George Esposito is a 79-year-old male admitted to a medicalward. George was taken to the emergency department by his daughterfollowing a fall at home. George tells the staff it was “nothingbut a bit of a dizzy spell”.
George lives alone and his daughter, Angela describes him as avery private man who prefers his own company. George owns his ownsmall weatherboard home on a small farm. He has tank water only atthe property. He has a vegetable garden, three chickens and hisJack Russel dog, Bella. George and Bella are inseparable.
George enjoys watching sport and news programs on television,loves a good strong cup of black tea with three teaspoons of sugarand chocolate biscuits. He likes to get up early and go to bedearly. He does not like the recent hot weather.
Angela visits once a week and has been dropping off his meals,but she reports he says that he has not been eating them recentlybecause he is not hungry, and things seem to get stuck in histhroat. She notes her father has lost weight in recent months andthere has been a significant decrease in his intake. She has beencleaning the bathroom and vacuuming the house when she visits,which her father has never let her do before but now seems happy tolet her.
Angela tells you “Dad just seems to have really slowed down – hehas always been such an active man, but he is just nothimself”.
George has chronic pain from osteoarthritis and suffers fromconstipation. Hearing loss is also becoming a significant issue forGeorge. He visits his GP once a year for his influenza vaccination,he takes no prescribed medication. His GP has spoken to Georgeabout analgesia and options to manage constipation, but he doesn’twant to ‘rattle with all those pills and potions’. He does takecastor oil for his constipation and paracetamol and aspirin for hispain, which he buys from the local supermarket on his weekly tripto the shops. George has not visited the dentist for over 25years.
George is a tall, thin gentleman (185cm and 53kg), he is pale,and his skin is dry, and you note poor skin turgor.
Question 3
Collect cues/information (gather)
You need complete a Mini Nutritional Assessment (MNA) withGeorge.
Question 3a.
After completing the MNA, do you consider George has a normalnutritional status, is at risk of malnutrition or is hemalnourished? Provide a brief rationale for your response.
Question 3b.
This screening score provides you will one cue. List four (4)other cues you can collect from George’s case study to inform yournutrition assessment
While undertaking the nutritional assessment with George younote he has halitosis. An inspection of his oral cavity revealsmucositis and xerostomia.
Question 3c. Given the cues provided in thecase study, provide four (4) factors which may be contributing toGeorge’s poor oral health. Ensure you include a rationale for eachfactor.
Question 4
Process information (infer).
Question 4. George reports a long history ofconstipation. What factors place George at risk of constipation?Provide a justification for your response (maximum 200 words).
Question 5
Collect cues/information.
As part of your admission assessment, you are required toundertake a pressure injury risk assessment.
Question 5a) Select one risk assessment tool toassess George’s risk. Identify this tool, the score and provide ajustification for selecting this tool.
Question 5b) Describe the measures you wouldput in place to prevent George developing pressure injuries. Ensureyou consider George’s situation and the context of his care in yourresponse (Maximum 200 words).
