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Skin Integrity
The following is the list of the different actions that a nurse cantake to maintain skin integrity.
Evaluate the site of skin alteration to determine the etiology. It includes the presence of a wound, pressure ulcers, dermatological lesion or skin tear.
Assess whether the skin alteration has damaged only the skin.
Observe the point of skin impairment for a minimum of one day for warmth, color changes, swelling, redness or other signs of infections. While doing this, the nurse should monitor whether the patient is having changes in pain or sensation (Gardiner, et al., 2008). Special attention should be given to areas considered as high-risk, such as the skin folds.
Evaluate the patient’s skin care habits such as the type of soap, cleansing agent, the frequency at which they cleanse, and the temperature of the water they use.
Develop an individualized plan to tackle the client’s condition depending on the client’s preferences and needs.
Evaluate the client’s continence status while at the same time minimizing the impaired skin’s exposure to moisture from wound drainage, perspiration, and incontinence.
In case the nurse finds the client to be incontinent, they should apply a plan to manage the incontinence, and prevent the affected part from coming into contact with chemicals found in the stool or the urine (Wurster, 2007).
In case, the client experience limited mobility, the nurse should utilize the risk-assessment tool to determine the risk factors related to immobility.
Assess whether or not a client needs to use specialty devices, bed or mattress as appropriate.
Maintaining Healthy Urinary Elimination
Factors that influence the volume and the ability to urinate.
When the levels of the antidiuretic hormone in the body increase, thevolume of urine decreases and vice versa. Additionally, the amount ofaldosterone in circulation influences the amount and volume of urine.When the level of aldosterone circulating in the body increases, thevolume of urine decreases and vice versa. Besides, the amount ofliquid drunk by an individual on a particular day is also animportant factor influencing the amount of urine. Urine volumeincreases when a person consumes much liquid. Also, the consumptionof fruits and vegetables that have high water content increases theamount and volume of urine. When an individual’s perspiration levelincrease, they urinate less often(Crisp, et al., 2005)
Factors affecting an individual’s ability to urinate may beclassified into growth and development, medicinal factors, andsociological factors. Regarding growth and development, adultexperiences weak muscles that affect their ability to urinate. Also,as a person ages, they experience decreased glomerular filtrate ratewhere a person`s kidneys fail to filter all waste products. Ages alsoaffect a man`s ability to urinate as it results in the enlargement ofthe prostate gland hindering the free flow of urine from the blunder.Certain disease such as Parkinson’s disease and arthritis affectsthe rigidity of muscles sometimes resulting in impaired balance. Whenan individual suffers from decreased alertness or becomes disorientedor confused, they face challenges urinating. There are also somesociological factors that include anxiety and emotional stress, timeand privacy amongst other(Estridge, et al., 2000). 
Nutrition
The toddler is the developmental stage marked by age 1 to 3 years. Ascompared to children below one year, toddlers do not need much food.However, several factors affect the amount of food a toddler needs.These factors include their activity level, size, and age. However,on overall, toddlers require approximately 1,000 to 1,400 caloriesevery day (Kidshealth, 2015). For two years toddlers, they require 3ounces of grains, particularly the whole grain ones, one cup ofvegetables, one cup fruits, two cups of milk, and two ounces of meatand beans (Kidshealth, 2015). For three year old toddlers, theyrequire Four to five ounces of grains, one and a half cups ofvegetables, one to one and a half cups of fruits, two cups of milkand two ounces of meat and beans (Kidshealth, 2015). While the aboveportions are the recommended amount for toddlers every day, otherfactors come to play when determining the amount of food a toddlerconsumes(Fox, et al., 2004). Sometimes, toddlers do not feelthe urge to eat or shows less appetite. Additionally, a toddler’sappetite changes from time to time. It is, therefore, theresponsibility of the individuals feeding the toddler to be keen andkeep offering favorites alongside new foods to the baby.
Medication Administration.
Challenges experienced when administering medication to theelderly
Memory: elderly patients often forget to take their medication. Whenthis is the case, medication administration to the elderly shouldinvolve the use of special pill boxes that acts as a reminder to theseniors that it is time to take their medicine (Family CareGiverAlliance, 2015). There is a variety of devices that one may use andincludes the low-techs, for example simple containers with labelssuch as for bedtime. There are also high techs that involve acontainer that beeps when it is time for taking the medication.
Vision: the elderly face challenges when reading medicine labels(Family CareGiver Alliance, 2015). To solve this problem, medicationadministration to the elderly should involve large letters in thelabels. Also, elderly patients may be given a magnifying glass.
Hearing: elderly patients face the challenge of hearing theinstruction as given to them by health care givers. To solve thisproblem, health caregivers should always speak louder or write downall the crucial information for the safe use of the medication.
Dexterity: An elderly encounters problems when breaking the labelseals and opening medicine bottles. Also, due to their feeble hands,they are unable to have a firm grip on containers such as the asthmainhalers, and eye drops, among others(Leufkens, et al., 2014). To overcome this hurdle,health care givers should ensure that they use easy to open and largebottle tops when prescribing medication to the elderly.
Swallowing. The elderlies encounter difficulties when swallowingcapsules and tablets. To overcome this challenge, liquid doses shouldbe used when available.
E. Factors affecting Bowel elimination.
One of the numerous factors that affect bowel elimination is thelifestyle. Lifestyle habits that affect bowel elimination include anindividual’s fluid intake, exercises, and diet (Basavanthappa,2003). The other lifestyle habit is the dietary issue.When an individual eats insoluble fiber, it does not get changed asit passes through the intestines and thus adds bulk to the stoolhindering bowel emanation. An individual ought to use both insolubleand soluble fibers as the two compliments each other. As the solublefiber softens the stool, insoluble fiber adds bulk aiding inperistalsis by stimulating the defecation reflex.
Another lifestyle issue that affects bowel elimination is the amountof fluid consumed. When an individual does not consume enough fluid,more fluids get absorbed in the body for the maintenance of theadequate hydration. Additionally, if a person travels a longdistance or engages in activities that result in them experiencinghigh perspiration rate, it results in constipation. The otherlifestyle factor is the exercises as they the muscle tone. When anindividual has atrophied or weak muscles, they face hurdleseliminating bowel as these muscles tend to be ineffective intriggering an increase in intra-abdominal pressure. Additionally,weak muscle resulting from lack of exercise fails to aid the anuscontrol defecation(Comerford, 2007).
Reflection
I must say that the above exercise has been helpful and insightful.Particularly, I had not known that there is so much a nurse can dofor a client experiencing mild pain or sensation in their skin.Something that left me surprised is that exercises are pertinent inbowel elimination. Now, I understand why the U.S. Department ofHealth & Human Services (2002), reports that 23% of deaths resultfrom a sedentary life. Before conducting research on various commonconditions facing human beings, the only factor I thought influencesbowel elimination was the amount of water consumed. Since I was achild, I have always known that water helps in peristalsis.Therefore, in the future, I will be more knowledgeable, all-roundedand bold when advising people on how to avoid certain conditionswithout incurring huge amounts of money.
References
Basavanthappa,B. T. (2003). Fundamentalsof Nursing.Jaypee Brothers Publishers.
Crisp, J., &Potter, T. C. (2005). Perry`s Fundamentals of Nursing. Google books
Comerford, K.C. (Ed.). (2007). Fundamentalsof Nursing Made Incredibly Easy!.Lippincott Williams & Wilkins.
Estridge, B.H., Reynolds, A. P., & Walters, N. J. (2000). BasicMedical Laboratory Techniques.Cengage Learning.
Family CareGivers Alliance. (2015). “CareGivers’ Guide toMedication and Aging.” Accessed on May 5, 2016.https://www.caregiver.org/caregivers-guide-medications-and-aging
Fox, M. K.,Pac, S., Devaney, B., & Jankowski, L. (2004). Feeding infants andtoddlers study: What foods are infants and toddlers eating?. Journalof the American Dietetic Association, 104,22-30.
Gardiner, L.,Lampshire, S., Biggins, A., McMurray, A., Noake, N., Van Zyl, M., &Edgar, M. (2008). Evidence-based best practice in maintaining skinintegrity. WoundPractice & Research: Journal of the Australian Wound ManagementAssociation, 16(2),5.
Kidshealth. (2015). Nutritional Guide for Toddlers.http://kidshealth.org/en/parents/toddler-food.html
Leufkens, H.G., Jansen, P. A., & Bouvy, M. L. (2014). Practical problems withmedication use that older people experience: a qualitative study.Journal of the American Geriatrics Society.
U.S. Departments of Health & Human Services. (2002). “PhysicalActivity Fundamental to Preventing Diseases.” Accessed on May 5,2016.https://aspe.hhs.gov/basic-report/physical-activity-fundamental-preventing-disease
Wurster, J.(2007). What role can nurse leaders play in reducing the incidence ofpressure sores?. NursingEconomics, 25(5),267.