Case Study: Health Care of the Older Adult

1.The nurse is completing the admission assessment for a patient scheduled for cataract surgery in the outpatient center. Because the patient is over the age of 70 and has several chronic conditions, including hypertension and congestive heart failure, the nurse focuses on completing a thorough medication history. (Learning Objective 4)

a. What questions should the nurse include in the medication history? 

b. The patient states that she stopped taking one of her medications due to cost, since her health insurance would not reimburse for the medication. What are other reasons that older adults may be non-compliant with ordered medications?

c. How does aging affect drug absorption, metabolism, distribution, and excretion?

2. Care Plan and Medication 

Medical Diagnosis: Arthritis

Arthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis. Osteoarthritis is usually caused by normal wear and tear, while rheumatoid arthritis is an autoimmune disorder. Other types of arthritis can be caused by uric acid crystals, infections or even an underlying disease, such as psoriasis or lupus.

 I NEED A RESPONSE TO THIS ASSIGNMENT

2 REFERENCES

Gender Dysphoria disorder

The main components of the DSM-5 diagnosis of gender dysphoria include longstanding discomfort with the incongruence between gender identity and external sexual anatomy at birth along with interference with social, school, or other areas of function (APA,2013). Children who have a gender identity or feeling that does not match or correspond with their designated gender (based upon genital anatomy or chromosomes) are referred to as transgender or gender-diverse (TGD) (Rafferty , 2018). Although not really clear how children learn gender, they are ware of differences as an infant, many experiment with expression of roles (Rafferty, 2018). Young (TGD) children may prefer clothing, hairstyles, toys, activities, and playmates that usually are stereotypically considered more appropriate for the opposite sex (Spack et al, 2012).  Studies show demonstration of gender-diverse behaviors and expression are not a choice they reflect an innate preference of the child (APA, 2013).  Strong social pressures to conform to same-sex gender stereotypes may suppress the child’s desire to express, and create the psychological issues related to this topic. Early identification permits psychosocial support for the child or adolescent and their family members and family rejection may have negative consequences for the youth physically and mentally (Ryan et al, 2021). There are many roles for treatment which is loosely defined, such as:

1. Assessing gender identity in the context of the youth’s psychosocial and family milieu and evaluating extent of gender dysphoria
2. Educating about and modeling acceptance of diversity and fluidity in gender and sexuality
3. Addressing the negative impact of gender dysphoria and stigma on mental health alleviating internalized transphobia (ie, fear of gender diversity)
4. Providing support and helping to build the resiliency/coping skills necessary to navigate difficult social, educational, and professional situations (see ‘Associated concerns’ above)
5. Evaluating and treating mental health symptoms or conditions that may diminish self-esteem or impede successful transition (eg, depression, anxiety, substance abuse)
6. Providing support to parents and family members who have difficulty adjusting to the child’s “new” identity
7. Providing information about gender diversity to parents, family members, teachers, schools, and other communities
8. Assisting in the development of a safety plan around disclosure (see ‘Disclosure’ above)
9. Assisting in transition preparation and planning (see “Management of transgender and gender-diverse children and adolescents”, section on ‘Social transition’)
10. RESOURCES – (WPATH, 2021).

Culturally it is noted that “How gender is presented to the outside world (eg, feminine, masculine, androgynous); gender expression does not necessarily correlate with birth-designated gender or gender identity. In addition, gender expression varies across geography, culture, and time. Some individuals may present their gender differently within different environments” ( Rafferty , 2018 , p.142).

References

American Psychiatric Association. Gender dysphoria. In: Diagnostic and Statistical Manual of

Mental Disorders, Fifth Edition, American Psychiatric Association, Arlington, VA 2013.

Rafferty J, COMMITTEE ON PSYCHOSOCIAL ASPECTS OF CHILD AND FAMILY

HEALTH, COMMITTEE ON ADOLESCENCE, SECTION ON LESBIAN, GAY,

 BISEXUAL, AND TRANSGENDER HEALTH AND WELLNESS. Ensuring

Comprehensive Care and Support for Transgender and Gender-Diverse Children and

Adolescents. Pediatrics 2018; 142.

Ryan C, Huebner D, Diaz RM, Sanchez J. Family rejection as a predictor of negative health

 outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics 2009.

 123:346. Retrieved February 10, 2021 from: https://www.uptodate.com/contents/gender-

development-and-clinical-presentation-of-gender-diversity-in-children-and-adolescents?

Spack NP, Edwards-Leeper L, Feldman HA, et al. Children and adolescents with gender identity

disorder referred to a pediatric medical center. Pediatrics 2012; 129:418.

World Professional Association for Transgender Health (WPATH). WPATH Standards of Care

for the Health of Transsexual, Transgender, and Gender Nonconforming People, 7th

 Version. Available at:

www.wpath.org/documents/Standards%20of%20Care_FullBook_1g-1.pdf

Assignment Content

1. Part A
   Complete the Information Systems Worksheet.

   Using complete sentences, define, describe, and provide an example of each term in the table within the worksheet. Use your textbooks or an outside source as references.  

   Cite any outside sources.

   Part B
   Write a 150- to 350-word response to each of the following questions based on this week’s readings and your personal experience. Use your own words and provide examples to support your answers.  

   • What is the difference between computer hardware and software?  
   • Why is the use of information systems in health care important? Explain your answer.  
   • Cite any references to support your assignment.

     Format your assignment according to APA guidelines.

 

 Data Collection – Your essay should be 1500-1700 words and should include at least three (3) citations. Clearly mark each heading to identify the interviews and summaries. Follow the guidelines for APA writing style. Be sure to use APA guidelines for referencing in an interview.  

Choose a research topic that interests. This can be any topic you would like to research either qualitatively or quantitatively. An example might be effectiveness of a tool for monitoring home administration of medications however you can choose any topic you like. Develop a tool for collecting data (be sure to keep it fairly simple in the interests of the project), 

 

After watching the videos in this weeks presentation please choose one question from below to discuss with the class.  You can include your thoughts/feelings of the videos watched.

1. How can we promote healthy behaviors?  What do you do?

2. How can we target dangerous conditions, such as hazardous waste sites, and ensure healthy spaces and places?

3. How can individuals protect themselves against health threats?  What do you do?

4. Which populations have the worst health?

5. What causes the unequal production and distribution of the conditions that promote and harm health?