Need a reply 1
Exercise at any age is beneficial but it is especially beneficial for the elderly as physical exercise like aerobic power, strength, balance, and flexibility can reduce medical complications likes fractures, myocardial infarctions, and cerebrovascular accidents (Meiner, 2015.) If the woman has no other health issues, I will take this as an opportunity to work on health promotion and to educate her on primary disease prevention activities like exercise. I would teach the woman about the advantages of exercising like positive physical health benefits, positive mental health benefits, decreases fatigue, decreases pain, helps maintain weight, and helps maintain physical function (Meiner, 2015.) It is recommended the woman be screened using the Exercise Assessment and Screening for You tool to assess whether it is safe for her to start exercising and this tool will also match her with an appropriate workout program/regiment (Meiner, 2015.) Older adults should complete 30 minutes of physical activity and I would be sure to mention this to the woman if it’s been confirmed she has no health limitations (Meiner, 2015.) The precautions I would include in my recommendations are to ask about pain, fatigue, history of falls, fears about falling, and assess her ability to complete her ADLs/IADLs before recommending a particular exercise program (Meiner, 2015.)
Need a reply 2 (but for this I would support no need for restraint)
After numerous attempts of explaining to this patient that climbing over the rails or the bed isn’t safe and making sure the call light is easily available for her to use when she needs to use the restroom, yes I do think the restraints are necessary. Falls in the elderly result to higher rates of morbidity and mortality of those older than 75 (Meiner, 2015). It is important to use every mechanism possible before requesting restraints but when everything else fails, it is important to keep the patient safe. This patient already is a high fall risk because of her bad vision from her diabetes so it is important to closely monitor this patient. Her agitation may allow her to think that she doesn’t need anyones help and that she can do it herself, but sometimes we have to take action when people that need help don’t ask or want it.
If the facility has the resource of “sitters”, I think this could also be a better option, although not all facilities has these resources. When restraints are used it is important to leave two fingers of a space between the restraint and patients skin. The restraint must be applied to the bed itself and easily be available to untie quickly. The nurse will complete frequent checks on the patient throughout the night. Restraints are never easy but when it is the safest option for the patient, they are important. If this patient has any family that calls or visits, I think it is important for the nurse to update the family as well. The family may be able to help the patient understand the importance of asking for help.