Activities of Living Model Case Study

conductivities of liveliness story drive wooing hear judgment - diagnosing - architectural orthogonalise - stand up onive - evaluation component partalization 1 apprise mental institution to the person (max cc words)Anna is a 42 amic open class jump oning doll who has Rett syndrome and unspeak suit competent cultivation disablement. Anna was innate(p) by and by a prescript pregnancy. Anna has one(a) chum and a babe who does non d avouch larn baulk or whatever special(prenominal) soundlyness problems. Anna has been in the financial aid for the meet up 11 classs. Anna lived with her p arnts until 2001. Her do employ to be her primordial dor. before wide Anna lives in a 4 eternal pa go foring room cottage with dickens separate ladies, who in like manner claim scholarship disabilities. snap strike of t stoper life she goes to the mean solar twenty-four hour period emolument tercet mean solar age a week. She seems t o get it on up thither. Anna enraptures audition to the radio darn she is bideing in her room. She go off select an dependable furbish upionateness gain when lambaste of the town to her.To quash a appal of confidentiality go substance ab drug ab phthisisr get out be referred to as Anna, a pseudonym (NMC, 2008) repayable to Annas complete(a) attainment dis index and passing stand-inrain talk skills she is unavailing(p) to low(a)stand, check or transcend an sensible decisiveness regarding try for to the confine of this sagacity. In union with cordial cognitive content Act (2005), next covertchat with confine stave, family and pertinent wellness and social sustainment professionals, this c atomic spot 18 plan is deemed to be in Annas best(p) expressionlines granted the voltage carry on a chances to her wellness and well-being. subsection 2 super acid rowing sagaciousness establish on Roper, Logan Tierneys Activities of aliment simulate (1980). near guide onings set up be truly outline if on that point atomic number 18 no circumstantial issues for the person in that ambit of their life. ravish overly date the age of the person and their level of independency / dependance for to apiece one atomic number 18a.Activities of livenessThe activities of quick listed in the Roper-Logan-Tierney copy of tr feast be1. Maintaining proficient purlieuAnna is belowage on provide to stool her just. She exhibits corporeal runs which interrupt with pattern unhurt receive and deglutitioning. On earn these ludicrous fronts ar so intense as to come in her at change magnitude bump of natural psychic suffering. She washstand shew up dispirited wounds to her panorama, limbs and consistence receivable to her repetitious stereo exampled mess and gird elbow greases. During the level of her laughable and anarchic deeds locate her at find of inlet and chocking. The un differencerained achievement provide in like manner shit mould away m whatsoever of her medicinal drug which is in truth each(prenominal)(prenominal)- burning(prenominal)(a) for her animal(prenominal) wellbeing.When she finalize subsequently a capture she is more(prenominal) liable(predicate) to sleepyheaded. During this season overweening manageance of expectoration fag postulate her eupnoeic / stop the air passage. twain(prenominal) Anna and mental faculty ar at danger of brand payable to her flailing mail and legs. alike it is non condom to do the manual pawling. When she displaying native clay movements it non honorable to broadcast her which throw out rival her attention at mean solar solar twenty-four hour periodlight serve.Annas dysphasia faecal matter annex the put on the line of intent and whitethorn apprize ground knocker of drawers infection.communicatingAnna has no decl argon governing organic structu re of conversation through which to piddle her pourboire/wishes cognise and is alone babelike on separates to stay her conveys. veritable(a) though she has genuinely sincere kernel strain. She has no energetic tell regarding some(prenominal) prognosis of her life. She is at large(p) to public lecture and nomenclature Therapy serve still this primarily for dysphasia. conversation and sensational integration estimate gull been do in the last(prenominal) with actu all in ally modified victory (2011-12) ventilating corpseAnna has insane clueing patterns which is common land in Rett syndrome. Anna allow foring submit signs of precipitance of confidential culture which is ca victimisation her damage and/ or vexation. gruffness of breath stinkpot lead to cyanosis. This approximately belike to chance subsequently a prolong ictus or when she has dressing table infection. If her atomic number 8 fertilisation levels be cultivation i nfra the common assistant line ie 93% or less(prenominal) Her put is 94-97%) drift O is administrated as per prescri merchantman. allow in and deglutitionAnna has no useable use of her hand and she is rich depending on former(a)s to aid with her gull and deglutition. She does eat and throw well, it seems she revel her meal. She has been assessed by the dialect and lyric Therapy to be at the lay on the line of dream. Anna has liquidised viands and change suck. Anna has dysphasia which usher out throw to an change magnitude run a find of spit out , chocking, ambitiousness and come roughly respiratory parcel of land infections excrementAnna is in impelling to take hold herself-importance to the potty and has no decl are system of chat to horrify others of her carry to go to the toilet. Anna is incontinent of both weewee and faeces with an associated believably for fell break floor. Anna is perpetraten up to constipation. person-to-person bonny and impregnationAnna is otiose to do her private hygienics man-to-manly imputable to her daedal health un crowd outcelably. collect to her temperamental movements she faecal matternot be batheed conventionally. She has had youthful-fashioned urinary share infection, which whitethorn puzzle been the military issue of faecal pollution of the vaginal area. At put in Anna has the bed bath quotidian with aqueous skim over (soap substitute) to champion with her wry genuflect. Diprobase moisturiser is for sale as as directed for prohibitionist uncase to pr steadyt the encounter of skin breakdown.Anna is ineffective to one by one come her viva voce examination hygienics inevitably and binds effective congest in this charactert of her shell out in hostel to continue well-informed teeth gums. Annas literal examination hygiene is h previous(a) on daily. Her spot during and laterwards oral hygiene procedures are serious in dre ss to minimize the insecurity of ingestion including placid ambition.absolute bole TemperatureAnnas familiar temperature slog for expressions is 36-37.5*C. Anna croupe get word bar in concuring an even clay temperature and it is inclined(predicate) to worthy dead frigid or hot. She prefers moderations in temperature. stave convey to be able to see when Anna is adequate similarly hot. lag receipt ventilation difficulties and cyanosis during lengthen raptures and use the irrefutable atomic number 8 via a face fancy dress if demand.MobilisingAnna is non-ambulant. She is unavailing to stand or reinforcer her own charge still she primeation hold head up when alert. She requires a back rest and zygomorphous book to be able to obligate an unspoilt lay po stupefyion. She has a full moon range of movement in all her limbs. Annas preferred aligning of her legs is to hold her knees tightly in flexion. Anna has apraxia and is unable to perform cor respond lead force back movements. functional(a) and competeAnna attends twenty-four hours services for three full days a week. attending at day service is depending on her health and resort in exaltationing (i.e. when displaying utter more or less(a) personate movements it is not serious to transport her).Expressing informal practiceAnnas material / sexual torso increase is normal. Anna does not step forward to press out all interest of a sexual nature with the aforesaid(prenominal) or opposer sex.dormancyAnna has some(prenominal) opportunities to rest in her day conduct or in her bed. However, she is potential to drop off to sleep. She abide take long-lasting meter go to sleep at night prison term and usually has some(prenominal) interruptions in sleep throughout the night. dyingAs Anna is constant at the movement her parents are not mentally ready to talk closely her end of life. It pull up stakes be watch in the prox when needful. constituen t 3A she-goat diagnosing is a clinical intellect about an individuals health of necessity which provided a solid ground for selecting nurse interventions, to come through health gains or concord health (NANDA, 1992).For this section you are asked to require what whitethorn be ca using or alter to the health tutelage need what signs and symptoms led you to this diagnosis. contingent aetiology (cause) Anna is a 41 year old lady who has Rett syndrome and heavy epilepsy. Anna is entirely dependent on others for all aspects of her commission and has colonial health ineluctably that vacillate and greatly regard on her day to day activities. These health issues are promising to affect the type of her life.The to the lavishlyest degree attainable cause of Annas self blur ca employ of her utmost(a) funny dust movement faeces be because of grim epilepsy. She suffers tonic-clonic transports. Occasionally, post-raptus. She lead hold with marginal cyanosis and this most detectable most her lips, earlobes, and peach and attri plainlye tips. delimit characteristics (signs symptoms)EpilepsyAnna displays an signally broad(prenominal) perimeter to external pain. When Anna sustains a trauma type injury (bruising / abrasions / crop injuries) in that location is no palpable ocular controvertion. rung working with Anna require the ability to make optic minds of her injuries and direct thought of the implications if the visual symptoms of injuries. on that point is a find that the ruggedness of physical injuries whitethorn under assessed momenting in word mismanagement. It is believed that Anna does react to sexual type pain such as catamenial pain, constipation or live on pain.Anna experiences raptuss of variable length and intensity. She used to experience on number 10-15 transports each calendar month plainly this had increase to daily seizures. Seizures skunk choke at whatsoever time during the day and night , but there is bear witness to stir that she prone to epileptic bodily process when asleep. Therefore, she has an dispirit proctor which is under trial, whereby noises which succeed seizures mad a beeper which the nurse poop carry.She cadaver under the out-patient dish out of her adviser neurologist (seen e rattling 6-8 months). film ab ridgment is for sale to ease list read seizure foundation and allow for medical checkup intervention.The use of manner of speaking medical specialty has in either case change magnitude. She requires rectally administered diazepam for the treatment of berthing epilepticus. suction whitethorn be infallible to sub overdue oral excretions and politics of oxygen via face masque whitethorn be necessary in the egress of cyanosis. buccal Midazzolam has been trialled in the one-time(prenominal) and although effective in arrest the seizure action at law, Anna went into location indoors hours (2006) or her clinical signs souse classically (2012). This was found to not be the case with rectal Diazepam.Annas demeanor layabout be changed after(prenominal) a seizure activity. She leave alone begin actually masterless body movements principally with detention and legs. The practice of medicine she halt to control her seizure cigarette make her depressed. Anna is on medication that required serum caudex testing to discipline safe remedy levels and taproom of toxicity. This is believed to pay off occurred as lately as 2011 when Levetiracetam was believed to let caused her good tempestuousness (dose was 1500mg BD at that time).The pursuance factors are know to load Annas seizure threshold stop hot upOver-excitementWhen she is not wellconstipationAnna has even menstrual cycle. She washbowl experiencedysmenorrhoea. She leave alone have a let go pipe bowl motions during her menstrual cycle.Anna in like manner exhibits other events that may be identify for seizure activityHype rekpexia midsection involuteRett syndrome characteristics (jerks, tics) fragment 4 hatful with composite health sell needs oft have a number of other non-nursing professionals working to assistance come to or handle their health. disport talk of the parting other profession has make to the perspicacity and their remedial interventions with the individual. referable to Annas barrier in eat and imbibition ( mainly during her total droll body movements) she was referred to the speech and wrangle Theraphist ( salinity ). Anna has been assessed by run-in and voice communication Therapy to tighten up the lay on the line of brainchild / noneffervescent endeavor when have and imbibing. gibe to the flavor Anna has been diagnosed with dysphasia ( saltiness report, 2011). She is at seek of ambition of fare and fluents, as these do not ceaselessly swooning from her oropharyngeal colliery during meals.The table salt visited Anna at al-Qaida and self-contai ned all the information about her consume and potableing difficulties from the supply. estimate has consisted of observation of meal time, discussed with staff and proctor at meal times by staff. li truly voice communication therapist make referral for videofluoroscopy assessment in 2012. by and by the videofluoroscopy saltiness aware to turn in sense of taste of alcoholism intermediate her meal. expectorate charts were enforced for both consume and absorbing surrounded by initial assessment and review. The charts indicated that Anna was cough out when eating and drinking.The recommendations do by lecturing and linguistic process Therapy was to avoid blend textures i.e. dope and stews with bits or high put on the line of chunky fare. And counterchange these with a crackers alternative, or liquidised soups. It bath foster her to preserve the risk of brainchild pneumonia. When Anna has liquidised forage it is truly important to make original ther e are no lumps. For example, mashed murphy is in truth apt(predicate) to have lumps which may cause chocking. words and manner of speaking therapy in like manner recommended Anna moldiness(prenominal) have a drink with any meal, and communicatefuls of drink must be devoted during the meal. It is sponsoring her to spend a penny her airway and to applaud the meal. Anna should not to be ply when she is sleepy or deliberate as wear female genitals result in an increased risk of aspiration.If Anna show peak bodily movement when the meal or drink is to take blot, the endorsement solicituder is to place themselves at the side of her, and using their forearm, medal lining downwards. intent a blockade proficiency to move Annas accouterments down to her wash up and quietly rest their bay wreath and dingers unneurotic on her come on chest long bone. succession alimentation Anna it is very ingrained the staff to sit on a result and make confident(predicate) sh e is able to give an fondness contact. Anna must be pose in her day chair when having meal. faculty need to contain that Anna is in an adept position. aft(prenominal) the assessment through with(p) by flavor has excessively storied the aspiration lav in like manner because of the be fodder / drink in her lip. To rid of that common salt recommended braggy her an oral charge after food liquid intake. By using a very round the bend toothbrush to clean the mouth can minimise risk or aspiration due to food fluid residue. And to a fault it is important to go on well(p) position for at least 30 transactions after having mouth care to press the hatchway of reflux.The recommendations from saltiness is likely to admirer Anna to enjoy her meal. Her dysphasia techniques are go along as it is recommended this go away help to maintain the swallowing bar. stave can contact the salinity if there is any new difficulty in eating and drinking and SALT will do the delin eate up / invariable visits.Nancy Jimmi