Hi, as we work before I need to have 6 responses to my peers (120-170 words) and include one or more references and citations.
PEER 1: (THIS IS THE RESPONSE OF ONE OF MY PEERS:)
In this case of Mr. Juarez recovering from a broken right tibia, it is imperative to implement stringent infection control measures. Given his recent history of a catheter-associated urinary tract infection (CAUTI) during his rehabilitation, preventing further infections becomes a priority. During visits, standard precautions should be rigorously adhered to, including proper hand hygiene before and after patient contact, wearing gloves when in contact with body fluids, and using appropriate personal protective equipment (PPE) such as gowns and masks when necessary (Werneburg, 2022).
Specifically, due to the indwelling urinary catheter, extra care is needed to maintain aseptic technique during catheter care and ensure proper hygiene to minimize the risk of recurrent infections. Regular assessment of the catheter site for signs of infection and addressing any concerns promptly is crucial. Proper disposal of medical waste, such as catheter bags, should also be emphasized to minimize the risk of contamination within the home environment (Mancuso et al., 2023).
In addition to infection control measures, understanding the characteristics of the aging process is essential to address vulnerabilities related to independent living for elderly individuals like Mr. Juarez. Aging often brings physical limitations and challenges, making routine activities of daily living (ADLs) difficult. As an RN, assessing Mr. Juarez’s mobility, strength, and overall physical health is crucial to identify areas where support or adaptive measures may be required to facilitate independent living (Gao et al., 2022). Moreover, the aging process may render elderly individuals more susceptible to social isolation, elder abuse, and the deterioration of social connections (Abdi et al., 2019). Mr. Juarez’s limited mobility and dependence on others for certain ADLs may place him at risk for social isolation. Regular assessments of his mental well-being, engagement with community resources, and encouragement of social interactions can help mitigate this risk.
Responses to peers or faculty should be 120-170 words and include one or more references and citations.
PEER 2: (THIS IS THE RESPONSE OF ONE OF MY PEERS:)
As a nurse, avoiding exposing patients to infection by using the correct personal protective equipment is extremely important and part of every day. In this scenario, the pt is an older man who has an indwelling urinary catheter in place. As people age they get weaker and are not able to perform activities of daily living as they once did. the weakness is most likely the reason that this patient fell and broke his tibia and needed and indwelling catheter inserted in the first place. Knowing things like this when taking care of and older person can help a nurse understand and be prepared that an older person may need more assistance than a younger patient would especially with things like an indwelling urinary catheter. A urinary catheter can be used as a short term or long term intervention. However, the longer the catheter is in place, the higher the risk of getting an infection (Management of patients with long-term indwelling urinary catheters: A … (n.d.). As a home health nurse taking care of this patient I would make sure he is properly taking care of the indwelling catheter as well as assist him in doing so. when caring for an indwelling catheter some of the most important things to remember is hand hygiene, gloves and making sure to clean it properly so that no new bacteria can be introduced (U.S. National Library of Medicine. (n.d.).
Responses to peers or faculty should be 120-170 words and include one or more references and citations
PEER 3: (THIS IS THE RESPONSE OF ONE OF MY PEERS:)
The proper PPE needed to protect the patient would be a simple set of gloves and a mask (Personal Protective Equipment (PPE): Coaching and Training Frontline Health Care Professionals, n.d.). The gloves would be necessary for catheter care and the mask to prevent the spread of any droplet spread disease. Elderly patients tend to be immunocompromised and become easily sick. A simple illness that a younger person may find to be an inconvenience for a couple days can be fatal with the elderly. Becoming older can also lead to the loss of function or performance. For the described patient, they have a high risk of falling and limited performance of ADLs. A comprehensive geriatric assessment should be performed to assess the level of care needed in all facets of life as well as preventative measures (Spirgiene & Brent, 2018). In this situation I would question the need for the foley. Is the patient able to use a urinal easily, are they able to urinate with ease, is the patient capable of emptying the foley bag safely? Foleys increase the chances of getting an infection and could lead to urethral erosion as well. Assess their home. Is there anything that can cause them to trip like rugs, are frequently used items accessible to them, do they have stairs, etc. It mentions that they have a spouse but is there spouse fully abled or do they also suffer from limited mobility and poor ADL performance. For this specific patient, the greatest vulnerabilities to focus on would be risk of infection and fall.
Responses to peers or faculty should be 120-170 words and include one or more references and citations
PEER 4: (THIS IS THE RESPONSE OF ONE OF MY PEERS:)
Palliative care vs. hospice care can be very confusing to many. They are very similar in the way that they are both considered a form of end of life care. End of life care is defined as care that is meant to help a person live as well as possible until they pass. All wishes should be honored and dignity should be kept (NHS. (n.d.-a). Palliative care focuses on relief of pain and suffering and can be available to both terminally ill patients as well as the non-terminally ill. Palliative care also uses life prolonging medications (Medicaid Integrity Program. CMS.gov. (n.d.). Hospice care is different from that in the way that the focus is to make the patient as comfortable as possible until they pass. Hospice is used for terminally ill patients and they do not use life prolonging medications (Medicaid Integrity Program. CMS.gov. (n.d.).
As a nurse caring for someone during their end of life can be difficult. Sometimes, family members can get in the way of performing end of life care. denial can often be an issue when it comes to end of life care and loved ones. As the patients nurse i would make sure that all of their wants and needs are taken care of and that they are as comfortable as they could possibly be.
Advance directives and Physician orders for life sustaining treatment or POLST can often be confused as well. Advance directives are somthing that all healthy capable adults should have that states general wishes for healthcare decisions and treatment. this document can be modified at any time by the patient themselves (Cunningham, J. L. (2023, November 13). A POLST form is somthing that one who is unhealthy or has a serious medical condition should have. First responders and professionals can base action off of this form. This form is more specific than an advanced directive (Cunningham, J. L. (2023, November 13). Both of these forms are legal forms. If healthcare providers do not follow the forms they can be taken to court if the family or patient decided to do so.
Responses to peers or faculty should be 120-170 words and include one or more references and citations
PEER 5: (THIS IS THE RESPONSE OF ONE OF MY PEERS:)
Palliative care and hospice care are two programs that focus on providing comfort and quality of life to patients facing serious illnesses. Palliative care focuses on maintaining the highest quality of life while managing treatment and other needs. Hospice care focuses on the period closest to death. Palliative care focuses on easing pain and discomfort, reducing stress, and helping people have the highest quality of life possible. Hospice care focuses on quality of life when a cure is no longer possible or the burdens of treatment outweigh the benefits. Palliative care is a resource for anyone living with a serious illness. People can be enrolled in the hospice medicare benefit if their doctor thinks they have fewer than six months to live (Caring Info, 2024).
The primary responsibility of the nurse is to make sure the patient’s wishes are honored. These wishes are not always the family’s wishes. The role of the nurse during the active dying phase is to support the patient and family by educating them on what they might expect to happen during this time, addressing their questions and concerns honestly, being an active listener, and providing emotional support and guidance (Lowey, 2015). Nurses are responsible for recognizing patients’ symptoms, taking measures within their scope of practice to administer medications, providing other measures for symptom alleviation, and collaborating with other professionals to optimize patients’ comfort and families’ understanding and adaptation.
An advanced directive Is a legal document used to guide what types of treatments a patient may receive. and identifies surrogates who can help make treatment decisions for the patient. An advance directive is not a medical order. The advance directives are recommended for all adults irrespective of their health status.
A POLST (Physician Order for life-sustaining treatment) is a medical order for a specific medical treatment the patient would want based on his/her diagnosis, prognosis, and goals of care. The POLST form is being signed by both the doctor and the patient. It includes directions regarding resuscitation, hospitalization, use of antibiotics, and intubation. (National POLST, 2022)
Responses to peers or faculty should be 120-170 words and include one or more references and citations
PEER 6: (THIS IS THE RESPONSE OF ONE OF MY PEERS:)
End-of-Life Care
All humans require extensive medical care and support during the time surrounding death. End-of-life care describes medical care and support during the time nearing death (Koekkoek et al., 2022). Hospice and palliative care focus on patients needs and quality of life (Moseley & Hammond, 2024). Palliative care is concerned with sustaining the highest quality of life while managing treatment and other patient needs, while hospice care focuses on the period closest to death. Nurses do not act with the singular intention to end a patients life but are expected to provide interventions to relieve symptoms and pain in the dying process consistent with care standards. End-of-life care is a critical aspect of patient care at some point in the lives of elderly patients and must be undertaken within the confines of care guidelines by nursing professionals.
End-of-life care becomes a critical issue for consideration at some point for elderly patients in diverse health contexts. Palliative care focuses on easing discomfort and pain, helping people attain the highest quality of life, and reducing stress (Siddiqui et al., 2023). Hospice care focuses on optimizing the quality of life when the treatment burden outweighs the benefits or a cure is no longer possible (Moseley & Hammond, 2024). Palliative care involves spiritual care, help with advanced directives, help with insurance, assistance in developing a plan of care, care coordination with the healthcare team, and symptom and pain management. Hospice care involves special services like physical and speech therapy, grief support, medical supplies and medications, emotional support, and symptom and pain management. Understanding the significance of hospice and palliative care is essential to supporting patients accordingly.
A Physician Order for Life-Sustaining Treatment (POLST) is a medical order that addresses a limited number of critical medical decisions and applies to a limited population of patients. A POLST mainly benefits patients who desire less than entirely aggressive medical treatment, given their healthcare status (Bigelow et al., 2023). An advance directive is not a medical order but a direction from the patient. An advanced directive usually appoints an individual to make decisions, while a POLST does not designate an individual. Understanding the difference between POLSTs and advanced directives is necessary for providing appropriate end-of-life care for elderly patients.
