Table of Contents
NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Example
NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Assignment
NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Assignment Brief
Course: NRNP 6540 – Advanced Practice Care of Older Adults
Assignment Title: NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Assignment
Assignment Instructions Overview
This assignment involves creating an evaluation plan for an elderly patient based on a case study provided by the instructor. The focus is on assessing the patient’s health and functional ability to determine if their needs are being met. Students are required to use comprehensive geriatric assessments to identify age-related changes that may interfere with the patient’s functional status.
Understanding Assignment Objectives
The primary objective of this assignment is to develop a detailed evaluation plan for an elderly patient. Students must:
- Assess the patient’s health and functional stability.
- Identify appropriate assessment tools to evaluate wellness and functional ability.
- Consider factors such as the setting of the evaluation, involvement of other professionals or family members, and potential challenges like language barriers or cognitive impairment.
- Determine immunization requirements relevant to the patient’s health promotion and disease prevention.
The Student’s Role
Students will assume the role of a nurse practitioner responsible for evaluating the health and functional status of an elderly patient. This involves:
- Reviewing the provided case study thoroughly.
- Developing an evaluation plan that includes specific assessment tools.
- Justifying the choice of assessment tools and considering their validation for the patient population.
- Addressing potential issues during the assessment, such as cognitive impairment or sensory deprivation.
- Recommending necessary immunizations for health promotion and disease prevention.
Competencies Measured
This assignment measures several key competencies essential for advanced practice nurse practitioners, including:
- Clinical reasoning and decision-making skills.
- Ability to conduct comprehensive geriatric assessments.
- Proficiency in using validated assessment tools for elderly patients.
- Understanding of immunization requirements for older adults.
- Communication skills, particularly in explaining the evaluation plan and addressing potential challenges.
You Can Also Check Other Related Assessments for the NRNP 6540 – Advanced Practice Care of Older Adults Course:
NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Example
As individuals age, they are more likely to develop various chronic health conditions that can significantly impact their quality of life. Advanced practice nurse practitioners (APNPs) frequently interact with elderly patients, and it is crucial to evaluate and address these conditions to maintain the patients’ functional ability. Common age-related health issues include obstructive sleep apnea (OSA), hypertension, chronic anemia, restless leg syndrome, osteoporosis, and cognitive impairment. Comprehensive assessments are essential to identify and manage these conditions effectively.
Case Study Overview
Mr. Raymond Young, a 92-year-old retired college professor, presents a case that exemplifies the complexity of caring for elderly patients. Despite his advanced age and several chronic health issues, Mr. Young is able to perform all basic activities of daily living independently. His medical history includes obstructive sleep apnea, hypertension managed with lifestyle modifications, mild chronic anemia, restless leg syndrome, and osteoporosis. He has also experienced falls and has reported instances of getting lost while driving to familiar locations. These issues suggest potential underlying problems related to immobility, sensory deprivation, and cognitive dysfunction that require thorough evaluation.
Evaluation Plan
Developing an evaluation plan for Mr. Young involves several critical steps. First, the assessment should be conducted in a setting that ensures the patient’s comfort and safety, such as his home or a familiar clinical environment. Involving family members, particularly his wife, in the evaluation process can provide additional insights into his daily functioning and any changes observed over time. Collaboration with other healthcare professionals, including a geriatrician, neurologist, and physical therapist, may also be necessary to provide a comprehensive evaluation.
Assessment Tools
Several assessment tools are appropriate for evaluating Mr. Young’s cognitive function, mobility, and overall health status. The Mini-Mental State Examination (MMSE) is a widely used tool for assessing cognitive function in older adults. It evaluates attention, orientation, memory, registration, recall, calculation, language, and visuospatial skills through a series of 30 questions (Arevalo-Rodriguez et al., 2021). Given Mr. Young’s history of cognitive impairment, the MMSE is suitable for monitoring any progression of cognitive decline. However, it is important to note that while the MMSE is validated for use in older adults, it may have limitations in patients with varying educational backgrounds or language barriers (Arevalo-Rodriguez et al., 2021).
The Comprehensive Geriatric Assessment (CGA) is another essential tool, incorporating multiple scales to evaluate various aspects of an elderly patient’s health. This multidisciplinary instrument includes the Berg Balance Scale to assess balance, the Falls Efficacy Scale to evaluate the fear of falling, and the Timed Up and Go Test to measure mobility (Appeadu & Bordoni, 2023). Given Mr. Young’s history of falls, these assessments can help identify specific risk factors and guide interventions to prevent future incidents.
For evaluating Mr. Young’s driving competency, performance-based road tests and driving simulation studies can be utilized. These tests assess the coordination of cognitive and physical tasks required for safe driving. Additionally, psychometric evaluations, such as the MMSE, can provide insights into cognitive functions relevant to driving (Toups et al., 2022).
Addressing Potential Issues
Several factors might present challenges during Mr. Young’s assessment. Cognitive impairment could affect his ability to recall past events accurately, which may hinder the history-taking process. Ensuring that questions are clear and straightforward can help mitigate this issue. Additionally, his educational background and any language barriers should be considered when administering cognitive tests to ensure accurate results. Cultural competency is crucial, as cultural beliefs and practices can influence how symptoms are perceived and reported by the patient (Khanna & Metgud, 2020).
Immunization Requirements
Vaccinations play a vital role in promoting health and preventing disease among older adults. Mr. Young should receive recommended vaccines to protect against common infections that can have severe consequences in the elderly. These include the annual influenza vaccine, pneumococcal vaccine, tetanus, and polio vaccines (Michel & Frangos, 2022). Ensuring that Mr. Young is up-to-date with his immunizations can help prevent infections that may exacerbate his existing health conditions.
Conclusion
A comprehensive and multidisciplinary approach is essential for evaluating and managing the health of elderly patients like Mr. Young. Utilizing appropriate assessment tools and considering potential issues related to cognitive function, educational background, and cultural factors can enhance the accuracy of the evaluation. Additionally, maintaining up-to-date immunizations is crucial for promoting overall health and preventing disease in older adults.
References
Appeadu, M., & Bordoni, B. (2023, June 4). Falls and Fall Prevention in the Elderly. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560761/
Arevalo-Rodriguez, I., Smailagic, N., Roqué-Figuls, M., Ciapponi, A., Sanchez-Perez, E., Giannakou, A., Pedraza, O. L., Bonfill Cosp, X., & Cullum, S. (2021). Mini-Mental State Examination (MMSE) for the Early Detection of Dementia in People with Mild Cognitive Impairment (MCI). Cochrane Database of Systematic Reviews, 2021(7). https://doi.org/10.1002/14651858.cd010783.pub3
Khanna, A., & Metgud, C. (2020). Prevalence of cognitive impairment in elderly population residing in an urban area of Belagavi. Journal of Family Medicine and Primary Care, 9(6), 2699. https://doi.org/10.4103/jfmpc.jfmpc_240_20
Michel, J.-P., & Frangos, E. (2022). The Implications of Vaccines in Older Populations. Vaccines, 10(3), 431. https://doi.org/10.3390/vaccines10030431
Toups, R., Chirles, T. J., Ehsani, J. P., Michael, J. P., Bernstein, J. P. K., Calamia, M., Parsons, T. D., Carr, D. B., & Keller, J. N. (2022). Driving Performance in Older Adults: Current Measures, Findings, and Implications for Roadway Safety. Innovation in Aging, 6(1), igab051. https://doi.org/10.1093/geroni/igab051
Detailed Assessment Instructions for the NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Assignment
NRNP 6540 Raymond Young Week 1 Assessment of Older Adults Instructions
As patients age, they are more likely to develop health issues. While some of these health issues are normal changes due to aging, some of them are abnormal and require further evaluation. Consider a 92-year-old patient who has been diagnosed with several disorders, including obstructive sleep apnea, hypertension, mild chronic anemia, restless leg syndrome, and osteoporosis. Despite these disorders, he can independently perform all basic activities of daily living, walk a quarter mile without difficulty, and pass functional and cognitive assessments. However, he did report that he fell a few times and had lost his way while driving to a familiar location (Carr & Ott, 2010).
As an advanced practice nurse caring for geriatric patients, you will likely encounter patients like this. While he can pass the basic assessments, the report of falls and confusion might indicate underlying issues of immobility, sensory deprivation, and/or cognitive dysfunction that require further attention. To identify these potential underlying issues and distinguish between normal and abnormal changes due to aging, healthcare providers use a variety of assessments. These assessments are a key tool in the care of geriatric patients.
This week, you examine assessment tools and evaluation plans used to assess geriatric patients presenting with potential issues of immobility, sensory deprivation, and cognitive dysfunction.
Reference:
Carr, D. B., & Ott, B. R. (2010). The older adult driver with cognitive impairment: “It’s a very frustrating life.” Journal of the American Medical Association, 303(16), 1632–1641. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915446/
NRNP 6540 Raymond Young Week 1 Assessment of Older Adults Learning Objectives
Students will:
- Analyze assessment tools used to assess older adults
- Design evaluation plans for patients with immobility, sensory deprivation, and/or cognitive dysfunction
- Identify immunization requirements related to health promotion and disease prevention for older adults
Learning Resources
Required Readings (click to expand/reduce)
Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Changes with aging. In Advanced practice nursing in the care of older adults (2nd ed., pp. 2–5). F. A. Davis.
Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Health promotion. In Advanced practice nursing in the care of older adults (2nd ed., pp. 6–18). F. A. Davis.
Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Exercise in older adults. In Advanced practice nursing in the care of older adults (2nd ed., pp. 19–24). F. A. Davis.
Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Comprehensive geriatric assessment. In Advanced practice nursing in the care of older adults (2nd ed., pp. 26–33). F. A. Davis.
Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Symptoms and syndromes. In Advanced practice nursing in the care of older adults (2nd ed., pp. 34–94). F. A. Davis.
Recommended Reading (click to expand/reduce)
Recommended Media (click to expand/reduce)
Note: View the Process of Aging video module available in this free course.
Discussion: Evaluation Plan
As geriatric patients age, their health and functional stability may decline resulting in the inability to perform basic activities of daily living. In your role as a nurse practitioner, you must assess whether the needs of these aging patients are being met. Comprehensive geriatric assessments are used to determine whether these patients have developed or are at risk of developing age-related changes that interfere with their functional status. Since the health status and living situation of older adult patients often differ, there are a variety of assessment tools that can be used to evaluate wellness and functional ability. For this Discussion, you will consider which assessment tools would be appropriate for a patient in a case scenario.
Photo Credit: LIGHTFIELD STUDIOS / Adobe Stock
To prepare:
- Review this week’s Learning Resources, considering how assessment tools are used to evaluate patients.
- Your Instructor will assign a case study to use for this Discussion. Review the case study and, based on the provided information, think about a possible patient evaluation plan. As part of your evaluation planning, consider where the evaluation would take place, whether any other professionals or family members should be present, appropriate assessment tools and guidelines, and any other relevant information you may wish to address.
- Consider whether the assessment tool you identified was validated for use with this specific patient population and if this poses issues. Think about additional factors that might present issues when performing assessments such as language, education, prosthetics, missing limbs, etc.
- Consider immunization requirements that may be needed for this patient.
By Day 3
Post an explanation of your evaluation plan for the patient in the case study provided, and explain which type of assessment tool you might use for the patient. Explain whether the assessment tool was validated for use with this patient’s specific patient population and whether this poses issues. Include additional factors that might present issues when performing assessments, such as language, education, prosthetics, etc. Also explain the immunization requirements related to health promotion and disease prevention for the patient.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days in one or more of the following ways:
- Suggest alternative assessment tools and explain why these tools might be appropriate for your colleagues’ patients.
- Recommend strategies for mitigating issues related to use of the assessment tools your colleagues discussed.
- Explain other health promotion considerations for patients in this population or with related issues.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Post to Discussion Question link, and then select Create Thread to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
NRNP 6540 Raymond Young Week 1 Assessment of Older Adults Rubric Detail
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Name: NRNP_6540_Week1_Discussion_Rubric
Grid View
List View
Excellent
Point range: 90–100 Good
Point range: 80–89 Fair
Point range: 70–79 Poor
Point range: 0–69
Main Posting:
Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
40 (40%) – 44 (44%)
Thoroughly responds to the discussion question(s).
Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
No less than 75% of post has exceptional depth and breadth.
Supported by at least 3 current credible sources.
35 (35%) – 39 (39%)
Responds to most of the discussion question(s).
Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.
50% of the post has exceptional depth and breadth.
Supported by at least 3 credible references.
31 (31%) – 34 (34%)
Responds to some of the discussion question(s).
One to two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with fewer than 2 credible references.
0 (0%) – 30 (30%)
Does not respond to the discussion question(s).
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only 1 or no credible references.
Main Posting:
Writing
6 (6%) – 6 (6%)
Written clearly and concisely.
Contains no grammatical or spelling errors.
Further adheres to current APA manual writing rules and style.
5 (5%) – 5 (5%)
Written concisely.
May contain one to two grammatical or spelling errors.
Adheres to current APA manual writing rules and style.
4 (4%) – 4 (4%)
Written somewhat concisely.
May contain more than two spelling or grammatical errors.
Contains some APA formatting errors.
0 (0%) – 3 (3%)
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style.
Main Posting:
Timely and full participation
9 (9%) – 10 (10%)
Meets requirements for timely, full, and active participation.
Posts main discussion by due date.
8 (8%) – 8 (8%)
Posts main discussion by due date.
Meets requirements for full participation.
7 (7%) – 7 (7%)
Posts main discussion by due date.
0 (0%) – 6 (6%)
Does not meet requirements for full participation.
Does not post main discussion by due date.
First Response:
Post to colleague’s main post that is reflective and justified with credible sources.
9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings.
Responds to questions posed by faculty.
The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
7 (7%) – 7 (7%)
Response is on topic, may have some depth.
0 (0%) – 6 (6%)
Response may not be on topic, lacks depth.
First Response:
Writing
6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues.
Response to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in Standard, Edited English.
5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues.
Response to faculty questions are mostly answered, if posed.
Provides opinions and ideas that are supported by few credible sources.
Response is written in Standard, Edited English.
4 (4%) – 4 (4%)
Response posed in the discussion may lack effective professional communication.
Response to faculty questions are somewhat answered, if posed.
Few or no credible sources are cited.
0 (0%) – 3 (3%)
Responses posted in the discussion lack effective communication.
Response to faculty questions are missing.
No credible sources are cited.
First Response:
Timely and full participation
5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation.
Posts by due date.
4 (4%) – 4 (4%)
Meets requirements for full participation.
Posts by due date.
3 (3%) – 3 (3%)
Posts by due date.
0 (0%) – 2 (2%)
Does not meet requirements for full participation.
Does not post by due date.
Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.
9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings.
Responds to questions posed by faculty.
The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
7 (7%) – 7 (7%)
Response is on topic, may have some depth.
0 (0%) – 6 (6%)
Response may not be on topic, lacks depth.
Second Response:
Writing
6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues.
Response to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in Standard, Edited English.
5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues.
Response to faculty questions are mostly answered, if posed.
Provides opinions and ideas that are supported by few credible sources.
Response is written in Standard, Edited English.
4 (4%) – 4 (4%)
Response posed in the discussion may lack effective professional communication.
Response to faculty questions are somewhat answered, if posed.
Few or no credible sources are cited.
0 (0%) – 3 (3%)
Responses posted in the discussion lack effective communication.
Response to faculty questions are missing.
No credible sources are cited.
Second Response:
Timely and full participation
5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation.
Posts by due date.
4 (4%) – 4 (4%)
Meets requirements for full participation.
Posts by due date.
3 (3%) – 3 (3%)
Posts by due date.
0 (0%) – 2 (2%)
Does not meet requirements for full participation.
Does not post by due date.
Total Points: 100
Name: NRNP_6540_Week1_Discussion_Rubric
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