You are working in a general practice (GP) clinic as a registered nurse. Your next patient is Mr Alexander Kumar and his Wife Sarah. Alexander is 85 years of age and is the main carer for his wife who has dementia. Alex has not attended the clinic for himself in over 3 years, but normally attends with his wife for regular check-ups.

When Alex and Sarah arrive, you notice that Alex is limping and both Alex and Sarah look underweight. You also notice that both their clothes look a little dirty, which is unusual for them. When you read their medical file, you note that they have no services in place and their children all live interstate. When you ask Alex, what has brought him in, he tells you he has a wound on his leg which he has been dressing at home for three months, but it is not getting better. Alex tells you he hasn’t seen a doctor about his leg earlier as he can no longer drive and finds it difficult to catch public transport with his wife, who sometimes becomes agitated and upset.

1. Aged care services and interdisciplinary care

  1. Identify and discuss aged care services and interdisciplinary referrals that you would make as a registered nurse to promote Alex and Sarah independence. Provide a rationale for the services you have selected and link this to the case study.

2. Age related changes and Patient assessments

  1. Identify five body systems you would like to assess with specific linkage to the case study. Provide a description of the assessment and possible age-related changes (specific to the body system) that the patient may be experiencing and how this is impacting on the patient’s quality of life.
  2. Identify five different assessments (not body systems) you would perform on Alex and link these assessment to the case study. With each assessment provide a rationale as to why you would perform this assessment.

3. Medication management

Examining the patient’s medication history answer the following questions:

  1. Identify and describe the age-related changes that impact on pharmacokinetics (Absorption, Distribution, Metabolism & Excretion)
  2. The older person is vulnerable to adverse drug events. Identify and describe what factors in the case study increase the risk of an adverse drug event.
  3. For each medication describe what the medication is used for and any potential complications that Alex may experience while taking this medication.

4. Reflection

  1. Reflecting on the case study evaluate the impact of your own personal experiences and beliefs on how you would feel in this situation.

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