Hernandez Family Assessment

Address in a comprehensive client assessment of the Hernandez family the following: 

  • Demographic information
  • Presenting problem
  • History or present illness
  • Past psychiatric history
  • Medical history
  • Substance use history
  • Developmental history
  • Family psychiatric history
  • Psychosocial history
  • History of abuse and/or trauma
  • Review of systems
  • Physical assessment
  • Mental status exam
  • Differential diagnosis
  • Case formulation
  • Treatment plan

Helpful link

http://mym.cdn.laureate-media.com/2dett4d/Walden/SOCW/MSWP/CH/mm/homepage/episodes.html

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The Application of Data to Problem-Solving

The Application of Data to Problem-Solving

In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.

Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.

In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.

To Prepare:

  • Reflect on the concepts of informatics and knowledge work as presented in the Resources.
  • Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.
By Day 3 of Week 1

Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?

By Day 6 of Week 1

Respond to at least two of your colleagues* on two different days, asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

*Note: Throughout this program, your fellow students are referred to as colleagues.

 Will be posting additional discussion replies that will require two replies which will be included in this discussion post. 

Each requires at least three references and all need to be in APA format.

Monicas discussion 

Discussion #1- Initial Post    

All healthcare workers are trained to share the common goal of providing the best quality of care to their patients.  Regardless of what role one may serve on the multidisciplinary team, they all have an obligation to accurately assess the needs of the patient, to efficiently collect and record data, to contribute to diagnosing, and to treat/ evaluate properly. “Informatics blend technology and information to blend something new that people, organizations and society can make use of” (Laureate, 2018). Advancement in technologies such as, electronic health records (EHR), electronic medication administration records (EMARS), computerized physician order entry (COPOE) and etcetera, have all played an intricate role in reassuring that healthcare teams are on one accord with providing safe and effective treatment to patients. Each electronic system mentioned have parameters put in place to promote safety and warrant issues that need to be addressed during patient treatment.  It is crucial for the multidisciplinary team to communicate with each other to come up with solutions on how to provide the best care.  It is also imperative to communicate information and treatment with the patients. As a staff nurse, I have witnessed ineffective communication between the healthcare team and patients far too often.  Patient care should be patient centered therefore, it is the nurse’s to duty to ensure that patients are actively involved and well informed on their medical issues and care. Besides verbalizing care with patients, it is a great idea for nurses to promote the use of patient health portals as a resource for patients to be informed on their care.

“A patient portal is a secure online website that gives patients convenient, 24-hour access to personal health information (PHI) from anywhere with an internet connection” (Oliveira, 2019).  Patient portals provide data of all of the care rendered, lab values, testing, discharge information, appointments, billing, and so on, entered by healthcare staff during the patient’s stay.  The data collected comes from the various electronic tools that the healthcare team used to record data. The portal also has a patient satisfactory survey and comment section for patients to evaluate the care rendered and offer suggestions on ways that the hospital and staff can improve with providing care.

The patient portal is a valuable tool for both the patient and the healthcare team. For the patients, it is a great resource for patients to educate themselves on their conditions and they do not have to rely heavily on verbal communication from staff.  It is helpful and supports understanding; therefore patients may have fewer questions due to them being well informed. For the healthcare team, input from the patient gathered from the online surveys and comments sections provide feedback on ways the staff and hospital can improve care from all aspects. Nurse leaders serve as informatians which “enable communication between people and systems to more effectively protect the population’s well-being” (Public Health Informatics Institute, 2017). Nurse leaders can use the information gathered from the surveys and comments sections of the patient portal to identify issues that may need to be addressed to improve quality of care and/or the hospital environment.  Data gathered from the patient portal provides a constant evaluation of healthcare rendered by staff and provides a baseline to evaluate whether care is improving or not. Nurse leaders can take the information gathered to identify problems and come up with problem solving strategies to present to staff and hospital administration during meetings.

References:

Laureate Education (Producer). (2018). What is informatics? [Video file]. Baltimore, MD: Author.

Oliveira, K. (2019, November 5). Best practices for effective patient portals. Amazing Charts. https://amazingcharts.com/best-practices-for-effective-patient-portals/

Public Health Informatics Institute. (2017). Public Health Informatics: “translating” knowledge for health [Video file].Retrieved from https:// www.youtube.com/watch?v=fLUygA8Hpfo

Micheals discussion

 The concept of informatics centers on the careful gathering, sequencing and the obtaining of information from various sources with the intent of making it readily accessible for use in a more cohesive format across various platforms for use either by healthcare teams, law enforcement, researchers and or students in and out of the classroom setting. “Healthcare and nursing informatics are both vastly growing fields within the medical field and are continuously incorporating new and evolving technology. Both have been around for the past three decades, at least. The technology boom at the turn of the century has helped informatics and information systems further evolve. Enhanced delivery of care, improved health outcomes, and advanced patient education are just a few aspects that have improved.” (Sweeney, 2017) 

 My scenario follows from the background of my work in a surgical oncology hospital where I work as a registered nurse in the care of post operative surgical patients who are battling cancer, often at times some of the cancer patients that arrive my unit have undergone some form of plastic surgery where a piece of tissue has been derived either form the back or the leg muscles for the reconstruction of the jaw or the mandible which translate to a flap with the need for hourly monitoring within the first seventy two hours, and picture uploading of the flap, this parameters are put in place for careful monitoring of the flap site to rule out hematoma, seroma or failure of the flap due to non viability or tissue rejection.

     Following from careful monitoring and reporting of patient flap and its viability to the treatment team, any adverse outcome like flap failure, hematoma, or undesired coloration of the flap indicating poor perfusion can be readily addressed which could mean the difference between redoing the surgery or salvaging the surgery before it further deteriorates. Data for the flap can be collected via computer interface and also via the work phone picture platform where hourly flap check reports are documented and every shift flap pictures are uploaded to the patient chart electronically, with this system in place and the synch ability across different computer models on real time makes it easy for all providers associated with the surgery to gain access to patient data, pictures, documentation on post surgical state of the patient in real time, this in turn gives the team peace of mind knowing they are able to monitor and manage a post surgical patient’s care even when they are away from the unit. According to McGonigle (2017, p30), “An IS acquires data or inputs; processes data through the retrieval, analysis, or synthesis of those data; disseminates or outputs information in the form of reports, documents, summaries, alerts, prompts, or outcomes”.

     Based upon the lay out of the hospital, and the sync ability of the pyxis with the computer modules, every medication pulled from the pyxis shows pending administration, and when the medication is scanned and given to the patient the medication reconciles with the pyxis as given and no longer pending, this safety parameter provides administrators with first hand information and knowledge about all medications that have been pulled from the pyxis, those that were scanned, those that were returned due to patient refusal and those that were not administered, it also gives the administrators a real time data on the monitoring of controlled substances and mismanagement of access to narcotics by the nurses if such occasion arises.

     Stemming from the technological advancement in computer informatics and parameters that have been made possible due to the ability of these systems to communicate coherently across various platforms in real time, information derived from these systems present as ready resource for nurses, nurse leaders, administrators and other related healthcare providers to use for their discernment in making clinical judgment and best case scenarios in their plan of care to bring about a better prognosis for the patient in their care. “Nursing informatics roles have taken many forms in focus and function over the last decades; suffice it to say that they have not been consistently described or defined in terms of scope of practice. At the time of this writing it is clear that role of nursing informatics specialists will continue to evolve at an increasingly rapid rate in the coming years. The unfolding of new health care paradigms will bring greater connectivity between care providers and patients, include a wide array of emerging technologies and an increasing emphasis on data analytics will make the integration of informatics competencies into every area of nursing an imperative.” (Nagle et al., 2017, p212)

                                                                                                             References

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Nagle, L., Sermeus, W., & Junger, A. (2017).  Evolving Role of the Nursing Infomatics Specialist. In J. Murphy, W. Goosen, &  P. Weber  (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF

Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1.

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Where in the World Is Evidence-Based Practice?

March 21, 2010, was not EBP’s date of birth, but it may be the date the approach “grew up” and left home to take on the world.

When the Affordable Care Act was passed, it came with a requirement of empirical evidence. Research on EBP increased significantly. Application of EBP spread to allied health professions, education, healthcare technology, and more. Health organizations began to adopt and promote EBP.

In this Discussion, you will consider this adoption. You will examine healthcare organization websites and analyze to what extent these organizations use EBP.

To Prepare:

  1. Review the Resources and reflect on the definition and goal of EBP.
  2. Choose a professional healthcare organization’s website (e.g., a reimbursing body, an accredited body, or a national initiative).
  3. Explore the website to determine where and to what extent EBP is evident.

By Day 3 of Week 1

Post a description of the healthcare organization website you reviewed. Describe where, if at all, EBP appears (e.g., the mission, vision, philosophy, and/or goals of the healthcare organization, or in other locations on the website). Then, explain whether this healthcare organization’s work is grounded in EBP and why or why not. Finally, explain whether the information you discovered on the healthcare organization’s website has changed your perception of the healthcare organization. Be specific and provide examples.

By Day 6 of Week 1

Respond to at least two of your colleagues on two different days by visiting the websites they shared and offering additional examples of EBP or alternative views/interpretations to those shared in your colleagues’ posts.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

Will be adding two discussions that will need at least three references all in APA 7 format each.

The mail discussion will need at least 3 references and also in APA 7 format.

Micheals  discussion

Evidence based practice presents with summation of ideas, experiences, coupled with literature centered around dedicated man power and hours of work both in the clinical and or research setting which could span for a number of years based on the mission and or vision of the facility working on a certain intervention to bring about global change in the dynamics of either how healthcare is delivered, managed and or improved. Following from a careful perusing of the medical university of South Carolina, the institution presents with a healthcare setting centered on the need to achieve excellence through innovative implementation of quality assurance, patient centered care based on improved clinical practices based on improvements and incorporation of new data on evidence based practices. According to Crabtree et al., (2016, p172) “The MUSC Center for Evidence-Based Practice (EBP), housed jointly in the Library and the Quality Management department of the MUSC Hospital, aims to promote scientific inquiry, EBP, and quality outcomes at MUSC. Through education, the development of evidence-based clinical decision support tools and outcomes research, the Center for EBP has begun to transform the culture of MUSC into one that incorporates best evidence into clinical practice on both an individual and system level”.

     Following from the presentation as rendered by Crabtree et al., (2016, p172) “The EBP Nurse Scholars course provides nurses with a comprehensive overview of EBP, prepares them to frame clinical questions, perform literature searches, analyze and evaluate evidence, and translate that knowledge into something clinically meaningful… Pre- and post-course surveys demonstrated that the course improved nurses’ confidence with EBP methods and skills related to research tools, statistical concepts, and study designs. Data collected included responses from students from two EBP Nurse Scholars courses: Spring 2013 and Spring 2014”. The literature speaks to the mission, vision and philosophy of evidence based practice while also bearing in mind the goal of this organization in making their nurses frontiers in the quest and search for results that correlate with caring for patients with evidence based information at the top of their list.

     Based on the careful scrutiny and analysis of the recommended resource list, I would be made to understand that the organizations priority and goals centered on the need to show case, while also embracing the innovations of evidence based practices, and its contribution to the healthcare sector. “A regional, collaborative EBP fellowship program, the EBP Institute, was founded in 2006 by nurse leaders from multiple hospitals and academia in San Diego County, California, to promote implementation of EBP by hospital nurses. The fellowship program utilized institution-matched mentors to assist in executing unit-based EBP projects, and included didactic as well as interactive learning experiences in six daylong educational sessions over a 9-month period.” (Kim et al., 2016, p340)

     Following from some of the literature on the resource reading list and some of the organizations mode of operation in terms of their mission, philosophy and vision as set forth by their quest for in depth knowledge on evidence based practices and some of their acquired results individually and collectively, I would say I am convinced evidence based practice is worth the time, attention and resources utilized in sustaining researches, grooming future innovators, while also honing in on how to better incorporate evidence based practices into most if not all aspects of healthcare. An example of evidence based practice at work would be the change that was incorporated to the new ways of following through with CPR which formally was accessing a patients airway, breathing and circulation (ABC), but now following from innovative results backed by evidence based practice, the new order of CPR is circulation, airway and breathing (CAB). According to Melnyk (2018, p29) “It is time for practitioners from all healthcare professions to embrace EBP and quickly move from practices steeped in tradition or based on outdated policies to those supported by sound evidence form well designed studies.”

                                                                                                            References

Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving Patient Care Through Nursing Engagement in Evidence-Based Practice. Worldviews on Evidence-Based Nursing, 13(2), 172–175. https://doi-org.ezp.waldenulibrary.org/10.1111/wvn.12126

Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A., & Davidson, J. E. (2016). Predictors of Evidence-Based Practice Implementation, Job Satisfaction, and Group Cohesion Among Regional Fellowship Program Participants. Worldviews on Evidence-Based Nursing, 13(5), 340–348. https://doi-org.ezp.waldenulibrary.org/10.1111/wvn.12171

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Deannas discussion

The healthcare organization website I reviewed is the American Psychiatric Nurse Association (APNA). This organization is the largest membership organization that focuses on different aspects of mental health. For example, they focus on wellness, prevention, and treatment for mental health disorders (APNA, n.d.). As I look for evidence-based practice (EBP) on this website, it is spread out through their vision, structure, collegiality, and continuing education. According to Melnyk and Fineout-Overholt (2018), “EBP enhances healthcare quality, improves patient outcomes, reduces costs, and empowers clinicians”.

The work is grounded in EBP. In the vision statement, they promote EBP advances. In their structure, APNA shares research via online, conference calls, and through chapter meetings. APNA believes this is a way to distribute standards quickly and can reach a wide audience. With collegiality, APNA disperses state of the art information through the website and other modalities that are available to their members only. Lastly, APNA uses continuing education that provides the most current information in mental health research and practices (APNA, n.d.).

The information I discovered change my perception of the organization. I did not know very much about the organization, but after looking into it, I have a better appreciation for what they offer psychiatric nurses and providers who work in this field. I like the idea of conferences that provide continuing education and current information. APNA provides in-person education and online education (APNA, n.d.). It is important to belong to some type of professional organization and one that is specific to your field because they help promote policy and practice. They also provide career growth, networking, and education (Nichols, 2020).

References

American Psychiatric Nurses Association. (n.d.).  About the American psychiatric nurses association: An introduction. Retrieved December 1, 2020, from https://www.apna.org/i4a/pages/index.cfm?pageid=3277

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Nichols, J. (2020, September 2020). 10 benefits of joining professional nursing organizations and associations. Retrieved December 1, 2020, from https://nurseslabs.com/10-benefits-joining-professional-nursing-organizations-associations/

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In order to formulate your evidence-based practice (EBP),

 

In order to formulate your evidence-based practice (EBP), you need to assess your organization. In this assignment, you will be responsible for setting the stage for EBP. This assignment is conducted in two parts: an organizational cultural and readiness assessment and the proposal/problem statement and literature review, which you completed in NUR-550.

Section A: Organizational Culture and Readiness Assessment

It is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation. Select an appropriate organizational culture survey tool and use this instrument to assess the organization’s readiness.

  1. Develop an analysis of 250 words from the results of the survey, addressing your organization’s readiness level, possible project barriers and facilitators, and how to integrate clinical inquiry, providing strategies that strengthen the organization’s weaker areas.
  2. Make sure to include the rationale for the survey category scores that were significantly high and low, incorporating details or examples. Explain how to integrate clinical inquiry into the organization.
  3. Submit a summary of your results. The actual survey results do not need to be included.

Section B: Proposal/Problem Statement and Literature Review

In NUR-550, you developed a PICOT statement and literature review for a population quality initiative. In 500-750 words, include the following:

  1. Refine your PICOT into a proposal or problem statement.
  2. Provide a summary of the research you conducted to support your PICOT, including subjects, methods, key findings, and limitations.

 

P: The lower SES population diagnosed with diabetes type 2.

I: Analysis of the current SES barrier health disparities impedes the provision of quality health care facilities.

C: Promoting equality in the provision of health care procedures to patients with diabetes from the lower SES population.

O: Deliver improved quality of healthcare to the lower SES population to attain the healthy people goal 2020.

This research shows health disparities and determinants regarding those individuals who have diabetes. This PICO is modifiable and open to exploring.

 My PICO was based on the Socioeconomic Status (SES) and geographical location. the disparities in the health care system, with a specific focus on SES and how it affects the access and availability of quality care. In general, the SES can be classified by one’s education, earnings, and occupation. They live in rural and undeveloped regions where there is a lack of medical support, education, and job. Health disparities place a tremendous strain on the community of health care and on culture. Evidence shows that lower SES is associated with the increased health disparities in diabetes patients among U.S. populations. In addition, the collection of data and information among high-risk diabetes groups is appropriate to tackle the health problem in the United States. I provided an intervention that utilized appropriate financing and donation programs would encourage health interventions from distinct ethnic and racial groups to treat diagnosed patients. People have different beliefs and attitudes about individuals with diabetes. Diabetes incidence is different among the various ethnic groups. Appropriate projects need to be developed to eliminate lower SES health disparities.(Healthy People 2020, 2018) 

General Guidelines:

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.

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Death and Dying

  • No single word responses (at least 50+ words in each response)
  • Give the questions some thought and answer honestly.
  • Give examples if you have them
  • Cite resources
  • Number your answers to correspond with the question
  • Worth 12 points / 5%

Questions:

  1. Describe the location, age, and reasons most people in the United States die today. Use and cite resources.
  2. What are advances in medical technology that impact chronic illnesses and ultimately dying? Give examples.
  3. In your opinion, what is the difference between death and dying? Give examples.
  4. Identify characteristics of what a good death might be for yourself. Include characteristics that are related to your culture. 
  5. What age do you wish to live to and why? 
  6. I do not wish to die before, but I do wish to die before…Support your answer.

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Strategy

 

Now that Barbara has an understanding of the factors that influence clinic performance, it is time to set priorities and develop a preliminary strategy. A clear strategy helps to focus energy and resources, establish organizational direction, and strengthen operations where there are opportunities for improvement.

For this project assignment on UCCO, complete a minimum of a 2-page report to describe a high-level strategy with associated action items for, to include the following concepts:

  • Based on the results of the SWOT analysis, what should Barbara recommend as an overall strategy?
  • How will the selection of the chosen EHR system contribute to the strategy? Further explain why it was the best choice.
  • On what basis should she develop actions items? What should the action items be, as they directly relate to the strategy?
  • What should the recommended outcomes and/ or long-term goals be, based on the action items?

Visit the Rasmussen online Library and search for a minimum of 2 articles covering the topics of strategic planning and healthcare management. Conduct academic research using the library’s databases, like:

  • CINAHL
  • Discovery
  • Business Source Complete via EBSCO
  • Business via ProQuest

Remember to integrate citations accurately and appropriately for all resource types; use attribution (credit) as a method to avoid plagiarism. Use NoodleBib to document your sources and to complete your APA formatted reference page and in-text citations.

Transferable Skills for this Project Stage:Critical Thinking

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Research Ethics

Find a Research Article and state under which category you think the researchers obtained approval for their study, is it Research Exempt from Full Review, Expeditable Research, or Research Requiring Full Review? 

On the discussion board, post a description of the study, including the methodology and your rationale to support it fitting the category you selected (Research Exempt from Full Review, Expeditable Research, or Research Requiring Full Review), defend your answer. 

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Nursing Leadership in a Diverse Society

Discussion Question 1

The COVID-19 Pandemic has presented the nation and health care organizations with an unforeseen emergency. This type of situation requires all health professionals to be leaders in their communities.

·  Review this article https://gacc.nifc.gov/cism/documents/leadership.pdf 

·  Review the ANA statement calling for a collaborative effort to respond to COVID-19 at this link https://www.nursingworld.org/news/news-releases/2020/american-nurses-association-calls-for-collaborative-effort-to-respond-to-the-coronavirus/

Answer these questions:

1. In your present health care organization how well prepared is the organization and the staff to respond to the pandemic?

2. What was the nursing leaders’ response to the crisis?

3. Relate the response to the theories you learned in this course and the Crisis Leadership article.

4. What else should be done to improve the response? What is the leader’s role in this improvement?

5. How are you responding to the pandemic as a health care professional and leader?

As in all assignments, cite your sources in your work and provide references for the citations in APA format. Support your work, using your course lectures and textbook readings. Helpful APA guides and resources are available in the  University Online Library. Below are guides that are located in the library and can be accessed and downloaded via the  University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.

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Anticipatory Grief

Topic: Anticipatory Grief

What is anticipatory grief?

Stages of anticipatory grieving ?

sign and symptoms

Ways of coping?

3 paragraphs include include at least 2 references nothing older than 2015

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REPLY 1

Neurological System

The nervous system is a collection of nerves and specialized cells forming a spectacular network of connections which transmit signals between different parts of the body. It controls the activities of all body organs and tissues. Structurally, it is organized into two parts: the central nervous system, comprising the brain and spinal cord, and the peripheral nervous system, which connects the central nervous system to other parts of the body. 

The aging process is associated with many biological, physiological, environmental, psychological, behavioral, and physical processes. These changes often result in several complex health conditions dubbed geriatric syndromes. Most cells have a short life span and are easily regenerated and replaced by new cells in the human body. On the other hand, nerve cells are generated in vivo, have a longer life span, and are usually not replaced when they die or are destroyed. 

Several changes occur in the central nervous system. Firstly, nerve cells and supporting neuroglia are gradually lost with age. On the other hand, the remaining cells function less efficiently, and there is an increased concentration of harmful materials such as free radicals and iron in the remaining brain tissue (Knight & Nigam, 2017). Secondly, there is a decrease in brain mass leading to decreased function of affected areas such as the cerebral cortex, hippocampus, and motor cortex, manifesting as impairments in higher functions, memory loss, and gait. Thirdly, the ventricles increase in size and due to the loss of cells lining the ventricles. Fourthly, there is a decrease in cerebral blood flow and diminished integrity of the blood-brain barrier over time. There is also a decline in the production of neurotransmitters. Lastly, age-related changes to the vertebrae and intervertebral discs may increase pressure on the spinal cord and its branching nerve roots. This can slow down nerve impulses’ conduction along motor neurons, contributing to reduced muscular strength (Manini et al., 2013).

There is a slowed nerve conduction in the peripheral nervous system attributed to decreased axonal length, loss of mitochondria, and degeneration of peripheral neurons’ myelin sheath. This may result in decreased sensation, slower reflexes, and clumsiness. On top of that, damaged neurons are not repaired efficiently in older adults, and some are not repaired at all. 

The decrease in brain function with aging may impair mental function seen in neurodegenerative conditions such as delirium and dementia. Delirium is defined as an acute confusional state characterized by an acute decline in attention-focus, perception, cognition, and consciousness. In contrast, dementia is an acquired global impairment of intellect, memory, and personality but without impaired consciousness. 

The two conditions are similar in that they exhibit similarities in their presentation: impaired memory and judgment, confusion, disorientation, and variable degrees of paranoia and hallucinations (Fong et al., 2015). However, they also have some differences. Delirium usually has an acute onset, fluctuating course lasting days to weeks can occur at any age but is more common in the elderly with underlying conditions. On the contrary, dementia has an insidious onset, has a chronic course lasting months to years, and is more common in the elderly. Delirium is essentially due to reversible impairment of cerebral oxidative metabolism, while dementia is caused by exogenous insult or an intrinsic process affecting cerebral neurochemistry. The causes of delirium include metabolic disorders, toxins, infections, anatomic disorders, withdrawal, trauma, hypoxia, deficiencies, endocrinopathies, heavy metals, and acute vascular events (Inouye et al., 2014). On the other hand, dementia results from neurodegeneration, vascular defects, toxins, infections, autoimmune disorders, neurometabolic disorders, and other endocrinopathies.

References

Knight, J., & Nigam, Y. (2017). Anatomy and physiology of ageing 5: the nervous system. Nursing times113(6), 55-58.

Inouye, S. K., Westendorp, R. G., & Saczynski, J. S. (2014). Delirium in elderly people. The Lancet383(9920), 911-922.

Manini, T. M., Hong, S. L., & Clark, B. C. (2013). Aging and muscle: a neuron’s perspective. Current opinion in clinical nutrition and metabolic care16(1).

Fong, T. G., Davis, D., Growdon, M. E., Albuquerque, A., & Inouye, S. K. (2015). The interface between delirium and dementia in elderly adults. The Lancet Neurology14(8), 823-832

REPLY 2

Neurological SystemAs human beings age, the cerebral and the nervous system experience natural modifications as they begin to decline. The cerebral framework and the spinal cord get deprived of nerve cells along with their mass, known as atrophy (Xu et al., 2017). The nervous cells begin to convey messages slower than before. Byproducts can accumulate in the cerebrum tissue as the nerve cells disintegrate. This breaking down can cause strange alterations in the cerebrum known as tangles and plaques to begin to develop.The malfunctioning of the nerves may influence an individual’s senses. A fatty brown colored shade termed lipofuscin may likewise form in the nerve tissue. The patient may lose or have diminished reflexes or reduced sensation. This reduction in sensation and reflexes triggers problems with locomotion and an individual’s health. The slowing down of thinking, memory, and thought is a usual phase of aging. These advances are not identical for every human being.Some individuals have numerous adjustments in their nervous and cerebral tissue, other individuals have minimal to no changes. These advances are not ordinarily recognized with the influences on an individual’s capability to think. At the age of 30, an individual’s neurons decrease in quantity, the size and number of neurological cells increase, axons and dendrites start thinning and declining in quantity (Xu et al., 2017). The deviations that transpire in the central nervous system during the aging process are a reduction of the inflow of blood to the brain and a decrease in the brain’s size and weight.As one continues to age, some peripheral neurons depict shrinking of axonal extent, degeneration of myelin sheaths, and mitochondria reduction. The harm may begin due to an increase in the concentration of pro-inflammatory influences in the human body. The maturing body turns out to be less compelling in clearing harmful metabolites, and as the peripheral nerves are hardly managed, this inefficiency can add to peripheral nerve injury. The reduction of myelin eases back the conduction of peripheral nerve driving forces. In healthy patients, this decrease in conductivity leads to a few issues, but in high-risk patients such as those with diabetes, it might intensify to diabetic neuropathy (Wong et al., 2018). Harmed peripheral nerves are not fixed as easily in more seasoned individuals as in their more youthful years. A portion of these nerves are never fixed, and the damage can lead to decreased motor control and sensation.Delirium refers to an abrupt modification in the brain that leads to emotional disturbance and mental confusion. Delirium makes it challenging to remember, pay attention, think, and sleep. Although the cause of delirium is not exact, it is commonly caused by infections, organ failure, or medications. Dementia, on the other hand, is a loss of memory, problem-solving capabilities, language, and other thinking capabilities that are serious enough to disrupt one’s daily life (Livingston et al., 2020). Dementia occurs as a result of loss or damage of nerve cells and the links with the brain. Both dementia and delirium get attributed to confusion, hallucinations, impaired memory, and disorientation. The difference between the two is that delirium is a result of drug toxicity or acute illness and is usually reversible. Moreover, dementia is caused by anatomical changes in the brain and is usually irreversible.

ReferencesLivingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., … Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413–446. https://doi.org/10.1016/s0140-6736(20)30367-6.  (Links to an external site.)Wong, J. C., Walsh, K., Hayden, D., & Eichler, F. S. (2018). Natural history of neurological abnormalities in cerebrotendinous xanthomatosis. Journal of Inherited Metabolic Disease, 41(4), 647–656. https://doi.org/10.1007/s10545-018-0152-9.  (Links to an external site.)Xu, X., Wang, B., Ren, C., Hu, J., Greenberg, D. A., Chen, T., Xie, L., & Jin, K. (2017). Age-related Impairment of Vascular Structure and Functions. Aging and Disease, 8(5), 590.

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