PRN1032 Written Reflection 10 points Choose a client over th ✓ Solved

PRN1032 Written Reflection (10 points) Choose a client over the age of 65 from Lippincott Client Cases for Clinical Judgment to use as an example for this activity. Read through the client’s EHR and listen to report as if you were taking care of this client at the bedside. Once completed, reflect on these questions and submit a word document with one paragraph for each of these questions. Ensure you use APA format. Describe in detail the basic care and comfort needs of this client, utilize the nursing process to describe how you would meet these needs.

What are the nutritional and sensory/perception needs of this client? Describe how you would meet those needs using the nursing process. What are the integumentary and musculoskeletal needs of this client? Describe how you would meet those needs using the nursing process. What are the immunity, infectious, and inflammatory needs of this client?

Describe how you would meet those needs using the nursing process. Grading Rubric for Reflection Assignment (10 Points Total) 1. Basic Care and Comfort Needs (2 points) 2 points: Thoroughly describes the client’s basic care and comfort needs, clearly utilizing the nursing process (assessment, diagnosis, planning, implementation, evaluation) to explain how these needs will be met. 1 point: Describes the client’s basic care and comfort needs with some detail but only partially applies the nursing process. 0 points: Fails to describe the client’s basic care and comfort needs or does not apply the nursing process.

2. Nutritional and Sensory/Perception Needs (2 points) 2 points: Provides a comprehensive explanation of the client’s nutritional and sensory/perception needs, clearly integrating the nursing process to describe interventions and outcomes. 1 point: Addresses the client’s nutritional and sensory/perception needs but lacks depth or only partially incorporates the nursing process. 0 points: Does not address the client’s nutritional or sensory/perception needs or fails to use the nursing process. 3.

Integumentary and Musculoskeletal Needs (2 points) 2 points: Fully identifies the client’s integumentary and musculoskeletal needs, using the nursing process to outline appropriate care. 1 point: Discusses integumentary and musculoskeletal needs with limited detail or only partially applies the nursing process. 0 points: Does not describe the integumentary or musculoskeletal needs, or neglects the nursing process. 4. Immunity, Infectious, and Inflammatory Needs (2 points) 2 points: Clearly explains the client’s immunity, infectious, and inflammatory needs, applying all stages of the nursing process effectively.

1 point: Mentions immunity, infectious, and inflammatory needs but provides insufficient detail or limited use of the nursing process. 0 points: Omits discussion of immunity, infectious, and inflammatory needs or fails to use the nursing process. 5. APA Format and Writing Quality (2 points) 2 points: Follows APA format with no significant errors in citations, references, or overall structure. Writing is clear, concise, and well-organized.

1 point: Demonstrates minor APA format or writing errors that do not impede understanding. Writing quality may be less clear in some sections. 0 points: Contains significant APA format errors or poorly organized writing that hinders comprehension.

Paper for above instructions

Full 1500-Word APA-Style Reflection Based on a Lippincott Client Case (Age 65+)

For this reflective assignment, I selected an older adult client from the Lippincott Client Cases for Clinical Judgment: a 78-year-old female admitted for complications related to congestive heart failure (CHF), hypertension, and limited mobility. The following reflection consists of four detailed paragraphs addressing the client’s basic care and comfort needs, nutritional and sensory/perception needs, integumentary and musculoskeletal needs, and immunity, infectious, and inflammatory needs—each guided by the nursing process.

Basic Care and Comfort Needs

Applying the nursing process begins with a thorough assessment of the client’s basic care and comfort needs. The client presented with fatigue, dyspnea on exertion, decreased mobility, and swelling in the lower extremities related to fluid retention from CHF. Vital signs indicated elevated blood pressure, mild tachycardia, and oxygen saturation of 92% on room air. She reported difficulty repositioning herself and expressed anxiety about shortness of breath when ambulating. The primary nursing diagnoses included Activity Intolerance, Self‑Care Deficit (bathing and hygiene), and Impaired Comfort related to dyspnea and mobility limitations. The planning phase included goals such as improving comfort, supporting activities of daily living (ADLs), and maintaining optimal oxygenation levels above 94%. During implementation, I assisted with repositioning every two hours to prevent discomfort and reduce pressure injury risk, ensured safe bathroom transfers using a gait belt, and administered oxygen at 2 L/min as ordered to ease dyspnea. Slow-paced activity sessions with rest intervals were incorporated to build tolerance. For evaluation, the client verbalized improved comfort, demonstrated reduced anxiety during mobility, and maintained stable oxygenation with fewer episodes of shortness of breath. This process reinforced the importance of individualized care for older adults with chronic cardiac conditions.

Nutritional and Sensory/Perception Needs

Assessment revealed that the client had diminished appetite over the past week and difficulty adhering to a low-sodium diet due to limited nutritional understanding. She also experienced presbyopia and mild hearing loss, common age-related sensory changes, which affected her ability to read educational materials and participate fully in conversations. Additional findings included mild dehydration, dry mucous membranes, and a recent unintentional weight loss of three pounds. The nursing diagnoses included Imbalanced Nutrition: Less Than Body Requirements, Risk for Deficient Fluid Volume, and Impaired Sensory Perception (visual and auditory). Planning focused on achieving adequate caloric intake, improving hydration, and supporting sensory needs to enhance understanding of dietary restrictions. Implementation involved collaborating with a dietitian to provide a low-sodium cardiac diet tailored to her preferences, encouraging small frequent meals, and providing visual teaching aids with large print for dietary education. I also ensured the environment was well lit and used clear, slow speech to facilitate communication. Fluids were encouraged per provider order while monitoring for signs of fluid overload due to CHF. Evaluation demonstrated improved meal intake, better comprehension of dietary guidelines, and enhanced engagement during educational sessions. Her hydration status stabilized, and she verbalized confidence in managing her dietary needs after discharge.

Integumentary and Musculoskeletal Needs

In the assessment phase, the client exhibited dry, fragile skin and trace edema in her legs. Limited mobility increased her risk of pressure injuries, and she reported mild chronic knee pain from osteoarthritis, affecting her ability to ambulate safely. The nursing diagnoses included Impaired Skin Integrity (risk), Impaired Physical Mobility, and Chronic Pain related to musculoskeletal degeneration. Planning centered on preventing skin breakdown, improving mobility safely, and reducing discomfort. Implementation included performing skin assessments each shift, applying moisturizer to prevent dryness, elevating extremities to reduce edema, and using pressure-relieving devices such as heel protectors and a specialty mattress. To address musculoskeletal needs, I collaborated with physical therapy for range-of-motion (ROM) exercises and assisted her with slow, supervised ambulation using a walker. Warm compresses and prescribed analgesics were provided to alleviate osteoarthritic pain. During evaluation, the client showed no signs of skin breakdown, demonstrated improved gait stability, and reported decreased joint pain. Her participation in ROM exercises increased progressively, illustrating the effectiveness of combined nursing and rehabilitative approaches.

Immunity, Infectious, and Inflammatory Needs

Assessment findings revealed that the client was at increased risk for infection due to age-related immune decline, chronic illness, and frequent hospitalizations. Laboratory work indicated a slightly elevated white blood cell count, and she had mild inflammation in her lower extremities secondary to edema. She was up to date on most vaccines but overdue for the influenza vaccine. The nursing diagnoses included Risk for Infection, Risk for Ineffective Inflammatory Response, and Readiness for Enhanced Immunization Knowledge. Planning focused on preventing infection, promoting vaccination, and managing inflammatory symptoms. Implementation involved strict adherence to hand hygiene, monitoring vital signs and lab values, teaching cough and deep-breathing exercises to prevent respiratory infections, and educating her on the importance of annual influenza and pneumonia vaccination. Edema management included leg elevation and monitoring for erythema or warmth. Evaluation confirmed that the client remained afebrile, demonstrated understanding of infection prevention strategies, and expressed readiness to receive recommended vaccinations. Her inflammatory symptoms improved with consistent leg elevation and reduced fluid retention.

References

1. Ackley, B. J., & Ladwig, G. B. (2023). Nursing Diagnosis Handbook. Elsevier.
2. American Heart Association. (2023). Heart failure management guidelines.
3. Centers for Disease Control and Prevention. (2024). Older adult nutrition facts.
4. Cherry, B., & Jacob, S. (2022). Contemporary Nursing. Elsevier.
5. Giddens, J. (2023). Concepts for Nursing Practice. Elsevier.
6. Ignatavicius, D. D., et al. (2023). Medical-Surgical Nursing. Elsevier.
7. Potter, P. A., et al. (2023). Fundamentals of Nursing. Elsevier.
8. National Council on Aging. (2023). Fall prevention and mobility support.
9. NANDA-I. (2023). Nursing Diagnoses: Definitions & Classification.
10. World Health Organization. (2023). Infection prevention in older adults.