Alzheimer’s disease Research Paper

Alzheimer’s disease
Alzheimer’s disease

Want help to write your Essay or Assignments? Click here

Alzheimer’s disease

Since patient wandering and confusion are common for the patient with moderate-to-severe Alzheimer’s disease, what would the RN teach the family about maintaining a safe environment? Provide three examples.

The RN should teach the family that patients diagnosed with Alzheimer can comfortably live in their homes, provided the safety measures are put in place. The family members must be educated on ways Alzheimer disease causes changes in the patient’s brain and body functions. This affects the patient reasoning, judgement, physical ability, behaviour, cognitive functions and sense of time (Bridenbaugh, Monsch & Kressig, 2012).

The family should be taught on ways to identify the possible dangers.  The hazardous areas should be locked.  Drugs and other chemical substances should be stored out of reach, in lockable cupboards.  The family must be ready for emergencies. This implies that they should keep emergency phone numbers such as fire departments and local police helplines. The family members should ensure that the safety devices are   working.

These include smoke detectors and carbon monoxide detectors and fire extinguishers.  Walkways should be well lit to prevent falls. All weapons such as guns or other types of weapons must be removed. Basically, the home must be well lit, ventilated and free from hazards. The home should not be too restrictive, but one that encourage social interaction and independence (Schneider, 2011).

Want help to write your Essay or Assignments? Click here

To prevent the patient from wandering, the patient’s relatives and care givers should be taught the following strategies. To start with, they should create a daily activity plan. This helps identify the times of the day that wandering occurred. The patient must be reassured whenever they feel lost, disoriented or abandoned.  The care giver must refrain from using correcting the patient using harsh voice.

All patients’ basic need must be met. They should not allow the patient to go places that trigger confusion and disorientation such as grocery stalls, malls or other venues that are busy.  The doors must remain locked, and keys including car keys put out of sight. The patient must never be left alone i.e. they should always be under supervision. If the main issue is night wandering, devices that signal motions should be used (Lacey, Jones, Trigg & Niecko, 2012).

How would the RN adjust the teaching based on the family’s educational level, socioeconomic status or culture? Provide two examples

 Despite the increase emphasis on patient centred care, when it comes to coping strategies for Alzheimer, the healthcare provider should focus on family centred care. In this case, the RN must conduct a family assessment   to understand patient structure as well as style. This helps RN formulate effective teaching plan (Skoog, 2011).

To begin with, the RN should evaluate the barriers that would hinder the family ability to deliver health care.  This includes the ages, sex and health status of the family member. The family socioeconomic status influences the teaching strategy. People from high socioeconomic status are most likely to be educated, thus basic healthcare can be used during the teaching process.

However, those from low income households tend to have low level of education which determines people’s attitudes and perceptions of care. Additionally, some family members lack basic knowledge of the disease. Cultural backgrounds could make some patients to believe in folk medicine. These factors must be addressed when teaching the patient’s family members (Trigg, Jones, Lacey & Niecko, 2012).

Want help to write your Essay or Assignments? Click here

What are common symptoms of caregiver role strain?

 The demands of giving care to Alzheimer patients are very taxing which can lead to care givers strain and burnout. These are manifested through stress, anxiety, exhaustion, and sleep disturbances. Other common symptoms of care giver role strains include changes in appetite, depression, withdrawal and mood swings (Trigg, Jones, Lacey & Niecko, 2012).

Provide one nursing diagnosis statement (statement must include an actual nursing diagnosis, related factor and as evidenced by) that may be appropriate for a patient with moderate-to-severe Alzheimer’s disease.

Anxiety related to stress and situational crisis as evidenced by insomnia, restlessness, memory loss, and cognitive functions deficits.


Bridenbaugh, S., Monsch, A., & Kressig, R. (2012). How does gait change as cognitive decline progresses in the elderly?. Alzheimer’s & Dementia, 8(4), P131-P132.

Lacey, L., Jones, R., Trigg, R., & Niecko, T. (2012). Caregiver burden as illness progresses in Alzheimer’s disease (AD): Association with patient dependence on others and other factors—Results from the Dependence in Alzheimer’s Disease in England (DADE) study. Alzheimer’s & Dementia, 8(4), P248-P249.

Schneider, L. (2011). Agitation and Alzheimer’s disease. Alzheimer’s & Dementia, 7(4), S92.

Skoog, I. (2011). Vascular Disease Risk Factors and Alzheimer’s Disease. Alzheimer’s & Dementia, 7(4), S284.

Trigg, R., Jones, R., Lacey, L., & Niecko, T. (2012). Relationship between patient self-assessed and proxy-assessed quality of life (QoL) and patient dependence on others as illness progresses in Alzheimer’s disease: Results from the Dependence in Alzheimer’s Disease in England (DADE) study. Alzheimer’s & Dementia, 8(4), P250-P251.

Want help to write your Essay or Assignments? Click here

Chronic Venous Insufficiency (CVI)

Chronic Venous Insufficiency (CVI)

Chronic Venous Insufficiency (CVI)
Chronic Venous Insufficiency (CVI)

Chronic Venous Insufficiency (CVI)

Chronic Venous Insufficiency (CVI) arises due to incompetence of vascular walls as well as valves of the veins. This disorder leads reduction in blood flow to the heart resulting in pooling of blood or stasis in the extremities especially the lower limbs. Patients with CVI usually complain of pain and swelling in the limbs.

Conversely, deep venous thrombosis (DVT) arises when clotting occurs in the deep veins in the lower limbs (Patel & Brenner, 2013). Patients suffering from DVT usually complain of pain as welling as swelling just as those with CVI. The presentation of these conditions is almost similar. It is for this reason that health care providers take extra caution when diagnosis CVI and DVT.  

The Pathophysiological Presentation of DVT and Chronic Venous Insufficiency

The key pathophysiological difference between CVI and DVT is that DVT occurs in deep veins whereas CVI occurs majorly in superficial veins. Chronic Venous Insufficiency affects popliteal, femoral, and peroneal veins while DVT mail affects the soleal vein. Chronic Venous Insufficiency arises as a result of damage of the endothelial walls and valves in the veins (Eberhardt & Raffetto, 2014).

Some of the common causes of CVI include pelvic tumors, DVI, and vascular malformations. The valves of patients suffering from CVI are incompetent in that they cannot hold blood back against the force of gravity. Consequently, blood pools in the lower extremities leading to swelling especially in the ankles and the legs. Moreover, individuals with CVI present with venous stasis ulcers, varicose veins, pain the feet, and itching and flaking of the skin.

On the other hand, DVT develops due to clotting in the veins. Severe clinical complications occur when the formed clots lyse and get into the general circulation. Blood from deep veins usually flows into the lungs. Therefore, when this blood carries clots with it, it may lodge them in the lungs causing pulmonary embolism, one of the most severe result of DVT (Goldhaber & Bounameaux, 2012).

Often CVI presents with dermatitis and ulceration due to the structural difference between the deep veins and superficial veins. That is, the superficial veins have an adipose layer and a connective tissue whereas the deep veins have a fascia and muscles. This gives deep veins more protection and structural support.

Venous and arterial thrombosis have a number of similarities although they differ in terms of their pathophysiology, clinical interventions, and epidemiology. Venous thrombosis occurs in undamaged parts of venous walls and in areas that have low sheer pressure. This disorder leads to formation of red thrombi. Conversely, arterial thrombosis occurs in parts that have high sheer stress and are rich in plaques. Unlike, venous thrombosis, arterial thrombosis forms white thrombi.

Patient Behavior

The predisposition and pathophysiological advancement of DVT and Chronic Venous Insufficiency relies heavily on the lifestyle of an individual. The pathophysiology of DVT and CVI is enhanced when a person engages in activities that enhance the metabolic syndrome. Some of the most notable practices that have been cited to predispose individuals to CVI and DVT include lack of physical exercises, smoking, intake of meals rich in cholesterol, and psychosocial behavior (Csordas & Bernhard, 2013).

Smoking affects the circulation of blood and enhances blood clotting. On the other hand, inactivity such as sitting for long periods causes calf muscles to contract hence inhibiting proper circulation of blood. Lack of activity may also result in increase of weight which then increases pressure in veins especially in the legs and the pelvis.

When diagnosing of CVI and DVT based on behavior, a physician should enquire the social history of the patient. For instance, s/he can ask the patient whether s/he smokes or has ever smoked. If the patient smokes, he should enquire when the patient started smoking and how many sticks he smokes in a day. Questions on whether the patient engages in physical exercises such as jogging or long distance travelling are also essential in finding a differential diagnosis.

Clinical interventions for these patients involves the use of pharmacological as well as non-pharmacological approaches. If the patient smokes, a physician should assess the willingness of the patient to quit smoking. If s/he is willing to make a quit attempt, a brief counselling session should be introduced, medications such as bupropion will be offered as well as self-help resources. Follow-up visits should also be scheduled. The patient should also be advised to engage in physical exercises such as jogging. The patient should also limit his/her intake of cholesterol, leading factor in DVT development. 


Berkman, L. F., Kawachi, I., & Glymour, M. M. (Eds.). (2014). Social epidemiology. Oxford University Press.

Csordas, A., & Bernhard, D. (2013). The biology behind the atherothrombotic effects of cigarette smoke. Nature Reviews Cardiology10(4), 219-230.

Eberhardt, R. T., & Raffetto, J. D. (2014). Chronic venous insufficiency.Circulation130(4), 333-346.

Goldhaber, S. Z., & Bounameaux, H. (2012). Pulmonary embolism and deep vein thrombosis. The Lancet379(9828), 1835-1846.

Patel, K., & Brenner, B. (2013). Deep venous thrombosis. Medscape reference.

Want help to write your Essay or Assignments? Click here