, and social or societal sequelae. (Arfoff, Ce 2007) As a consequence of this, other appropriate assessments methods may include sleep disturbances, depression/anxiety, decreases in activities of daily living, disability, and changes in relationships with friends or family. NRNP 6540 Week 1 Discussion : Assessment of Older Adults

Many of the tools like the numerical pain assessment tools, or the Wong Baker face assessment tools for example have been shown to be less useful in the cognitively impaired geriatric population. (Herr. K, Bjoro. K, Decker. S, 2006) Because there is difficulty in using certain tools in cognitively impaired patients, discrepancies governing the successfulness of use exist. NRNP 6540 Week 1 Discussion : Assessment of Older Adults

The Wong Baker face assessment scale has been criticized for assessing emotion rather than pain. Patients who interpret the FACES Scale to assess emotion may have difficulty using the scale, because the expression of emotion is gender and culturally based. (Dewaters, T.  Popovich J, Faut-Callahan M. 2003) Crying is not equally acceptable between genders and may not be an acceptable way of dealing with pain in some cultures.

NRNP 6540 Week 1 Discussion : Assessment of Older Adults

References

 

Argoff CE. Managing neuropathic pain: new approaches for today’s clinical practice. Available at: www.medscape.com/viewprogram/236_1pnt. Accessed April 20, 2007.

Herr K, Bjoro K, Decker S. Tools for assessment of pain in nonverbal older adults with dementia: a state-of-the-science review. J Pain Symptom Manage . 2006;31:170-192.

Dewaters T, Popovich J, Faut-Callahan M. An evaluation of clinical tools to measure pain in older people with cognitive impairment. Br J Community Nurs . 2003;8:226-233.

NRNP 6540 Week 1 Discussion : Assessment of Older Adults

© Copyright 2022 superbnursingessays.com
NURS 6512 Week 1 Discussion: Building a Health History Case Study: Grand Nursing Theories Based on Human Needs
Open chat
Need help with this or a different assignment? We offer CONFIDENTIAL, ORIGINAL (Turnitin/LopesWrite/SafeAssign checks), and PRIVATE services using latest (within 5 years) peer-reviewed articles. Kindly click on ORDER NOW to receive an A++ paper from our masters- and doctorate-prepared writers.