The person involved in my nursing assessment is a retired female patient

The person involved in my nursing assessment is a retired female patient approximately 82 years of age, living at own home alone with carers visiting multiple times a day. She has a history of ischaemic stroke. This is the most common type of stroke and is caused by a blockage of blood supply to the brain (Stroke Association, 2019) The patient has Type 2 diabetes which is consistent with her family history. Type 2 diabetes is an incurable condition which is identified by the advancement of resistance to insulin being made and a deterioration of the beta cells’ ability to improve the creation of insulin in response to the resistance. This results in high blood volumes of glucose (sugar) which in turn causes damaging effects to the beta cells and furthermore decreasing the production of insulin in the body (Peate, 2018). The patient also has angina pectoris, which is a lack of blood flow to the heart muscles. This condition causes chest pain in the patient and her oxygen levels are low as a consequence (Roth, 2018). As the patient has fallen multiple times, she has reduced mobility and multiple injuries all over her body. Most prominently she has a venous leg ulcer on her left side, distal and medial to the knee. A venous leg ulcer is caused by high pressure in the lower leg veins damaging the small blood vessels and causing the leg to feel inflamed. The healing of the ulcer is resisted because of the poor blood supply to the leg. A small trauma could cause the skin to break (British Association of Dermatologists, 2017). The patient also has a nasogastric feeding tube (NG) inserted as when the patient had her speech and language therapy she couldn’t swallow. Swallowing problems also known as dysphagia are common in patients with stroke, with around about 50% affected (Schilling, Konrad & Lüdemann, 2003). An NG tube is a thin catheter that is inserted through the nostril to the nasopharynx, this part of the procedure can often be uncomfortable for the care receiver, therefore, ensure the patient is aware of the nature of the procedure is paramount. The catheter then continues down to the oesophagus. The care giver must make sure the tube is not coiling throughout the procedure (Potter, 2019). The likelihood of conditions that impair mobility are increased not only by age but also conditions such as such as stroke, angina or arthritis. Age causes the skin’s elasticity to deplete over time, decreasing the support of the tissue and vessels in the body (Todd, 2019). Other multiple factors such as the patient’s age, her stroke and her diabetes mean that there is a higher risk of the patient developing a leg ulcer (Berry, 2019). The ulceration on this patient occurred though mild trauma to the area and as the treated individual is of old age and reduced mobility, this has caused the healing process of the skin to be delayed (Todd, 2019). Physical development has been impaired in some ways as the patient had returned to hospital with an evolution of a previous stroke shown by the computerised tomography scan (CT). The patient’s mobility is restricted as the stroke had caused hemiparesis, a weakness in the lateral side the same side as her venous leg ulcer. (Hemiparesis n.d). The stroke has also affected the cognitive development of the care user as she was unable to speak at all even though she appeared to be conscious. The main nursing problem to be assessed is the pain that the patient is in. In accordance with the Fundamentals of Care, (Welsh Assembly Government, 2003) “Ensuring comfort and Alleviating Pain” is of the utmost importance

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