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Course Competency :
Design plans for care specific to the older adult.
Consider the scenario below, then follow the instructions underneath it to complete the assignment.
Mrs. Y
Mrs. Y is an 84-year-old client who was recently discharged from the hospital for an infected diabetic ulcer on her left leg. During her hospitalization, Mrs. Y required intravenous antibiotic therapy through a peripherally inserted central catheter (PICC) line.
Due to Mrs. Y’s long history of diabetes, her physician ordered that intravenous antibiotic therapy be continued at home. Subsequently, home health services were initiated, a home health nurse was assigned to Mrs. Y’s case, and an initial home visit was scheduled.
The home health nurse arrives at Mrs. Y’s home and introduces herself to the client and the family. The nurse explains the home nursing services that will be provided, including the PICC line and intravenous antibiotic therapy treatments.
During the initial home visit, the nurse assessed the physiological, psychological, functional, and safety needs of the client. The nurse’s findings were as follows:
Mrs. Y lives alone; however, her daughter checks on her frequently throughout the day.
The client is noted to have moderate functional issues and ambulates with a cane.
The client has several throw rugs in the main walking quarters and minimal lighting throughout the hallways.
Mrs. Y states “I used to get around my house with ease, but now I get a little tired and have to sit down and rest frequently.”
Consider Mrs. Y’s current health status and functional decline, then address the following:
Download the Concept Map and Plan of Care worksheet below. An example is also provided for your reference.
Concept Map and Plan of Care worksheet
Concept Map and Plan of Care example
Identify three (3) priority nursing diagnoses for Mrs. Y. Visit the School of Nursing Guide Nursing Reference eBooks section for resources to assist with nursing diagnoses.
Create a visual representation of the three (3) priority nursing diagnoses by incorporating them into the Concept Map (template in the worksheet). Be sure each nursing diagnosis includes the following elements:
“related to (r/t)” — description of the client’s problem
“as evidenced by” — description of the client’s symptoms
Complete the Nursing Plan of Care (table in the worksheet) describing what should be implemented for Mrs. Y.
Goals: Establish at least one (1) goal for each of the nursing diagnoses you identified (for a total of 3 goals). Goals should be: patient specific, measurable, actionable, realistic, and time limited.
Nursing Interventions: Describe at least three (3) nursing interventions for each of the goals (for a total of 9 nursing interventions). Each intervention should be in alignment with the goal it is supporting.
Complete the assignment using proper spelling, grammar, and APA.
For information about creating a concept map, review the FAQ, What is a concept map and how do I create one

I need help responding to the attached 4 peers’ posts in 225 words each, please provide references too.

1) Minimum 6 pages (No word count per page)- Follow the 3 x 3 rule: minimum of three paragraphs per page ( minimum 300 words per page)
You must strictly comply with the number of paragraphs requested per page.
The number of words in each paragraph should be similar
Part 1: minimum 3 pages
Part 2: minimum 3 pages
2)¨******APA norms
The number of words in each paragraph should be similar
Must be written in the third person
All paragraphs must be narrative and cited in the text- each paragraph
The writing must be coherent, using connectors or conjunctive to extend, add information, or contrast information.
Bulleted responses are not accepted
Don’t write in the first person
Do not use subtitles or titles
Don’t copy and paste the questions.
Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph
Submit 1 document per part
3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks)
********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)
********************************It will be verified by the AI writing Detector (Identify the percentage of AI writing)
4) Minimum 4 references (APA format) per part not older than 5 years (Journals, books) (No websites)
All references must be consistent with the topic-purpose-focus of the parts. Different references are not allowed
5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next
Example:
Q 1. Nursing is XXXXX
Q 2. Health is XXXX
Q3. Research is…………………………………………………. (a) The relationship between……… (b) EBI has to
6) You must name the files according to the part you are answering:
Example:
Part 1.doc
Part 2.doc
_______________________________________________________________________________
Part 1: Evaluation and Evidence-Based Practice in Recreational Therapy
Case:
Margaret Mae is a 70-year-old retired therapeutic recreation university professor. She has no siblings or family members but maintains a close relationship with her best friend and colleague, Cheryl. She has two dogs that she loves deeply and has kept horses and an array of pets for years. Cheryl is her primary caregiver and support. She lived on a ranch in a rural community and was recently relocated to the assisted living facility. She enjoyed walks, visits to old friends, church, and concerts while able to travel. Margaret was highly respected in the field of recreation and very social. Cheryl first noticed Margaret showing signs of memory lapses; for example, losing reader glasses, poor driving judgment and position on the road, difficulty with checkbook calculations, forgetfulness, changes in reasoning capabilities, unnecessary purchases including a second home approximately two years prior to diagnosis. Cheryl voiced concerns to her primary care physician, but no testing was done until much later. Diagnostic MRI confirmed Cheryl’s suspicion of senior vascular dementia and Alzheimer’s dementia. Margaret became unable to care for herself and was placed in an assisted living facility. She was moved to your facility after an incident of elopement. You are a CTRS at the assisted living facility where Margaret now resides. You review
Significant past medical history:
– Family history of Alzheimer’s dementia, father and maternal grandmother.
– Mild hypothyroid treated with medication.
-Rheumatoid arthritis with minimal impact to mobility.
– Client had an incident of being overmedicated with psychotropic drugs, which led to a period of severe reduction in her overall function and ability to communicate and ambulate and masked a stroke that occurred; stroke induced aphasia.
– Once taken off these drugs, she began a 6-month period of regaining better overall functioning but never fully recovering
Medications: Levothyroxine (Synthroid) once daily.
Cognition/perception:
-Alzheimer’s dementia. Client has been admitted nonverbal but is alert and aware of environment.
– She reacts with head nods and smiles.
-She communicates with body language and occasionally will speak a few simple words.
Aphasia is present.
Physical examination:
-Client was examined upon entrance to the assisted living facility all physical functions with in normal limits.
-Stroke affected her left side minimally and she can ambulate without assistance.
Client Goals
1- Opportunities to socialize without pressure of speaking
2- Meaningful and safe activities to pass the time
3- Physical activity to assist with balance and coordination
1. Create a treatment plan for Margaret Mae, using evidence-based practice to guide your decision on appropriate interventions following the DENT problem solving method.
a. Define the problem: Clearly identify and articulate the specific problem or challenge that needs to be addressed. This involves understanding the current situation, desired outcomes, and any constraints or limitations (1 paragraph)
b.Explore possible solutions: Generate a range of potential solutions or approaches to solving the problem. Encourage creative thinking and consider different perspectives or alternative options.(1 paragraph)
c. Narrow down options: Evaluate the potential solutions and select the most feasible and effective ones. Consider the advantages, disadvantages, and potential risks associated with each option.(1 paragraph)
d. Take action: Implement the chosen solution or solutions. Develop a plan, allocate resources, and set specific goals and timelines for execution. (1 paragraph)
2. What assessment would be most appropriate for you to give to Margaret? (1 paragraph: Question 2 and Question 3)
3. What factors must be considered when planning Margaret’s treatment 3. What is your PICO question?
4. “What outcomes do you anticipate from your treatment plan? (1 paragraph: Question 4 and Question 5)
5. How will you evaluate the outcomes of your treatment plan?
6. How will you evaluate the outcomes of your treatment plan? (1 paragraph: Question 6 and Question 7)
7. What contraindications should you consider in Margaret’s treatment?
8. What recreational activities would be appropriate considering Margaret’s interests, goals, and current functioning level? (1 paragraph)
9. How would you communicate your recommendations to Margaret? (1 paragraph: Question 9 and Question 10)
10. How will you include Cheryl, Margaret’s caregiver, in your intervention plan?

Part 2: Evaluation and Evidence-Based Practice in Recreational Therapy
Case:
“The ClientDan Brown is a 47-year-old Mexican American who holds a master’s degree in recreation/sports management as well as a bronze medal in quad rugby from the Paralympic games. He lives independently with his wife and works for the facility. He has also written a book, co-starred in a movie, and is a disability advocate and public speaker. He enjoys participating in sports activities in addition to volunteering at his church and being an advocate in adaptive and competitive wheelchair sports. At the age of 9, Bob contracted a rare form of meningitis. To save his life, all four limbs had to be amputated. Dan uses prosthetic upper limbs to assist with dressing, driving, and activities as needed. He competes all ADLs independently.Dan comes to you, the intern at the training facility, to generate new ideas. Dan shares the following information from his background so you can begin brainstorming
Significant past medical history:
-Childhood meningitis resulting in amputation of four limbs.
-After amputations, Dan has had over 20 surgeries for skin grafts and plastic surgeries to reshape face and residual limb damage from the illness.
-Dan had a car accident, which resulted in the further amputation of the left residual limb.
-He also had a broken collarbone and minor hip fraction from this accident.
Medications: Claritin and multivitamin for men over 40.3.
Cognition/perception:
WNL4.
Physical examination
a. Sensation: Light touch pain at the end of all residual limbs. Phantom pain in amputated legs periodically.
b.ROM: WNL
c.Strength: Above normal limits. Can bench press 150 lbs.
d.Balance: WNL
e.Pain: Phantom pain lower limbs”
Mobility
a.Uses a Performax manual wheelchair, drives independently with hand controls.
Uses prosthetic arms for fine motor skills.
b.Transfers: Independently, including placing chair in car for driving
Client Goals
1.Continue playing competitive wheelchair sports: wheelchair rugby and tennis
2.Travel to places I’ve wanted to go; to Miami and Rome, Italy
3.To stay active in community and church community
4.Travel for book promotion
1. Create an inclusion plan for Dan Brown, using evidence-based practice to guide your decision on appropriate interventions following the DENT problem-solving method.
a. Define the problem: Clearly identify and articulate the specific problem or challenge that needs to be addressed. This involves understanding the current situation, desired outcomes, and any constraints or limitations (1 paragraph)
b.Explore possible solutions: Generate a range of potential solutions or approaches to solving the problem. Encourage creative thinking and consider different perspectives or alternative options.(1 paragraph)
c. Narrow down options: Evaluate the potential solutions and select the most feasible and effective ones. Consider the advantages, disadvantages, and potential risks associated with each option.(1 paragraph)
d. Take action: Implement the chosen solution or solutions. Develop a plan, allocate resources, and set specific goals and timelines for execution. (1 paragraph)
2. What assessment would be most appropriate for you to give to Dan (1 paragraph: Question 2 and Question 3)
3. What factors must be considered when planning Dan’s intervention?
4. What is your PICO question?(1 paragraph: Question 4 and Question 5)
5.What outcomes do you anticipate from your treatment plan?
6.How will you evaluate the outcomes of your treatment plan?(1 paragraph: Question 6 and Question 7)
7.What contraindications should you consider in Dan’s treatment?
8.What recreational activities would be appropriate considering Dan’s interests, goals, and current functioning level? (1 paragraph)
9.How would you communicate your recommendations to Dan?” (1 paragraph)