Mrs Walker is a 72-year-old lady who

Mrs Walker is a 72-year-old lady who lives alone and until recently was in her own home with a care package. Mrs Walker has a diagnosis of Alzheimer’s dementia (4 months) and has deteriorated both physically and mentally over the last 8 weeks, she habitually paces up and down even though she has very poor balance and appears very pale and tired. Mrs Walker has been deemed to have ‘lost capacity’ by her Psychogeriatrician and the Enduring Power of Attorney has been enacted. Mrs Walker’s family and the health team caring for her have all agreed that she is a danger to herself and others, a decision has been made to place her in a residential facility within a secure environment. Mrs Walker has had to be physically escorted into the residential facility and is very distressed. Mrs Walker has a severe contracture of her right hand caused by burns received in her kitchen 11 months ago, and her noncompliance with physiotherapy has rendered that hand unusable. Mrs Walker weighed 62kgs a year ago, today she weighs 34.5kgs. Her family advise you that she is refusing to eat and that they often find Mrs Walker’s ill-fitting dentures in bizarre places around the house, they tell you that Mrs Walker is still drinking plenty. You are unable to weigh Mrs Walker as she is not compliant. Discuss in detail at least four (4) reasons relating to dementia, for Mrs Walkers weight loss. Discuss how Mrs Walker’s physical disability may be a contributing factor to her weight lose. Mrs Walker is unsteady on her feet. Discuss what type of relevant assessment you might refer Mrs Walker for and who might undertake this. Given one example of this type of assessment. Discuss the need for the Mrs Walker to feel as though her environment is both physically and emotionally safe Provide two (2) nursing interventions that can be undertaken to identify probable causes and ways to improve Mrs Walker’s urinary incontinence. Mrs Walker requires a wash. Explain the benefit of showering/bathing and what aspects the nurse can directly observe while assisting Mrs Walker in this Whilst you are showering Mrs Walker you notice a reddened area on her toes and a skin tear on her left arm. a) Describe one (1) assessment tool you would use to assess Mrs Walker’s pressure injury risk including how often it should be used. b) Your physical assessment of Mrs Walker should include a review of her skin. Describe four (4) aspects that you would note and why. Mrs Walker has been found wondering the halls of the facility at 2am. She has been incontinent and removed her pad and her clothes are wet. She is confused and has a large laceration on her right arm. Within your scope as a student, what are your actions and priorities of care, keeping in mind her safety is important.

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