Case Study Mr. M
Neurological, perceptual, and cognitive complexities are common among elderly patients from the age of 55 years. They are associated with aging and chronic illnesses that affect the elderly. Neurocognitive complexities have been linked to poor health outcomes among patients and are a major cause of morbidity, prolonged hospital stays, and mortality rates among geriatric patients. The most prevalent neurocognitive disorder is dementia, which could be secondary to Alzheimer’s, Vascular, or Lewy Body. The purpose of this paper is to analyze the case of Mr. M, a patient with neurocognitive complexities. I will discuss the patient’s clinical manifestations, medical diagnoses, and support interventions.
Clinical Manifestations Present in Mr. M
Mr. M presents with a decline in memory with a history of having trouble recalling familiar names and places, repeating what he has just read, getting lost, and wandering at night. He is also easily agitated with aggression and cannot perform most ADLs. He has a history of hypertension and hypercholesterolemia. Positive objective data include a height of 69.5 inches and a weight of 87 kg, which calculates to a BMI of 27.9 categorized as overweight. Lab results reveal a WBC count of 19,200/uL and lymphocyte count of 6700 cells/uL, which indicates leukocytosis and lymphocytosis, respectively, with a systemic infection. In addition, urinalysis results show cloudy urine and moderate amounts of leukocytes, which point to a urinary tract infection. The patient’s protein, AST, and ALT levels are within the normal range.
Medical Diagnoses
Primary Diagnosis
Alzheimer’s disease (AD) Dementia. This is a neurodegenerative condition marked by impairment in cognitive and behavioral processes, which interferes with individuals’ occupational and social functioning (Rodríguez et al., 2016). Mr. M has Moderate AD based on positive symptoms of increasing memory loss, difficulties recalling familiar names and places, and the presence of agitation, aggression, and anxiety (Rodríguez et al., 2016). Moreover, Mr. M has confusion that causes wandering at night, difficulties in reading, and limitations in performing ADLs.
Secondary Diagnosis
Asymptomatic Bacteriuria (ABU): ABU is characterized by an infection in the urine but with no subjective data of a urinary tract infection such as dysuria or urinary frequency and urgency (Biggel et al., 2019). ABU refers to the isolation of bacteria in an appropriately collected urine specimen from a person without symptoms of urinary tract infection. ABU’s pertinent positive findings include urinalysis results revealing cloudy urine and a moderate amount of leukocytes with negative patient’s urinary symptoms. Besides, the patient has leukocytosis and lymphocytosis, which indicate presence of infection.
Expected Abnormalities in the Nursing Assessment
Patients with moderate AD are expected to portray abnormal findings in the neurologic and mental status exam. Expected findings on general examination include anxiety and restlessness, with the patient getting aggressive during the interview (Mukherjee et al., 2017). Cognitive impairment is expected with the patient portraying difficulties in reading, writing, and simple calculations secondary to cognitive difficulties.
Expected findings on neurologic exam include decreased attention and concentration levels, poor recent and remote memory, language difficulties, and declined executive function (Rodríguez et al., 2016). Expected finding in the mental status exam include an angry mood as a result of anxiety and confusion. Thought process is expected to be characterized by disorganizes thought and illogical thinking due to an altered thought process (Mukherjee et al., 2017). Thought content is likely to be marked by paranoia, visual or auditory hallucinations, and delusions. Mr. M might be disoriented to both place and time with a declined immediate, short, and long-term memory due to confusion (Rodríguez et al., 2016). Furthermore, the patient is expected to portray an impaired judgment marked by making poor decisions as well as lack of insight evidenced by denial of symptoms or decline in functioning.
Physical, Psychological, And Emotional Effects of Mr. M.’S Current Health Status
Mr. M’s current health status may result in physical injuries such as bruises and fractures secondary to falls. The patient has an unsteady gait with difficulties in ambulation as well as increased confusion levels that put him at a high risk of falls (Brooke, 2016). Besides, the ABU may result in complications in
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