Part B: Instructions

The purpose of this assignment is to engage your peers in an exploration of a health challenge across the lifespan and its impact on

the Canadian health care system. Your team is expected to design and deliver a comprehensive Nursing Care Plan that defines

specific nursing diagnosis, goals and interventions for the topic you are assigned.

NURS 4506 Course Learning Outcomes Evaluated in this Assignment:

1. Develop a plan of care for selected surgical and non-surgical conditions using the nursing process.

2. Apply principles of assessment, collaborative care, and nursing management of the patient with health challenges across the


3. Provide appropriate health teaching strategies that will enhance the client’s learning.

4. Apply a systematic approach to solve problems.

5. Use a variety of thinking skills to anticipate and solve problems.

6. Analyze, evaluate, and apply relevant information from a variety of sources.

7. Show respect for the diverse opinions, values, belief systems, and contributions of others.

8. Interact with others in groups or teams in ways that contribute to effective working relationships and the achievement of goals.

9. Takes responsibility for one’s own actions, decisions, and consequences.

The grade will apply to the entire group unless it can be proven that a team member did not evenly contribute to the

team project (through the DC discussion board only). In this situation, I have the right to assign an appropriate grade

ranging from 0-10 marks.)



1. Group Project Plan 2.5% -Due week 4 – One submission per team in the assignment folder.

2. Nursing Care Plan 15%- Due week 7- One submission per team in the assignment folder.

3. Peer Assessment 2.5%- Due week 7 – Each team member to submit in the assignment folder.

Requirements: Your team is expected to design and deliver a Nursing Care Plan related to your topic.

1. The following content must be covered:

 Title page following APA guidelines (tile page, margins, line spacing, format & font)

 A one-page introduction around the topic (Discuss what is it? Impact on Canadian Health Care system)

 A one to two-page clinical summary describing your patient profile

 5 Nursing diagnosis (Nanda statements) related to the topic (one per team member)

 You must include one nursing diagnosis on health education/promotion, and psychosocial needs

 Each nursing diagnosis must have 3 SMART goals (SMART goals must have a date or time for evaluation)

 Each SMART goal must have 3 nursing interventions

 Each nursing intervention must be supported by comprehensive referenced nursing rationale minimum 120 words

 References must include RNAO BPG Strategies to Support Self-Management in Chronic conditions, for a minimum of 10

current references in total. The use of nurse’s lab, blogs, Web MD, or references with n.d will result in a grade of zero.

 Each individual nursing diagnosis must be supported by 3 or more different scholarly references

 A one-page conclusion discussing your NCP

 Reference page following APA guidelines

 The expectation is that the use of direct quotes will be limited throughout the care plan. It is best practice to paraphrase were



Nursing diagnosis: Drastic weight loss with impaired memory related to change in cognitive abilities, sleep maintenance insomnia causing sleep disorders, personality changes as evident by lack of proper communication with family, increased frustration/confusion for new places (inappropriate behaviours), having very low propensity to trust and develop new relationships in life.

Goal #1: To have a reduced memory loss for the client with the help of pharmaceutical intervention that will help build its psychological function as long as possible and to bring about a reversal of inappropriate behaviours caused because of ageing whenever possible




The RPN will administer Donepezil 5 mg PO qHS daily for the first 3-4 weeks. This will increase to increase to 10 mg q per day after 4-6 weeks; and may further increase to 23 mg/day after 3 months, if warranted. This will improve the ability to think and remember or slow the loss of these abilities for Mr. Smith.

When talking to Mr Smith in the ER, it was determined he shows a significant amount of memory loss and is disoriented to time and place and could not recognize his son. It was also evident with the blisplac patient has not been taking her medication for some time and medication is the blispac is full, with missed doges. The Patient is in a confused state of mind and is unable to communicate properly (Ridder, et al., 2017).

The RPN will discuss with the patient different signs that promote eating to stop his drastic weight loss issue.  He will also identify ways to eliminate or reduce eating signs of the patient.

Mr Smith did not remember much about his food habits but stated that he ate frozen meals for his lunch and dinner and his diet included little fruits/vegetables. It was recognized that he often forgets to drink water and his son did grocery for him. Recognizing cues that lead him to little food and increasing the intake of fresh fruits and vegetables can help him get the desired nutrition due to the lack of which he might have started losing a lot of weight. His family needs to understand the fact that having too much-frozen food is not recommended for him at this age. The patient needs redirection to finish all his meals and develop his taste buds to complete his 3 healthy meals of the day. Drinking 8/10 glasses of water a day will be mandatory and setting a reminder for the patient to drink water will help here to take in the desired amount of water during a day (Souza et al., 2016).

The RPN will discuss with the patient his lifestyle different types of and behaviour modifications methods to promote successful weight management memory loss control

Mr Smith stated that he ate frozen meals and his diet did not include much fruits and vegetables. There are many things Mr Smith can do at home to help him manage weight by promoting strategies that help him eat healthily. The patient lost 5 kg weight but still is not underweight at present with 175 lbs at the age of 80 years. The patient needs to promote healthy eating and less frozen food intake and apart from three healthy meals, he should have fruits and vegetables (Ridder, 2017). He should also have a good liquid intake with juices and water at regular intervals to keep him hydrated throughout the day. All these can be managed by putting a caretaker who can see his food and drinking habits and make sure he does not forget to take his medicines

Evaluation: The goal will be met when Mr Smith identifies behaviours that lead him not to eat and forget to drink water and has a plan on how to tackle these triggers in the future.


Goal #2:


The Client should be able to put up three techniques/behaviours that will help him enable resumption of different activities by the end of his stay in the hospital.



The RPN will refer the patient to a rehabilitation team.

Mr Smith will need to learn managing his daily activities and referring to an occupational therapist will help him do it in a managed way. It is seen that his hygiene conditions have weakened in the last three months and the occupational therapist will help him teach ways to have proper bathing and maintaining his hygiene techniques. The therapist will help manage his daily activities well till he can or else will advise personal caretaker (Henrico, et al., 2019).


The RPN will also assist the patient with different exercises to maintain good health and boost energy

Mr Smith has had an external rotation of his right leg and swelling with bruises on his right hip. Since he needs to spend good time in physiotherapy to cure this, he needs to be healthy in his mind and energy to continue doing these to have relief from pain. Assisting Mr Smith with a simple range of motion movements will help him get relief from this problem. The exercises are usually aimed at strengthening and stretching the muscles of the hip and knee and the right leg altogether; external rotation elastic bands at the lower limb decrease rearfoot eversion during walking: a preliminary proof of concept.

The RPN will instruct the patient is having a lifestyle that is full of activity


Education of the patients and their families about various activities that will help to have a good lifestyle will be good to avoid these cases in future. Healthy lifestyle calls for good food habits, intake of fresh fruits and vegetables, interaction with family and friends, a good walk in the morning and evening. He has to follow his exercise regime that is prescribed by his physiotherapist to preserve his strength of leg, hip and it is important to encourage him to have a life in his life (Henrico, et al., 2019).


Evaluation: The goal will be met when Mr Smith understands the importance of having an active lifestyle and is regular with his exercises at home.

Goal #3:


The patient should start to show adaptations and know how to cope up with stress management by the end of hospital stay.




The RPN will refer the patient to a counsellor

The patients who are approaching their 80’s suffer from anxiety and hold things internally in regards to stress. If these symptoms are left untreated, then they can affect Mr Smith’s recovery, rehabilitation, and physical and mental health. Adjusting to life after 80 is a slow process and it is important to let Mr Smith know that life is still enjoyable and people are good around him. He needs to trust his life again and this will help him give the desired motivation to live his remaining part of life happily (Henrico, et al., 2019).


The RPN will encourage participation in different activities with different people to help develop relationships


It is important to encourage Mr Smith to participate in activities with different people and initiate communication with them that will give him back the life in his life and give him feelings of self-worth (Giorgi, et al., 2020). He should be around people who will help him understand that he is not lonely in his life and they are good enough to have his trust and feelings. Further advising him to be clear with himself and with his family is recommended so that he can manage his anxiety and stress well. He should be advised yoga and meditation to have peaceful mind thrice a week during early morning time (Giorgi, et al., 2020). 


The RPN will encourage the expression of feelings for having a life and express his emotions and stress with others

It is advisable that Mr Smith is coping with stress but not alone and he should be motivated to communicate his feelings with his near and dear ones. He should make friends and be around people to develop relationships. Expressing feelings to friends and family and also to the health professionals is a vital part of recovery in life and this can give Mr Smith a chance to regain the lost control of his life. He will be advised to start socializing again which he stopped after his wife died (Giorgi, et al., 2020).


Evaluation: This goal will be met when Mr Smith starts to show signs of acceptance of him and starts to express his feelings with other people.



Giorgi, G., Leone-Perez., J. M., Piagnata, S., Topa., G., & Mucci, N. (2020).

Addressing Risks: Mental Health, Work-Related Stress, and Occupational Disease Management to Enhance Well-Being. Hindawi, 2020. DOI:

Henrico, K., Maritz, J. E., & Bezuidenhout, J. (2019). Self-Managing Individual

Wellness for the Health Professional: A somatology Perspective. Health SA, 24(1119). doi: 10.4102/hsag.v24i0.1119.

Ridder, D. D., Kroese, F., Evers, C., Adriaaanse, M., Gillerbaart. (2017). Healthy

Diet: Health Impact, Prevalence, Correlates, And Interventions. Psychology & Health, 32(8): 907-941. doi: 10.1080/08870446.2017.1316849.

Souza, T. R., Araujo, V. L., Silva, P. L., Carvalhais, V. O., Resende, R. A., &

Fonseca S. T. (2016). External Rotation Elastic Bands at the Lower Limb Decrease Rearfoot Eversion during Walking: A Preliminary Proof of Concept.  Brazilian Journal of Physical Therapy, 20(6):571-579. doi: 10.1590/bjpt-rbf.2014.0194.