Aging Adult Case Study

N495 Module 1
3:18 min





 Module 1: Assignment 








 Assignment Description Aging Adult Case Study A 68-year-old client lives alone and is independent with all ADLs, has no restrictions for mobility, and is competent, and oriented x4. The client is on a fixed income, but has enough to manage a modest lifestyle. The client has family and social supports but is very independent and is proud of her self-reliance. The client’s height is 5’ 6”, weight is 210 lb. / 95.25 kg. Please answer the following: • What is the client’s BMI? • Identify what screening tools you would use to assess nutritional and exercise knowledge, and why? • Identify two client outcomes that are reasonable, measurable and realistic • Identify 3 nursing interventions for each client outcome and give rationales • Identify what weakness in the client’s life and supports may be impacting the client’s activity and diet? • What referrals would you make and why? • Identify your references in APA format. Use references not just opinion. Assignment Expectations: Length: 1500 to 1750 words in length Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion. References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (2) scholarly sources are required for this assignment. Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document (.pdf)

Normative aging is concerned with the effects of aging on a person’s health status. During the health assessment of older adults, it is incredibly crucial to consider the impact of aging on an individual’s health to recommend individualized, evidence-based approaches to improve the quality of life. According to Bickley (2017), history taking, interviewing, and health assessment for older adults should be comprehensive. Physical head to toe examination encompasses general survey, vital signs, skin, head, eyes, ears, nose, and throat (HEENT), neck, back, lungs, and lower extremities.Aging Adult Case Study.  Acquiring older patients’ health history requires health professionals to modify their usual approach, and their demeanor should convey respect, calmness, cultural awareness, and patience. In this essay, the author analyzes a case study of a 68-year old client living alone and independent with activities of daily living (ADLs). While the client has a stable income, she her salary allows her to manage a modest lifestyle. Specifically, the author uses the information provided to calculate the client’s BMI, identify appropriate screening tools to evaluate her exercise and nutritional knowledge, and identify measurable, realistic, and reasonable client outcomes. Lastly, the author identifies nursing interventions for each client outcome, weaknesses in the client’s life that impact her diet and exercise, and appropriate referrals.

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The Client’s BMI

The Body Mass Index (BMI) is a person’s weight in kilograms divided by their square height in meters. It is an indicator of high body fatness.  The client weighs 95.25 kgs with a height of 5.6 feet. After calculation, her BMI is 32.73, which implies that the client is obese. A healthy person with a BMI ranging from 18 to 24 and a BMI greater than 30 is considered obese. Obesity is subcategorized into three groups; class 1, class 2, and class 3 obesity. The client in this case study falls under class 1 obesity, comprising a BMI ranging between 30 and 35 (Kinlen et al., 2017). Obesity is associated with numerous health conditions, among them diabetes, cardiovascular illnesses, and hypertension.

Screening Tools used to assess the Client’s Nutrition and Exercise Knowledge

Various tools can be used to evaluate the client’s knowledge of nutrition and exercise. As dietary changes are useful in preventing chronic health conditions, there is a dire need for healthcare personnel to utilize user-friendly tools to evaluate patients’ diets and exercise habits accurately. These tools are incredibly crucial in nutritional counseling. Two standard screening tools for exercise and diet are WAVE and REAP.

WAVE is an acronym for Weight, Activity, Variety, and Excess formulated by the Nutrition Academic Award to help healthcare personnel perform nutrition assessment and guide their patients accordingly. When using WAVE as a screening tool, the physician assesses the client’s weight by determining their BMI status. To evaluate the client’s activity, the physician inquires about the client’s activity level in the past week. Here, physical activity encompasses brisk walks, jogging, golf, swimming, or gardening. The physician could also ask whether the client engages in lifestyle activities such as taking the stairs or elevators. The frequency and duration of physical exercises are also taken into consideration. If the client does not engage in any physical activity, the physician asks of the client’s willingness to increase their physical activity levels. The physician then assesses the variety of foods consumed by the client and their nutritional value. Lastly, the physician determines whether the client eats in excess by inquiring about the food portions and indulgence. Aging Adult Case Study.

The Rapid Eating and Activity Assessment for Patients (REAP) is another nutrition and exercise screening tool appropriate for this client. It is a form of a questionnaire designed based on the Food Guide Pyramid (Johnson et al., 2018). Questions included in this tool evaluate the intake of foods rich in calcium, vegetables, fruits, whole grains, sugar, dairy, alcoholic beverages, and the level of physical activity. The tool also encompasses inquiries that delve on whether clients shop or prepare their food, experience trouble cooking, follow a special diet, or limit specific foods for specific health reasons. Using the REAP tool, the physician can provide useful guidelines on improving the client’s diet and physical activity to prevent consequent health problems.

Reasonable, Measurable, and Realistic Client Outcomes

The first outcome for this patient is the acknowledgment that she is obese. According to her BMI, the client falls under class 1 obesity, a condition that places her at a greater risk of chronic health conditions such as diabetes and hypertension. Therefore, helping the patient understand the consequences of obesity and strategies for maintaining a healthy weight will be crucial. Several interventions can be instituted to achieve this outcome. First, the physician can educate the patient on overweight and obesity and their impact on a person’s health. Patient education should entail weight management strategies that are tailored to individual client needs (Walsh et al., 2019).  The client may not be aware she is overweight or understand its complications. As such, education as an intervention should be prioritized. Second, the physician can help the patient develop a healthy dietary plan, including healthy foods and correct portions. The client’s diet should be comprised of fruits, vegetables, and whole grains. Third, the physician can recommend resources to assist the patient in maintaining a healthy weight. For instance, the physician should encourage the client to join community centers and engage in moderate activities such as walking and gardening.

The client’s second outcome would be an increased level of physical activity and tolerance to improve her muscle strength and boost immunity. Various interventions would be employed by the physician to achieve this outcome. First, the physician can encourage the patient to engage in physical activity and engage the client in creating an exercise chart that best aligns with the client’s lifestyle. Second, the physician can educate the client on the benefits of physical activity. Besides increasing a person’s mood, exercises help an individual maintain a healthy weight, reduce the risk of cardiovascular diseases, improve immunity, and enhance muscle strength (Chase, 2015). The last intervention would be to encourage the client to attend health and wellness seminars in the community to increase her knowledge. In such meetings, the client could interact with her peers and utilize community resources to maintain a healthy weight.

Weaknesses in the Client’s Life and Support that Impact her Nutrition and Exercise

Several weaknesses are notable from the client’s information provided in the case study. For instance, she values independence. Currently, the 68-year-old lives alone and is independent with activities for daily living. Although the client has social and family support, she prefers being independent. Also, the client is self-reliant, and she earns enough income to sustain a modest lifestyle. Self-reliance and independence could be impacting the client’s nutrition, level of physical activity, and overall health. As a result of her desire to be self-reliant and independent, the client may find it challenging to seek help and decide to work through issues on her own. Additionally, self-reliance may limit some of the activities that the client chooses to engage in. Self-reliance and independence may contribute to the patient holding back from asking for help related to her weight, nutrition, and physical exercise.

Appropriate Referrals for the Client

I would consider several referrals for this client. First, I would refer her to a senior community center. Senior community centers are community centers where aging adults congregate to fulfill their social, physical, spiritual, and intellectual needs. These centers serve as gateways for the aging population by connecting them with vital community resources that enable them to maintain health and enhance their quality of life (Siegler et al., 2015). The majority of senior centers are designated at central points. This allows older adults to access multiple services in one setting. Aging Adult Case Study.  The client would obtain numerous benefits from the senior community center. These centers’ benefits include meal and nutrition programs, assistance with information, health, wellness, and fitness programs, available counseling, and social and recreational activities.

The second referral that would significantly benefit this client is nutritional counseling. Nutritional counseling is a form of assessment that analyzes various health needs relating to exercise and diet. A nutritional counselor would help the client achieve her health goals by providing education and teaching her to sustain these goals over time. Nutrition is a vital aspect of a healthy lifestyle. Without proper nutrition, the health status of individuals declines, and their functioning is negatively impacted. During nutritional counseling, the therapist offers information based on the client’s current weight and guides them in achieving optimal weight (Coppoolse et al., 2020). Most nutritional counselors recommend the consumption of healthy diets and engaging in physical activities as primary approaches to weight loss. The client’s basic health needs will be met through nutritional counseling, and specialized information that aligns with her lifestyle and preferences will be provided. Nutritional counseling will be beneficial for this client as she will receive personalized meal and exercise plans to assist her in nutrition and maintain a healthy weight.

Conclusion

In summary, the information provided in the case study shows that the client has class I obesity mainly contributed to the consumption of unhealthy diets and lack of physical activity. With a BMI above 30, the client is at a high risk of chronic health conditions related to overweight and obesity, such as hypertension, diabetes, and cardiovascular illnesses. Two primary outcomes for this patient are maintaining a healthy weight and incorporating physical exercises into her lifestyle. Interventions such as patient education, developing a dietary plan that incorporates healthy foods, creating individualized exercise plans, and encouraging the client to tap into community resources to improve health and wellness are applicable for this client. The client should also be aware of notable weaknesses in her current lifestyle and how they impact health behavior, including diet and exercise. She should not let her independence and self-reliance come in the way of seeking help related to her health and wellness. Overall, crucial referrals for this client are senior community centers and nutrition counseling. These two would be useful in assisting the client to improve her health and wellness as they provide information on nutrition, fitness, and wellness programs. Aging Adult Case Study.

References

Bickley, L. (2017). Bates’ guide to physical examination and history-taking (12th ed.) Philadelphia, PA: Lippincott Williams & Wilkins. ISBN: 978-1469893419

Chase, J. D. (2015). Interventions to increase physical activity among older adults: A meta-analysis. The Gerontologist, 55(4), 706-718. https://doi.org/10.1093/geront/gnu090

Coppoolse, H. L., Seidell, J. C., & Dijkstra, S. C. (2020). Impact of nutrition education on nutritional knowledge and intentions towards nutritional counselling in Dutch medical students: An intervention study. BMJ Open, 10(4), e034377. https://doi.org/10.1136/bmjopen-2019-034377

Kinlen, D., Cody, D., & O’Shea, D. (2017). Complications of obesity. QJM: An International Journal of Medicine, 111(7), 437-443. https://doi.org/10.1093/qjmed/hcx152

Johnston, C. S., Bliss, C., Knurick, J. R., & Scholtz, C. (2018). Rapid eating assessment for participants [shortened version] scores are associated with healthy eating index-2010 scores and other indices of diet quality in healthy adult omnivores and vegetarians. Nutrition Journal, 17(1). https://doi.org/10.1186/s12937-018-0399-x

Siegler, E. L., Lama, S. D., Knight, M. G., Laureano, E., & Reid, M. C. (2015). Community-based supports and services for older adults: A primer for clinicians. Journal of Geriatrics, 2015, 1-6. https://doi.org/10.1155/2015/678625

Walsh, K., Grech, C., & Hill, K. (2019). Health advice and education given to overweight patients by primary care doctors and nurses: A scoping literature review. Preventive Medicine Reports, 14, 100812. https://doi.org/10.1016/j.pmedr.2019.01.016

M1 – 495

N495: Health Assessment

N495 Health Assessment focuses on the complete health assessment, the nursing process, and its relationship to the prevention and early detection of disease in diverse patients across the life span. The process of health assessment is introduced, including: interviewing, history-taking, and physical assessment. Health assessment occurs within the context of the family and community and incorporates cultural and developmental variations and needs of the patient. Normal findings and cultural and age variations are emphasized. Incorporated throughout the course is the importance of communication and collaboration with patients American Psychological Association. (2019). Publication manual of the American Psychological Association (7th ed.). Washington, D.C.: Author. ISBN: 9781433832185. Aging Adult Case Study.

Additional Materials (optional): 

 Module 1: Normative Aging Changes

Every course you take should provide the knowledge and skills useful in the real world. Not every course will directly link to every task that you perform in your life or current employment, but learning how to review data, develop data analysis, critical thinking, and writing skills are all needed to convince someone that you can think critically and solve problems. Your ability to pull together and leverage information, insights, and lessons from a number of disparate disciplines in novel ways could be precisely what is needed to stay ahead of your competition and give you a competitive edge.

Your first task is to learn about the course and discover how the skills provided in this course are relevant to you. You will prepare for, post, and engage in a discussion with your classmates and your professor.

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Module Course Learning Objectives (CLO)

After completing this module, students will be able to:

• CLO 2: Apply anatomical, physiological, psychosocial, nutritional, developmental norms and theories, cultural and environmental factors to interpret health assessment data (PLG 3, UMBO 3, 4, 5)
• CLO 3: Differentiate normal findings for the client’s age, developmental stage, and cultural background and those unusual or abnormal findings, which need further evaluation (PLG 3; UMBO 3, 4, 5) Aging Adult Case Study.

Overview

It is not new to the healthcare field that over the past several decades the prevalence of obesity has hit an all-time high. Both obesity and being inactive increases the risk of heart disease, diabetes, and cancers and as we age, this increases even more. Due to the abundance of education now on this topic, healthy eating and getting enough physical activity as we age has become more apparent. As we get older, diet can play a major impact on our physical and cognitive condition, bone and eye health, vascular function, and the immune system. This module will discuss the importance of setting goals with diet and exercise as we age and how this can impact our lives.

Read:

• Bickley, L. (2017). Bates’ guide to physical examination and history-taking (12th ed.) Philadelphia, PA: Lippincott Williams & Wilkins. ISBN: 978-1469893419 – CHAPTER 20

Additional Resources:

• Eat Better Move Better Guide
• Eat Better Move Better Part 2

• N495 Module 1
3:18 min




Module 1: Assignment

Assignment Description

Aging Adult Case Study

A 68-year-old client lives alone and is independent with all ADLs, has no restrictions for mobility, and is competent, and oriented x4. The client is on a fixed income, but has enough to manage a modest lifestyle. The client has family and social supports but is very independent and is proud of her self-reliance. The client’s height is 5’ 6”, weight is 210 lb. / 95.25 kg.

Please answer the following:

• What is the client’s BMI?
• Identify what screening tools you would use to assess nutritional and exercise knowledge, and why?
• Identify two client outcomes that are reasonable, measurable and realistic
• Identify 3 nursing interventions for each client outcome and give rationales
• Identify what weakness in the client’s life and supports may be impacting the client’s activity and diet?
• What referrals would you make and why?
• Identify your references in APA format. Use references not just opinion. Aging Adult Case Study.

Assignment Expectations:

Length: 1500 to 1750 words in length

Structure: Include a title page and reference page in APA format.  These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.

References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (2) scholarly sources are required for this assignment.

Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document (.pdf) Aging Adult Case Study.