Systematic Review of Quantitative Studies †MyAssignmenthelp.com

Question: Discuss about the Systematic Review of Quantitative Studies. Answer: Introduction The current assignment focuses upon the aspect of designing effective nursing care priorities. For the purpose of which some of the evidence based approaches had been used by the nursing professional such as the clinical reasoning cycle as well as Millers functional consequences theory. The clinical reasoning cycle is used to identify some of the top nursing priorities based upon the condition assessment of the patient. The priority designing helps in the development of a sharp focus of care. It helps in improving the quality of care delivered to the patient. Additionally, adopting the millers functional consequences theory helps in understanding the effect of important factors such as age upon the health and lifestyle processes of a person. In the current assignment, the case study of Mrs. Amalie Jones had been taken intro consideration. She is an 89 year old woman living alone after the death of her husband and suffers from a number of co-morbid health conditions such as arthritis, hypothyroidism and macular degeneration. Thus, Amalie feels very connected with her community and wants to stay with them. However, in order to do that she may have to depend on health care professionals for help and support. Considering the condition of the patient The nurse deployed in the care concern of Amalie had to make an effective note of the number of co-morbid health conditions of the patient. The nursing professional in charge of Amalie noticed that she has difficulty with her vision owing to macular degeneration. The particular condition also restricted some of daily activities such as the driving to her German association. She had also recently felt the need to depend on someone for conducting her daily care activities owing to her restricted mobility patterns, as she had lately developed rheumatoid arthritis. Amalie had also recently lost a lot of weight which could be attributed to her condition of developing hypothyroidism. The macular degeneration may result in blurred vision at the centre of the visual field and has been related with age (Antoun, Titah Cochereau, 2016). On top of that the condition of rheumatoid arthritis had limited the daily level activities of the patient. As mentioned by Bliddal, Nielsen Feldt-Rasmussen ( 2017), a direct link has been found between the conditions of hypothyroidism and rheumatoid arthritis. The nurse had taken some important cues based upon the clinical condition of the patient. Amalie had stiff and painful joints which restricted her movements or perform some of the daily care tasks. Additionally, the patient suffered from occasional dizziness and vision deficit. The dizziness could be attributed to the condition of hypothyroidism, which resulted in low thyroxin levels, whereas the low vision restricted her from performing some of the active social activities. This had further resulted in the patient suffering from social isolation as she could no longer go and meet her German community. The patient was put on a number of effective medication strategies. The paracetamol was administered in order to provide effective pain management to the patient. This was further support with 400 mg ibuprofen doses three times daily. The patient was also provided hydrocholoroquine in a dose of 200 mg three times daily to manage her conditions of rheumatoid arthritis. The arthritis and vision impairment had limited some of her daily living activities; that is she could no longer get up and cook food for herself. Additionally, she suffered from social isolation owing to her physical disabilities which could further develop depression within the patient. As commented by Malaviya (2016), the lower levels of thyroxin could further worsen her condition of rheumatoid arthritis by triggering the autoimmune form of the disease. Processing of information The patient had lately developed hypothyroidism resulting in loss of weight. The hypothyroidism could have developed as an autoimmune disorder and could be related significantly to the development of the Rheumatoid arthritis. As mentioned by Bliddal, Nielsen Feldt-Rasmussen (2017), the rheumatoid arthritis have been seen to affect the immune cells of the body considerably. Under these conditions, the body treats the thyroid glands and its products as threats. Therefore, producing anrtibodies against the own bodys cells and tissues. As reported by Malaviya (2016), rheumatoid arthritis has been linked with menopause and hormonal changes in women. Hence, there is greater propensity for the development of rheumatoid arthritis after menopause. Therefore, based upon the issue identification a number of effective nursing interventions could be designed over here which are-pain management, medication management and support through counselling activities. Amalie had been complaining of stiffness and pain around the joints. Therefore, implementing light exercises for the patient would have helped in the revival of free muscle movement in the patient. As reported by Jones, Hamilton Murry (2015), it is important to move in rheumatoid arthritis, as exercises have been seen to reduce the amount of pain experienced by the patient. As commented by Papastavrou, Andreou Efstathiou (2014), light to moderate exercises have been seen to prevent muscle wasting. Amalie should be helped by the nursing professional in managing her movements. The agility in the patient could be restored with the help of stretching and weight training exercises (Liou et al., 2016). Impaired mobility in the patient In this case, the patient had movement restrictions owing to stiff and swollen joints, which further affected the activities for daily living (ADL) of the patient. Amalie was suffering from acute pain owing to rheumatoid arthritis, which further made moving around difficult for her, as the moment she would try to make movements her joints would wretch. However, in order to help the patient with the mobility patterns they could be provided with an aid such as walking sticks. Additionally, inculcation of light exercises in the daily routine of the patient can also help in easing the movement discomforts and revive mobility in the patient (Fletcher Meyer, 2016). Due to the movement disabilities of the patient medication management also becomes an issue where the medicines will be placed at a lower level close to the bed so that the patient can easily take them. The patient had also been living alone and due to her poor vision has lost connection with outside world as she could not drive to the German centre. Additionally, she considered herself a burden on her family secluding herself. Hence, it was required that she be provided with effective counselling and daily support care, which could reduce the feelings of depression and helplessness in the patient (Yardley, Morrison, Bradbury Muller, 2015). The nursing professional cam use millers functional consequences theory for wellness promotion in the patient by fostering a sense of value and dignity within the patient (Kaylor Strickland, 2015). The age related changes are taken into consideration while designing of the care plans (Lamothe, Rondeau, Malboeuf-Hurtubise, Duval Sultan, 2016). The millers pyramid helps in the development of attitudes, skills and knowledge in the nurse which can help them in growing from a novice to an expert (Dalton, Gee Levett-Jones, 2015). It covers a number of functional areas from knows to does. Therefore, based upon the identified nursing care priorities, the top nursing priority which had been identified over here is management of mobility in the patient. This is because rheumatoid arthritis is a progressive degenerative condition and is not curable (Bliddal, Nielsen Feldt-Rasmussen, 2017). Hence, it could lead to gradual degeneration of the free movements in the patient. Some of the nursing interventions which could be implemented for the condition management of the patient have been further discussed. The patient could be helped to resolve the issues of restricted movements by providing her with a walking aid. The pain the patient could be measured with the help of a Braden scale. The patient to be further referred the patient to an orthopaedic in case of aggravated symptoms, where the patient could be referred to a physiotherapist for regulation of joint stiffness and pain management. The assessment for activities of daily living (ADL) should be conducted of the patient and in turn carer could be deployed to help the patient with her ADL (LoBiondo-Wood Haber, 2017). A fall risk assessment could be conducted for Amalie as she lives alone and had recently developed macular degeneration. Hence, she was at a higher risk of fall. Evaluation of outcomes The evaluation of the outcomes can further help in understanding the success of the applied nursing interventions. Some of these have been noted in order to analyse the recovery rate of the patient. On successful dissemination of the nursing intervention it was seen that Amalie was able to move more easily and expressed less pain while moving .She depicted more confidence in managing her daily activities by self. She also depicted more autonomy in managing her daily care activities and was hopeful regarding getting well and looked forward to meeting her family. From my nursing care experiences of Amalie, I have realized that application of a person centred approach would have helped me in understanding the care concerns of the patient better. The patient here suffered from a number of co-morbid conditions such as hypothyroidism, rheumatoid arthritis and macular degeneration. Therefore, the patient had lost her control over her ADLs. This made the patient morose; hence, I felt the need to connect with the patient on a personal level. Therefore, using therapeutic communication approaches would have helped me in understanding the grievances of the patient. Additionally, the nursing exposure with Amalie also helped me to excel at making effective clinical related decisions using evidence based methods. Conclusion The current assignment discusses the nursing car priorities for a patient with a number of co-morbid health conditions. Therefore, it was necessary to develop an effective and nursing care plan for the patient. A number of nursing care priorities had been designed for the patient. In this respect, Amalie had to suffer from acute pain owing to rheumatoid arthritis. The joint stiffness allowed her with little freedom for physical movement. Additionally, the macular degeneration also resulted in the patient restraining from her daily activities which further led to isolation in the patient. Therefore, implementation of effective nursing care practices could have helped in restoring the autonomy of the patient over here daily care activities. However, at any stage of the nursing care and interventions the desires and concerns of the patient should also have been taken into consideration. Additionally, implement of the family members of the patients could help in improving the quality of the support and care services. Additionally, implementation of evidence based approaches could have further helped in measuring the effectiveness of the care and intervention approaches applied to the patient. 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