Challenge of Maintaining Homeostasis with Geriatric Patients

One of the greatest challenges with geriatric patients is maintaining homeostasis and managing pain during multisystem failure. With geriatric patients the body’s ability to regulate itself physiologically in response to changes due to illness is decreased, there by leading to multisystem failure. Elderly display shock with minimal signs and symptoms which leaves little time for intervention. The best treatment form multisystem failure is prevention. This can be obtained by collaborating with multidisciplinary team including; MD, nurse, lab, radiology, respiratory and spiritual care. The prevention of infection can be obtained by using universal precautions , discontinuing IV lines, frequent turning, encouraging cough and deep breathing as well as using a Incentive Spirometer to prevent pneumonia. To ensure optimal oxygen perfusion and to decrease workloads on the heart supplemental oxygen may be required.

I’m going to review the case of a 73 year old female who was transferred to the Emergency room after collapsing in back yard. Prior to her collapse she was talking on the phone with a friend who reported “patient seemed confused”. Upon arrival to the hospital patient complains of difficulty with breathing. Her respirations and heart rate are elevated and her previous history includes diabetes and hypertension. Patient states she “just started a new blood pressure medication, Lisinopril”. Her other medications include metformin for diabetes and hydrochlorothiazide for fluid retention. Patient becomes unresponsive and is having more difficult time breathing.

Assessment of Patient:

Upon admission to ER nurse would immediately get set of VS including blood pressure looking for range of systolic <120 and diastolic <80, h...

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...ological impairment. RN would check pupils for size and shape, normal response would be 3 mm with round shape and react quickly to light and they should be equal in size. If unequally dilated with poor response to light would indicate hematoma. If both pupils are fixed and dilated this indicates severe injury to brain stem with poor prognosis (Smelter, 2004). Verbal and motor response is measured by verbal commands if no response would check by use of painful stimuli for example sternal rub.

References

Mauk, K. (2010). Gerontological Nursing: competencies for care. Sudbury, Massachusetts: Jones and Bartlett.

Smeltzer, S., & Bare, B. (2004). Medical-Surgical Nursing. Philadelphia, PA: Lippincott-Raven.

Ali H Al-Khafaji, MD, MPH, FACP, FCCP(2010) Multisystem Organ Failure of Sepsis Retrieved 02/10/2011, from http://emedicine.medscape.com