In the process of planning care for each patient, holistic nursing care is the most effective and useful method to meet all the needs of each patient since holistic nursing care focuses on improvement and healing of an individual as a bio-psycho-social unit, from birth to death (Papathanasiou et al., 2014). Furthermore, the team approach is also vital in providing care as team members from different disciplines work collaboratively, with a common purpose which is to set goals, make decisions and share resources and responsibilities in providing to the patient person-centred care. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an Original Essay This article provides an in-depth discussion on providing holistic nursing care suited to the patient's needs in the scenario, applying the nursing process. Additionally, critical thinking skills will be used in formulating the treatment plan based on the patient's diagnosis and past and present medical history. The patient's medications will also be discussed in depth, including preoperative and postoperative nursing interventions to be administered to the patient. The patient in the scenario is Mrs. Audrey Smith, a 75-year-old female patient who entered the emergency room after being found lying a neighborhood on the kitchen floor following a slip and fall accident. She was diagnosed with a femoral neck fracture so hip arthroplasty was ordered. He was also noted to have soft tissue injuries and contusions to his left shoulder. GCS is 14 at the time of evaluation in the emergency room, however hourly neurological observation has been ordered as there is a small hematoma on the left forehead. Safety Always identify the patient by checking the identification band and asking her name before providing assistance. Ask Audrey if she has hearing difficulties, vision problems and check if she uses the necessary aids such as hearing aids and glasses so that the patient can correctly understand the instructions for the procedures to be performed. Orient the patient to the surrounding environment, ensure safety by keeping the side rails raised, place the bed in the lowest position and block the wheels to prevent falls every time the patient gets out of bed. Keep the patient's personal items and the call button within easy reach to prevent the patient from getting up or walking to get them. Monitor activities and neurological status hourly. Hygiene and comfort Rest, sleep, nutrition, hygiene and dignity should be taken into consideration to promote patient comfort because these elements have a significant impact on the health outcomes and satisfaction of all patients. Assess pain level and administer pain medication as directed by doctor. Encourage deep breathing, coughing exercises, and recommend performing relaxation techniques such as guided imagery. Practice bedsore prevention by repositioning the patient every two hours and hand hygiene to prevent transmission of health-related infections to the patient. Nutrition. Maintain a patent intravenous line for proper administration of IV fluids. Weigh the patient at the same time every day. and note body mass index to provide appropriate food to address her anorexia. Instruct the patient to increase fluids and include protein-rich foods in the diet to aid recovery after surgery and strengthenthe immune system. Monitor your blood sugar level, make sure it is in the normal range due to your history of diabetes mellitus. Elimination Several conditions can contribute to bowel dysfunction in geriatric patients, and an important way to maintain satisfactory elimination is by adhering to a correct diet and a regular schedule of meals and fluid intake. (Bargen, JA 2016) Administer laxatives as prescribed by a doctor to correct constipation Encourage a regular period of elimination and advise wearing incontinent pads Ensure privacy when using the toilet/pan or urinal, drape a blanket over the person's lap to reduce embarrassment. Activity levels Orient the patient frequently as neck fracture causes vascular disruptionfeeding leading to delirium, so should be considered Encourage range of motion exercises to promote circulation Work with a physical therapist as needed to further monitor activity and motor function Psychosocial needs Assess the level of pain and note the need to administer analgesia to relieve pain Monitor the patient's cognitive status and evaluate his understanding of his condition because it may affect his cooperation with the medical regimen and recovery Contact a social worker to address Audrey's concern about her dog Maintain a reassuring attitude when providing care to promote comfort and safety Past medical history Atrial fibrillation Atrial fibrillation is a common and important disorder of the heart's electrical system, commonly referred to as arrhythmias/ arrhythmias. This occurs when there are abnormal electrical impulses in the atria. (Heart Foundation 2016, p.2) Audrey needs to be monitored closely, get ECG monitoring to prevent potential risk of stroke. Hypertension Hypertension, also known as high or increased blood pressure, is a condition in which blood vessels have consistently high pressure. This happens when your systolic blood pressure is 140 mmHg or higher and/or your diastolic blood pressure is 90 mmHg or higher. (World Health Organization 2013). Audrey's blood pressure should be monitored carefully and notify the doctor when abnormal results are noticed and/or administer antihypertensive medications as ordered by the doctor. Left cardiovascular accident It is commonly known as a stroke. A stroke occurs when the blood supply to part of the brain is cut off, due to a blockage or rupture of a blood vessel that deprives brain tissue of oxygen and nutrients. (Stroke: Mayo Clinic 2018). Close monitoring of Audrey's neurological status is necessary. He has a history of left CVA in 2008 which resulted in weakness of his right body, he has a high risk of falling so constant care is required. Type II diabetes mellitus Type 2 diabetes is a serious and common chronic disease resulting from a complex heredity-environment interaction together with other risk factors such as obesity and sedentary lifestyle. (Wu et al., 2014). Monitor Audrey's blood glucose level before and after the procedure, report abnormal results to her doctor as it prolongs wound healing. Gastroesophageal reflux disease. It refers to the regurgitation of gastric contents into the esophagus caused by incompetence of the lower esophageal sphincter. . Offer Audrey small frequent meals that are high in calories and protein. Keep the head of the bed slightly elevated to 30-45 degrees for at least 2 hours and administer anti-reflux medication to relieve the symptom. Osteoporosis A diseasesystemic skeletal disorder characterized by low bone density leading to weakening of the bones which increases the risk of fracture. (William Morrison, 2018) Assess Audrey's immobility and assist her with her activities. Offer a diet rich in proteins, vitamins and minerals. Total Hysterectomy A total hysterectomy means that both the uterus and the cervix are surgically removed due to several reasons such as cancer, heavy and continuous bleeding, endometriosis and severe pelvic pain. Depression It is a cognitive disorder characterized by a constant feeling of sadness and loss of interest, desperation, pessimism, lowered self-esteem and increased self-devaluation and disproportionate to reality. You need to be a compassionate listener, show empathy with Audrey. DrugsDigoxin 62.5 odIt is a cardiac glycoside used to increase the strength and contraction of the myocardium. (Tiziani,A Harvard,M 2017, p831). Controls ventricular rate in the treatment of chronic atrial fibrillation. Monitor heart rate for a full minute, do not administer if pulse is less than 60. Ask patient to ask for assistance when getting out of bed as it causes dizziness, drowsiness and vision changes.Warfarin 2mg ODIt is an anticoagulant/antithrombotic used to prevent certain types of blood clots in people at risk of blood clots or who already have a blood clot. Have Audrey report bleeding gums, red or black bowel movements, easy bruising, difficulty breathing or swallowing, hematuria as these are signs of bleeding. Consider prothrombin time and INR control and should be discontinued before surgery. Coversyl 5 mg ODA An antihypertensive drug that helps control blood pressure by relaxing blood vessels. Ensure safety, monitor blood pressure and report to doctor if blood pressure drops below normal.Give the drug 30 minutes before meal, preferably in the morningVitamin D 1,000 units ODSupplement that improves the absorption of calcium and phosphorus, treats and manages osteoporosis.(Tiziani,A Harvard,M.2017, p1141).Monitor BUN, Creatinine, serum calcium and phosphate levels and encourage intake of foods rich in calcium and vitamin D. Metformin 500 mg BD (BSL5 @1200) Agent antidiabetic that lowers blood glucose in insulin-dependent diabetes mellitus. Monitor blood glucose and ketones as prescribed and watch for signs of hypoglycemia such as sweating, vision and sleep disturbances, headache, and palpitation. Administer whole tablets, do not cut, crush or chew Esomeprazole 40 mg ODA Proton pump inhibitor for the treatment of GORD. Obtain a baseline liver function test and monitor frequently during therapy. Give the drug 1 hour before meals, offer small frequent feedings if nausea and vomiting occur. Instruct Audrey to seek assistance as it may cause headaches and dizziness. Effexor 150 mg OD An antidepressant that treats major depressive disorder, anxiety, and panic disorder. Administer as prescribed to help Audrey improve her mood, but ensure safety and comfort as it causes dizziness and behavioral changes. Caltrate Calcium supplement 600 mg OD which reduces calcium levels, therefore necessary for Audrey's osteoporosis. Administering medications with meals and advising Audrey increases oral fluid intake as it causes constipation. Watch out for signs of hyperglycemia such as increased thirst, headache, difficulty concentrating and blurred visionMylanta 15-30 ml PRNAntacid administered to neutralize the acid in the stomach thus preventing heartburn. It should be taken 2 hours apart from other medications. Instruct Audrey to.