University of Bahrain

College of Health & Sport Sciences

Nursing Department
WHO Collaborating Center for Nursing Development

NUR 326: Care of the Older Adult

On line Case Study Assignment

Name: _________________________Student ID: _____________

Section: _______________________ Academic year: 2020 - 2021

Semester: II Faculty Name: _________________________

Prepared
March 2021
Learning Objectives

Upon completion of this case study, the student will be able to:

1. Discuss the possible age-related changes and risk factors that affect

psychosocial function in older adult.

2. List the changes that affect medication taking behavior.

3. Discuss nursing interventions to promote safe and effective medication

management.

4. Explain the functional consequences according to the Nursing Model for

Promoting Wellness in older adult.

5. Discuss the sociocultural theories in older adult.

6. Discuss the predisposing factors and the precipitating factors of delirium.

7. Identify the types of dementia.

8. Discuss the ethical issues related to care of older adult.

9. Develop a nursing care plan related to clients’ actual problem of the older

adult.

10. Plan a health education related to fall prevention.

10.
Background
Mr. H is a 90-year old Bahraini carpenter for 40 years. He has retired when he was
60 years old. He is economically independent, and his pension is the only source of
income. His is living with his wife in a rented flat. He has two daughters and both
daughters are married and living with their husbands .

Medical History:

Mr. H is a known case of hypertension and Diabetes mellitus for 20 years. He has a
history of stroke 6 years ago and he ended up with generalized weakness on his left
side. He is unable to see from his left eye and uses reading glasses. He stopped
going out with his friends to the coffee shop (Kahwa) and fishing because of his
weakness and unsteady gait on trying to get up to a chair or to the car. Mr. H attends
health centre for BP monitoring, and routine follow-ups. He smokes 2 packs of
cigarettes per day since he was 20 years old.

Mr. H stated, “I am cutting down my smoking little by little”. His wife complains that
he has difficulty in hearing. His wife stated that he turns the TV volume higher than
normal. Upon asking Mr. H on the reasons for turning the volume high! He Denis
having any hearing problems.

Mr. H had missed a couple of health care appointments during the last 6 months and
not taking his medication regularly. Mr. H had an operation to treat a cataract for his
left eye recently. He said that the operation has improved his vision tremendously.
The doctor always ordered a vison glasses to wear. The wife stated that he keeps
forgetting things and names of grandchildren.

Mr. H Medications:

 T. Amlodipine 5 mg P.O. OD This is a calcium-channel blocker.Indications:

hypertension; prophylaxis of angina
 T. Bisoprolol 2.5 mg P.O. OD HS BETA-ADRENOCEPTOR BLOCKING
DRUGS Indications: hypertension, angina and as an adjunct in heart failure.
  T. Omeprazole 40 mg P.O. BD PROTON PUMP INHIBITORS
Gastrointestinal System Suppresses gastric acid secretion by blocking acid
(proton) pump within gastric parietal cell. Indications: Benign gastric, duodenal
and NSAID induced ulcer, oesophageal reflux disease, ulcer associated with
H. pylori infection, Zollinger- Ellison syndrome, gastric acid reduction during
anaesthesia, acid- related dyspepsia and severe ulcerating reflux
oesophagitis.
 T. Metformin 500 mg P.O. BD INSULIN & HUMAN INSULIN ANALOGUES
Indications: maturity-onset diabetes especially when this accompanies obesity (BMI >
25) and insulin resistance, Women with Polycystic ovary syndrome and a body mass
index above 25 may be given metformin when other therapy has failed to produce
results.

T. Aspirin 81 mg tab OD
NON-NARCOTIC ANALGESICS mild to moderate, pain, pyrexia; antiplatelet.

Social Life History:

Mr. H visits with his grandchildren only in special occasions. The family started to
notice that he is withdrawn from social gathering and spends most of his time
reading Quran, listening to the radio, and at times watching television in his room.

Recent History:

Last month, Mr. H fell in the bathroom, and had right leg fracture. He was
admitted in SMC for 3 weeks. His condition improved after surgery. His blood
sugar was high and the doctor prescribed injection insulin 2 units before meals.
The nurses noticed that Mr. H is easily distracted and has diminished ability to
keep track on conversations and it fluctuates over the course of the day.

Assignment:

After reading the above scenario, please answer the following questions:

1. Discuss three possible age-related changes and three risk factors that affect Mr.

H. psychosocial function.

2. List five changes that affect medication taking behavior related to Mr. H.
3. List four nursing interventions to promote safe and effective medication

management for Mr. H.

4. Explain the functional consequences in Mr. H according to the Nursing Model for

Promoting Wellness.

5. Discuss one of the sociocultural theories applicable to Mr. H.

6. Discuss two predisposing factors and two precipitating factors which might be the

cause delirium in Mr. H.

7. Based on the clinical symptoms Mr. H. was diagnosed with dementia. In your

opinion, which type of dementia is Mr. H suffering from? Give the rationale behind

your answer.

8. What is the importance of ongoing assessment of a client with dementia?

9. Discuss six nursing interventions to facilitate communication with Mr. H who is

diagnosed with dementia?

10. Based on your opinion, does Mr. H have the right to refuse institutionalization?

Give rational for your answer.

There is no relationship between the answer and the question, what I need is if

the patient compline of dementia does he have the right to decide to be

institutionalized?

11. Identify three priority nursing diagnosis for Mr. H.

12. Develop a nursing care plan related to one of the identified nursing diagnoses.

(Use care plan format). Make sure to have at least five nursing interventions.

13. Develop a Health education Plan for Mr. H to prevent falls.

Good Luck!
 University of Bahrain
College of Health & Sport Sciences
Nursing Department
WHO Collaborating Center for Nursing Development
NUR 326: Care of the Older Adult

Online Case Study Evaluation Guidelines

NO. Item Allotted Completed Partially Not

Points completed completed
1 Age-related changes and risk factors that 3
affect psychosocial function.
2 Changes that affect medication taking 5
behavior
3 Nursing interventions to promote safe and 4
effective medication management
4 Functional consequences according to the 3
Nursing Model for Promoting Wellness
5 Sociocultural theories 3
6 Predisposing and precipitating factors of 4
delirium.
7 Type of dementia and rationale 2
8 Importance of ongoing assessment of a client 2
 with dementia
9 Interventions to facilitate communication with 6
client with dementia
10 The right to refuse institutionalization and 2
rationale
11 Priority nursing diagnosis 3
12 Nursing care plan
 Nursing Diagnosis 1
 Objectives (short and long term) 2
 Nursing interventions and rationale 10
 Evaluation (criteria) 2
13 Health education plan to prevent falls. 4
14 Reference (APA) 2
15 Organization /spelling & Grammar 2
Total Marks 60
Marks/30%
Signature of the Faculty: