Post a case study description of a geriatric patient from your practicum site who is at risk for falls. D

Fall risks are very high for the geriatric population. According to the Centers for Disease Control and Prevention (2013), one out of every three adults aged 65 years and older falls each year. This can be attributed to factors such as changes in aging, other health issues, environment, and effects of prescribed drugs. When caring for geriatric patients, it is important to screen them for risks and perform fall-risk assessments. These assessment tools help to determine the level of risk for patients so that preventive measures can be taken. The implications of falls are very serious and range from fractures to mental health disorders and even death. In this Discussion, you explore risk assessment tools for use with patients at your practicum site.

To prepare:

• Review the Kanis article in this week’s Learning Resources.
• Consider a geriatric patient at your practicum site who is at risk for falls. Coordinate an opportunity to assess this patient with your Preceptor.

Note: When referring to your patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.

• In addition to the Fracture Risk Assessment Tool (FRAX), select one of the following tools to assess this patient for falls:
  • Tinetti Performance Oriented Mobility Assessment (POMA)
  • Systems Approach
  • Berg Balance Scale
  • Elderly Mobility Scale
  • Timed Unsupported Stead Stand (TUSS)
  • Six-Minute Walk Test (6MWT)
  • Hendrich II Fall Risk Model
• Consider why you selected the assessment tool for this particular patient.
• Assess the patient using the tool you selected under Preceptor guidance. Reflect on the assessment, including any issues with the patient and/or the effectiveness of the tool.
• Think about strategies and interventions to reduce the risk of falls for frail elders.

By Day 3

Post a case study description of a geriatric patient from your practicum site who is at risk for falls. Describe this patient’s FRAX assessment. Then, describe the other assessment tool you used in the fall-risk assessment and explain why you selected the tool for this particular patient. Explain the patient assessment, including any issues with the patient and/or the effectiveness of the tool. Finally, explain strategies to reduce the risk of falls for your patient.

ANSWER

Journal 5

Mrs. H is a 76-year-old lady who lives independently in her own home. From risk assessment, Mrs. H has fallen in the last six months.  The patient also takes medicine to improve her mood and to help her sleep.  The risk score for this patient is 3.

FRAX Assessment

The age of the patient is established to be 76 years old, and the gender is female. The patient weighs 67 Kgs and is approximately 4’9. The patient has a history of previous fracture on her leg and hand but she does not have fracture arising from trauma. The patient has no history of parent fractured hip. She has no record of current smoking. However, the patient has the following medical problems; Hypothyroidism, a chronic kidney disease which is in stage 3, a schizoaffective disorder as well as a seizure disorder.

Another assessment tool that can best assess this patient is the Tinetti Performance Oriented Mobility Assessment (POMA). POMA assessment pays special attention to sitting balance, ability to arise, patients attempt to rise, the immediate standing balance, closing of eyes, turning ability, ability to seat among others (Mitchell & Newton, 2006). This assessment focuses on the physical fitness of the patient which complements the FRAX which is focused on structure fitness and wellbeing of the patient (Watts, 2011). POMA assessment indicates that the time up and Go for the patient is 12 seconds and the Gait decreases the arm swing but generally, it appears normal. The physical examination of the patient reveals that constitutionally she is well developed. The vitals including; spine which stands at 130/91, 107, sitting 138/78, 107; standing 146/95, 115 and the Body Mass Index is 21.0. The head is norm cephalic. She wears glasses with acuity of 20/30.  The respiratory if the patient is clear to auscultation bilaterally. The musculoskeletal strength is 5/5, she does not have knee joint laxity and foot evaluation has no calluses deformities and ulcerations.

A number of strategies would help to reduce the risk of falls. As a nurse, I would undertake to discuss the fall prevention basing the suggestions on stages of change model (Loria & Bhargava, 2013). I would also emphasize that falls, as opposed to accidents, do not have to happen again. I would offer CDC fall prevention brochures to inform the patient on how to prevent falls and to observe safety as well as offer the patient with a chair rise exercise manual and advise them to be doing the exercise on daily basis (Phstud, Svensson & Sarvimäki, 2011). On the same note, I would advise the patient to join community exercise, fall prevention program and fitness geared towards enhancing leg balance and strength by including exercise as a daily routine. Additionally, I would Recommend night lights and ophthalmologist for the eye exam….