Free Essay Sample «Clinical Reasoning Client Report»

«Clinical Reasoning Client Report»

Mr. Wong is an 81–year-old man who used to live with his daughter and grandchildren. He has been admitted to the hospital for six weeks. His daughter cannot take care of him and this might cause certain difficulties, because the man is not used to the new place of living. The state of Mr. Wong’s health is quite problematic. He is in the early stage of dementia, has obvious eating disorders and weights 50 kilograms. As the result, he has problems with coordination, tends to pull back while walking and is unsteady on his feet. He is incontinent of urine, has red and sore genitalia. It is possible to suppose that Mr. Wong understands his state of health more or less clearly, and such problems like incontinence of urine and bad memory makes him feel nervous and uncomfortable.

It is necessary to gather more detailed information about the main problems Mr. Wong has in order to understand their causes and their outcomes. It might turn out that all his diseases are interconnected, and it is possible to eliminate one of his problems by treating another. In addition, precise information about the diseases makes it easier for the medical personnel to communicate with a patient in the most appropriate way.

As it was mentioned earlier, Mr. Wong suffers from dementia on the early stage. It is necessary to understand that dementia itself cannot be called a disease, but rather a group of symptoms from the other problems like the Alzheimer’s or a damage of brains. People who suffer from dementia have problems not only with memory, but also with reasoning, focusing, communication and language.

There is a number of symptoms that are characterized to the early stage of dementia. The disease affects the mood of a patient greatly. Shifts of mood are common for this period of illness, as well as deep depression. A person him/herself cannot usually understand what is the reason of such behavior, and that is why it is crucial for a nurse to communicate with a patient in a diplomatic manner. People in the early stage of dementia, like Mr. Wong, can experience problems with short-term memory (Kovach et al. 1999). They can remember all the stories from their life, but in the same time they are unable of recollecting where they have put their glasses and why they have come to the particular place. This might cause various problems in communication with Mr. Wong. He cannot fully take care of himself, because he can forget something important about himself and the things he needs to do. In addition, it might cause inconveniences, because the patient might be shy to ask for help. People, who suffer from dementia in the early stage, have difficulties with expressing their thoughts. It is difficult for them to combine the right words to communicate the idea to the others, that is why it takes time and effort from the medical personnel to understand what a patient wants (Byrne 2005).

Mr. Wong, as the majority of those, who suffer from dementia, might feel apathy. The loss of appetite is one of the results of such lost of interest in life. The elderly often stop communicating with their family and friends, and become even more depressed, facing their problem alone. Mr. Wong is staying in the hospital only for six weeks, and both people and the place is new for him. It is necessary to emphasize that the deterioration of spatial orientation and the sense of direction is one of widely spread symptoms among the people, who suffer from dementia. It might be a stressful situation for him, because he needs to talk to strange people he does not know, and to visit the places he is not used to. Everyday rituals like shaving, taking a shower and going to breakfast might become serious problems for Mr. Wong, and he might become even more depressed.

The state of the patient is quite difficult, but it is crucial for nurses to remember that despite a series of health problems Mr. Wong has, he understands what is going on around him and is psychologically sane. That is why the medical personnel cannot allow themselves behave in the way like no one is watching them. Once I saw a situation in the hospital, when the young nurse was trying to communicate with the elderly patient and she nearly shouted, because she thought that the woman does not hear her properly. In the end, the elderly woman said to the nurse, that she is old and ill, but she is not deaf. I saw the embarrassment of the nurse and the irritation of the woman patient. The woman might have had troubles with communicating her ideas quickly, as it is in the early stage of dementia, and the nurse did not understand it and thought the woman was partially deaf.



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