Nursing Care Plan: Clinical Scenario in Older Adult

Divina G. Paragas Dean.
Ellen Gabriel
BSN – III Instructor
Nursing Care Plan: Clinical Scenario in Older Adult
Case Scenario 1 - Assessment Data

Joe aged 85, moved to assisted living facility 3 months after his wife died following a
long illness. He has no close relatives and had lost contact with friends during his wife
illness. Joe attends group activities occasionally, but appears sad and withdrawn. When
some neighbors invited him to attend church services with them, he replied that he had
not attended church since his wife died. He expressed feelings of being abandoned by
GOD because of the sufferings being endured by his wife. He said “A loving God would
not allow such a good person to endure such misery. Maybe it was His way of punishing
me for my mistakes in life” He also questions why God would let him continue living
when he is lonely and no longer has a purpose in life.
Questions: Make your nursing care plan.

 What is your nursing diagnosis
 Low self-esteem related to feeling of shame and guilt as evidenced by
withdrawn to deal with group activities.
 What is your goals/Suggested outcomes

 The patient will be able to maintain self-esteem.
 The patient will be able to decrease feelings of shame and guilt.
 The patient will be able to demonstrate ability to join in group activities and
events.
 Nursing interventions
 Assess patient’s level of self-esteem.
 Teach visualization techniques that can help the patient’s replace negative
self-images with more positive images and thought.
 Provide active listening and open-ended questions.
 Support the patient in his attempt to secure autonomy, and positive self-
esteem.
 Educate the patient to engage in activities anticipated to result in healthy
self-esteem.
 Give positive feedback after a task is achieved.
 Evaluation parameters
 Patient maintained self-esteem and express belief in self.
 Patient reports decreased feelings of self-hate.
 Patient demonstrated ability in joining group activities and events.
Case Scenario 2 - Assessment Data

Maria has been in assisted living apartment since recovering from a stroke 2 years ago.
She has some residual paralysis but manages well with a cane. She has been
complaining about her poor memory. This was confirmed by her daughter, who reports
that her mother has missed some appointments and failed to pay her utility bill. Maria
has been charging numerous unnecessary items purchased from television sales
channels and phone solicitations. When assessed by the nurse, Maria expressed
difficulty remembering dates and days of the week. It was noted that Maria was unable
to recall the nurse’s name even though two have had regular contact. A neurological
assessment revealed no changes from previous evaluations.
Questions: Make your nursing care plan

 What is your nursing diagnosis
 Disturbed thought process related to disorientation following stroke as
evidenced by change to orientation to time, place, person, and
circumstances.
 What is your goals/Suggested outcomes

 Patient will be able to maintain thought processing at a baseline level.
 Patient will be able to have appropriate maintenance of mental and
psychological function as long as possible.
 Family members will be able to exhibits understanding of required care
and will demonstrate appropriate coping skills.
 Nursing interventions
 Orient patient to surroundings, staff, and necessary activities as needed.
 Provide patient safety needs.
 Give simple directions and allow patient’s sufficient time to respond, and to
communicate.
 Offer reassurance to the patient and use therapeutic communication.
 Provide continuity of care.
 Instruct family in methods to use with communication with patient.
 Assist the family and significant others in developing coping strategies.
 Educate the family to recognize signs of early confusion and seek medical
help.
 Evaluation parameters
 Patient maintained thought processing at a baseline level.
 Patient achieved functional ability at her optimum level.
 Patient’s family members demonstrated coping skills.

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Divina G. Paragas Dean.

Nursing Care Plan: Clinical Scenario in Older Adult

Case Scenario 1 - Assessment Data

Questions: Make your nursing care plan.

 What is your goals/Suggested outcomes

Case Scenario 2 - Assessment Data

Questions: Make your nursing care plan

 What is your goals/Suggested outcomes

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