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You are an RN working in the ED, looking after Mrs. Wong, a 93-year-old with an admitting diagnosis of Acopia. Mrs. Wong is alert and oriented, has mild urge urinary incontinence, and general frailty. All acute interventions have been completed for Mrs. Wong, but the wards are full, so she will spend the next 8 hours (+) on an ED trolley in a corridor.

1. What is the potential impact on staff and patients of a diagnosis based on the labeling of a patient? In this case, the label of 'Acopia.'

2. How do normal physiological changes of aging increase the risk of Mrs. Wong developing a pressure injury in this scenario? Consider the integumentary system plus two other body systems in your answer and provide detailed science-based rationales for why the physiological changes mentioned impact pressure injury risk for Mrs. Wong.

3. Provide detailed evidence-based nursing interventions with rationales that should be implemented for Mrs. Wong to reduce the risk of her developing a pressure injury while in ED. Do not include referrals in your answer.

Aim of writing:
- Understand experiences of aging and how these are impacted by biopsychosocial, spiritual, and cultural factors.
- Demonstrate advanced knowledge of pathophysiology related to the aging process.
- Critically apply the Roper-Logan-Tierney Model of Nursing to the context of aging.
- Critically apply legal and ethical principles related to the care of the older adult.

Answer :

1. Labelling a patient with a diagnosis like "Acopia" can lead to bias, stereotyping, and reduced care from staff, while also affecting the patient's self-perception and engagement in their care.2. Age-related physiological changes, such as thinning and fragile skin, muscle wasting, decreased subcutaneous tissue, and impaired circulation, increase Mrs Wong's risk of pressure injuries in this scenario. 3. Nursing interventions should include frequent repositioning, adequate nutrition and hydration, regular skin assessments, moisture management, and patient/family education to reduce pressure injury risk for Mrs Wong in the ED.

1. Potential impact of a diagnosis based on labelling (Acopia): Staff: Labelling a patient with a diagnosis such as "Acopia" can have negative effects on staff. It may lead to bias, stigmatization, or stereotyping, where staff may assume the patient's condition is solely due to social consequences or non-medical causes. This could potentially result in reduced attention or inadequate care being provided.

2. Physiological changes of ageing increasing pressure injury risk for Mrs Wong: Integumentary system: With ageing, the skin becomes thinner, less elastic, and more fragile. This makes it more susceptible to damage and slower to heal. Mrs Wong's skin may have reduced protective capabilities, increasing the risk of pressure injuries. Musculoskeletal system: Age-related muscle wasting and decreased subcutaneous tissue can result in reduced padding over bony prominences. This exposes the skin to more direct pressure, increasing the likelihood of pressure injuries.

3. Evidence-based nursing interventions to reduce pressure injury risk for Mrs Wong in the ED: Frequent repositioning: Regularly reposition Mrs Wong every 1-2 hours to relieve pressure on vulnerable areas. Encourage small changes in position to reduce sustained pressure on specific areas. Adequate nutrition and hydration: Ensure Mrs Wong receives adequate nutrition and hydration to support skin health and tissue viability.

To learn more about social consequences , here

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