safety needs of clients with seizures. ➤ Discuss strategies to enhance communication with clients with sensory deficits, sensory overload, and confusion.
➤ Identify environmental, social, physical, and psychological factors that affect sensory stimulation. ➤ Assess clients for cues of altered sensory perception.
Sensory Deprivation Sensory Overload Sensory Deficits Visual and Hearing Olfactory and Gustatory Tactile and Kinesthetic Seizures
Build a solid foundation with either text
Meet Your Patients Joshua is a 28-year-old patient in the intensive care unit (ICU). He had a car accident 3 weeks ago and has had several surgeries to repair a fractured femur, ruptured spleen, and intracranial bleeding. He was ventilated mechanically for 10 days and has had numerous invasive procedures.The nurses report that he is very confused and has been hallucinating. Richard is a 90-year-old man who has been a resident at a skilled nursing facility for 10 years. He has no visitors, never leaves his room, has no television or radio in the room, and no longer speaks. He does not respond to verbal or tactile stimulation.When staff members try to move
him, he moans and howls. Consider how these patients are similar and how their care might overlap. It seems hard to imagine
Two types of case studies illustrate key points and bring concepts to life, connecting what students read to what they will see and do in practice.
that these patients could have much in common.What similarities can you see? What differences? As you read this chapter, follow these cases and other examples illustrating the effects of altered sensory or perceptual function.
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CHAPTER 23 Nutrition
Caring for the Williams Family Stanley Williams has been diagnosed with hypertension, type 2 diabetes mellitus, obesity, osteoarthritis, and tobacco abuse.Assad Johnson, FNP-BC, has advised an 1,800-kcal consistent carbohydrate (CCHO) diet with no added salt
and a daily brisk 30-minute walk. Mr.Williams discusses these challenges with his daughter Jayden Robinson.
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A. Why might Assad have selected this diet plan? Discuss the rationale for each component (i.e., 1,800-kcal, CCHO diet, no added salt). B. Mr.Williams’s diet is complex. He tells you he is overwhelmed by the many changes asked of him. How might Assad streamline his instructions about Mr. Williams’s diet?
C. Mr.Williams asks what the best way is for him to monitor his weight loss progress and how Assad will monitor his progress. How would you respond? D. Identify teaching tools that might help Mr.Williams understand his diet.
Think Like a Nurse 23-7: Clinical Judgment in Action The Nutrition Screening Initiative (NSI) is completed for a 70-year-old patient. ■ What major indicator on the NSI would indicate impaired nutritional status? ■ What minor indicator would you likely see? ■ What would malnourishment look like in the adult? ■ What type of anthropometric findings would be typical of an older adult with poor nutrition patterns? ■ What type of laboratory values would support impaired nutritional status?
4/18/2025 9:04:12 PM For Underweight/Malnutrition: Same as for obesity/overweight, except for weight loss behavior. You could choose other NOC outcomes based on the patient’s nursing diagnosis. For example: For situational low self-esteem related to obesity, you might use self-esteem.
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For Frailty Syndrome: Behavior: will to live Knowledge: health
Nutritional status: food and fluid intake Self-care status
Think Like a Nurse: Clinical Judgment in Action questions put students in the nurse’s role to begin developing their clinical judgment skills from day one. Applying the Full-Spectrum Nursing Model
Individualized Goals/Outcome Statements Statements you might identify for a patient with nutrition-related prob- lems include the following: Loses 2 lb per week until ideal weight is attained. Follows the prescribed modified diet that, at a minimum, meets the DRIs.
PATIENT SITUATION Mrs. Ong is a 75-year-old retired schoolteacher who suffered a stroke 8 months ago. After leaving the hospital, she has been living in a nursing home. Mrs. Ong has residual weakness on the right side—her dominant side—and has not mastered the use of tableware with her left hand. On admission to the nursing home 7 months ago, she weighed 150 pounds. Today she weighs only 125 pounds. Mrs. Ong refuses to go to the dining room for meals. The UAPs report that she eats a
NURSING DIAGNOSIS/ANALYZING CUES For clients who have no symptoms of or risk factors for nutri- tion problems, use the diagnostic label readiness for enhanced nutrition.
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