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Adult-Geriatric Patient Experiencing Acute or Chronic Immobility

 

 

 

Adult-Geriatric Patient Experiencing Acute or Chronic Immobility

 

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Adult Geriatric Patient Experiencing Acute or Chronic Immobility

The adult-geriatric patient with acute or chronic immobility should be referred to a physical and occupational therapist. The physical therapist conducts mobility assessment, transfer and gait assessment, and determines the patient’s need for skilled services. The occupational therapist assesses the patient’s need for ADL devices/aids and evaluates physical functioning. The requirements for acute rehabilitation include the patient being able to tolerate a minimum of 3 hours of therapy per day for 5 to 7 days a week. Services include intense, multidisciplinary therapy for patients with functional loss (Saenger et al., 2022). A patient must be medically stable to qualify for skilled care and should have a need that a skilled, licensed professional must perform daily. Skilled care offers 24-hour skilled nursing and personal care, and rehabilitation services.

In addition, a patient qualifies for long-term care if they have more than one serious health condition but whose condition may improve with time and extra care and return home. Patients stay in long-term care facilities for over 25 days (Makam et al., 2020). Services provided in long-term care include comprehensive rehabilitation, head trauma treatment, respiratory therapy, and pain management. The requirement for hospice care is for a physician to document that if the disease follows its normal course of progression, the patient’s life expectancy is less than six months. It includes providing end-of-life care to patients with a terminal illnesses and supporting their families.

An acute-care adult-geriatric patient can be transferred to home health care as a bridge to independent living. This system of care is provided by skilled practitioners to patients in their homes under a physician’s direction. Requirements for admission include a patient living at home but cannot travel to obtain treatment and has rehabilitation and nursing needs (Saenger et al., 2022). The services offered include nursing care, occupational, physical, and speech-language therapy, and medical social services.

Part 2

Pressure ulcers are a common immobility and wound management condition. Impaired mobility is the most common risk factor for pressure ulcers due to prolonged uninterrupted pressure. Patients with the highest risk include neurologically impaired, heavily sedated or anesthetized, demented, restrained, and those recovering from a traumatic injury (Mervis & Phillips, 2019).

During the assessment of a patient with pressure ulcers, the clinician should obtain information regarding pain, foul odor, or discharge, the period the ulcer has been present, the circumstances under which the ulcer developed, and the associated medical cause for the ulcer. Besides, a complete review of systems, including night sweats, fevers, rigors, weight loss, loss of appetite, and weakness, should be conducted. Diagnostic workups include a complete blood count to assess for inflammation or invasive infection (Mervis & Phillips, 2019). In addition, nutritional parameters should be evaluated to assess adequate nutritional stores required for wound healing with tests like Albumin, Prealbumin, Transferrin, and Serum protein levels.

The mainstays of pressure ulcer treatment include offloading the offending pressure source, adequate drainage of any areas of infection, debridement of devitalized tissue, and regular wound care to support healing (Boyko et al., 2018). Treatment interventions for pressure ulcers include innovative mattresses, creams, solutions, ointments, dressings, ultraviolet (UV) heat lamps, sugar, and surgery. Empiric antibiotics should be initiated immediately. Initial antimicrobial therapy should be broad-based to cover aerobic gram-positive and gram-negative organisms and anaerobes. The recommended antibiotics include Silver sulfadiazine and Mafenide.

 

 

References

Boyko, T. V., Longaker, M. T., & Yang, G. P. (2018). Review of the Current Management of Pressure Ulcers. Advances in wound care7(2), 57–67. https://doi.org/10.1089/wound.2016.0697

Makam, A. N., Nguyen, O. K., Miller, M. E., Shah, S. J., Kapinos, K. A., & Halm, E. A. (2020). Comparative effectiveness of long-term acute care hospital versus skilled nursing facility transfer. BMC health services research20(1), 1-10. https://doi.org/10.1186/s12913-020-05847-6

Mervis, J. S., & Phillips, T. J. (2019). Pressure ulcers: Prevention and management. Journal of the American Academy of Dermatology, 81(4), 893–902. https://doi.org/10.1016/j.jaad.2018.12.068

Saenger, P. M., Ornstein, K. A., Garrido, M. M., Lubetsky, S., Bollens-Lund, E., DeCherrie, L. V., Leff, B., Siu, A. L., & Federman, A. D. (2022). Cost of home hospitalization versus inpatient hospitalization inclusive of a 30-day post-acute period. Journal of the American Geriatrics Society70(5), 1374–1383. https://doi.org/10.1111/jgs.17706

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Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

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Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

  • A minimum of 6 responses per week, on at least 3 days of the week.
  • Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
  • Each response needs to be at least 75 words in length (does not include your list of references)
  • Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
  • Follow APA 7th edition
  • Points will be deducted if the above is not followed
  • Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
  • Here are some helpful links
  • Student paper example
  • Citing Sources
  • The Writing Center is a great resource