Professional Documents
Culture Documents
Nursing Program
For this Rotation, I will be your Virtual/Online Clinical Instructor. I am looking forward to guiding
you in learning this rotation well. If you want to reach me for any RLE concerns, you can reach
me through the following:
For this week, we will be learning about NCM 114 Care of Older Adults. I am looking forward
to guiding you in learning this course well. If you want to reach me for any RLE-related
concerns, you can reach me through the following:
Prerequisite:
MTW
Schedule:
Please expect that you might need to print some parts of the worksheets in this module (i.e.,
documentation and transcribing parts). If any difficulties in participating in synchronous classes
are encountered, inform your instructor right away! For absences, secure an excuse slip from
your RLE supervisor.
TAGUM DOCTORS COLLEGE, INC.
Nursing Program
Submissions must be submitted through the Learning Management System (LMS) so that it
will be traced and secured easily.
Daily Activities
Every week, you are expected to follow through the following deliverables:
Now that you are done acquainting yourself with the instructor and the course itself, please
proceed to Module 1: Assessment of an Elderly Client
MODULE 1:
TAGUM DOCTORS COLLEGE, INC.
Nursing Program
Instructions:
All output for this weeks RLE Activity must be handwritten, scanned and submitted to
corresponding emails of your Clinical Instructor
Learning Outcomes
At the end of this module, you are expected to:
1. Utilize the nursing process in the care of chronic illness and care of the older person.
2. Discuss special concerns issues and trends in caring for the chronically ill and the older
person.
As you start with this module, you are free to consult and coordinate with your assigned clinical
instructor. Be sure to get his/her email address and contact number for collaboration and
assistance. Just keep going, you can do it!
Read the Questions carefully and select the correct answer based on your
assessment. ( Will be deployed via Google Classroom)
TAGUM DOCTORS COLLEGE, INC.
Nursing Program
Case Scenario
Mrs. D, a 68-year-old female with early stage Alzheimer disease, presents to the subacute
rehabilitation unit of a long-term care institution for short-term rehabilitation. She is 3 days
postoperative for an open reduction internal fixation (ORIF) of a left head of femur fracture
sustained after she fell down a flight of stairs.. Her daughter is at her bedside during the
clinician’s admission assessment and serves as the primary historian. The daughter states that “
Lisdan pa gyud siya maglihok lihok tungod sa operasyon”. Her medical and surgical histories are
significant for psoriasis, “a touch of” emphysema, Cesarean section, and depression, a History of
Transient ischemic attack with Hypertension as one of her co-mordities.
Mrs. D, a widow and only child, lives in a “mother-daughter” home in a first-floor, 1-bedroom
apartment. She is financially “well-off”. Her daughter, her only child, lives in the second floor, 3-
bedroom apartment with her husband and 3 children all under the age of 12. Mrs. D attends a
social adult day care program 3 days a week and is able to prepare light cold meals, such as
cereal for breakfast or yogurt for a snack. She has dinner every night with her daughter’s family.
Prior to her diagnosis of Alzheimer’s approximately 2 years prior to this admission, she drank
approximately 4 glasses of wine a day. Since diagnosis she has only had glasses of non-alcoholic
wine to maintain a social appearance at family functions. Her daughter reports that she was a
pack-and-a-half per day smoker for over 40 years. Since her fall she has not asked for a
cigarette. She attends Catholic mass weekly. She was able to walk several blocks without
fatigue. Her father died of an unknown cancer and had rheumatoid arthritis, and her mother
died of a hemorrhagic stroke. At present Mrs. D is resting comfortably in bed, denies pain, and
is unable to provide a number on a pain scale of 1–10 due to incomprehension (She stated, “no
hurt.”). Her medications
include donepezil (Aricept®), 5mg daily; multivitamin daily; sertraline (Zoloft®), 25 mg daily;
TAGUM DOCTORS COLLEGE, INC.
Nursing Program
and topical steroid creams for psoriasis. She is allergic to penicillin. She also takes, Mefenamic
Acid 500mgs q 4-6 hours when in pain.
Mrs. D is lying in bed; she is awake, alert, and oriented to person but not to place or time. Her
Mini-Mental State Exam (MMSE) is 22/30 with errors in place, year, calculation, recall, and
naming. Her BMI is 28, and vital signs are 128/74, 84, and 22. Oxygen saturation is 89% on
room air
(base line is 88%–91%). Her temperature is 98.4 F orally. Neurological exam reveals no focal
deficits. Her head is normocephalic. PERRLA. Tympanic membranes are pearly grey. Breath
sounds are diminished throughout with poor inspiratory effort; no adventitious sounds are
noted. Heart rate is regular with S1 and S2. Bowel sounds are auscultated in all 4 quadrants;
and her abdomen is soft, nontender, and without suprapubic tenderness. There is a vertical
surgical incision scar on her abdomen. An indwelling urinary catheter is in place draining clear,
yellow urine into a bedside drainage bag. Extremities are without edema, and distal pulses are
2+ palpable. Left hip surgical incision is clean and dry; staples are intact with mild erythema, no
warmth or swelling. Otherwise the skin is intact without evidence of tissue damage
from pressure. Silvery scales (psoriasis) noted on elbows and lower legs. The indwelling urinary
catheter is removed at midnight. The next afternoon the daughter asks the clinician why her
mother is wearing a “diaper” since her mother did not have trouble getting to the bathroom
prior to the fall and subsequent hospitalization. The clinician assesses and learns that, after the
urinary catheter was removed, Mrs. D did not call for assistance. The nursing assistant found
her during 4 a.m. rounds trying to get out of bed, and her bed linens were wet with urine. At
that time, the nursing assistant cleaned Mrs. D and applied an absorbent brief. Thereafter, the
day nursing assistant performed morning care and, again, placed an absorbent brief on Mrs. D.
Task 4: Make 1 Actual Priority Nursing Care Plan for the Case Scenario of Mrs D.
(See and download attached copy of NCP Form in the Google Classroom)
Task 5: Make 1 Drug Study – (Refer to the List of Medications of the Case Scenario
given. The Clinical Instructor will assign the specific drug)
(See and download attached copy of Drug Study Form in the Google Classroom)
Task 6: Make a creative Video Journaling(2 mins) on what are your Perceptions on
Care of the Adults, Expectations and Forseeable Learnings in this rotation.
(Upload your Video file in your Google drive. Link only will be submitted in my
email: agravantenursingtdci@gmail.com )
References:
Jennifer Kim and Sally Miller (2017). Geriatric Syndromes. Journal American Geriatric
Society.
Maree, Bernoth (2016). Healthy Ageing and Aged Care
Reviewed by:
Approved by:
Willyn B. Adrias RN MN
Dean of Nursing