Nursing Diagnosis (Nursing)

by Brenda Marshall, EdD, MSN, RN

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    00:01 So what are we going to be thinking about when we're taking care of patients with neurocognitive disorders? It's really important once again that we're focusing on the person and the way that this disease might affect their life and their own relationship to the people around them and themselves.

    00:23 So the first thing, because there's confusion in all of these, let's think about how can they take care of themselves? There will be a self-care deficit.

    00:35 We're also going to be thinking about the fact that they won't be able to manage their own health.

    00:41 So one of the nursing diagnosis might be ineffective self-health management.

    00:48 How are they going to be able to determine how to get to the doctors, how to be able to do the regimens that they need to do? How can they cook for themselves if their tremors are getting in the way? We also want to know that because they may not be able to cook for themselves and not everyone is living with a family.

    01:12 A lot of our patients and clients are living on their own.

    01:16 How are they going to go shopping? How are they going to be able to remember how to cook? So they are at risk for imbalanced nutrition.

    01:28 Chronic confusion is a symptom that we want to think about and how it impacts their life and some of the ways that we can assist them to alleviate some of the confusion.

    01:41 There are patients that now use their cell phone.

    01:45 When they understand they're going to go to the store and come home, they can put the store in and they can follow the directions on how to get to the store and follow the directions how to get home to allow them to maintain their greatest amount of ability to take care of themselves.

    02:04 They also are very prone to risk.

    02:10 Falling, burning themselves, eating something perhaps that is toxic.

    02:17 So not having a good cognition, a capacity for self care and for understanding what we're putting in our body, what we need to do to keep ourselves healthy, these are all risk prone behaviors.

    02:34 And remember, we were talking about driving.

    02:36 It's very hard to have someone give up their driving because that is their freedom.

    02:43 But if you don't know how to make the cargo or you forget where is the brake, or you have a sudden jerking movement in your leg that you can't control and it happens to be on the gas gauge, we have to really be thinking globally on how these brain disorders are affecting every aspect of this person's life.

    03:10 Also, they have a risk for self directed or other directed violence.

    03:16 Remember, they have this mood lability, so they might be and one moment really angry with someone.

    03:23 They might not even know who that person is.

    03:26 They might think that you or another person taking care of them is someone who's come in to rob them and they might throw things.

    03:36 So we have to make sure that we're providing a safe environment, one where they can feel safe, where we can also feel safe.

    03:46 And if they have self-directed problems, if they are saying that they want to hurt themselves One to one constant observation is a must in these situations.

    04:00 Family education is also a must, because if it happens to be a mom or a dad or a grandma or grandpa, it's very hard to have the family understand that these outbursts are not directed towards them individually, that this is a brain disease and that these behaviors are a symptom of a brain disease.

    04:26 So as I'm saying this, I'm hopeful that you're all thinking about how difficult this must be for the family members as they see somebody who has always been someone who they love, who they respect, who has been in charge of things deteriorating in front of their own eyes and perhaps not even remembering who they are.

    04:49 So caregiver strain is a very big piece of coming up with some sort of solutions for the families who are dealing with these neurocognitive disorders.

    About the Lecture

    The lecture Nursing Diagnosis (Nursing) by Brenda Marshall, EdD, MSN, RN is from the course Neurocognitive and Neurodegenerative Disorders (Nursing).

    Included Quiz Questions

    1. Self-care deficit
    2. Risk for imbalanced nutrition
    3. Ineffective self-health management
    4. Risk for self-directed or other-directed violence
    1. “Have you had any falls recently?”
    2. “Do you drive?”
    3. “Do you often get upset with your children?”
    4. “Do you remember my name?”

    Author of lecture Nursing Diagnosis (Nursing)

     Brenda Marshall, EdD, MSN, RN

    Brenda Marshall, EdD, MSN, RN

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