What would be a concept map for end stage Alzheimer's disease/ NANDA chronic confusion going off this story?

Question Answered step-by-step What would be a concept map for end stage Alzheimer’s disease/ NANDA chronic confusion going off this story? Mickey Mouse has cancer. He has been going through chemo for 9 months and the cancer is not improving. He is tired of feeling tired, nauseous, having pain and spending all his free time in doctor offices. He thought during his retirement he would be golfing, traveling with his senior club and spending time running around with his grandkids. He lives with his partner of 50 years. His partner, Goofy, has been struggling watching Mickey feeling so down all the time. Mickey says he is ready to die. He had a full life but is disappointed he won’t get to see his granddaughter get married. He worries about how G will manage the house and their 5 cats alone. You are a hospice nurse and you received a call from Goofy. He said that Mickey doesn’t seem to be doing well and asks you to visit. He reports that Mickey is barely eating. He eats a few bites of oatmeal in the morning with half a cup of coffee. He sleeps through lunch. Goofy tried waking him for lunch but Mickey just grunts and falls back to sleep. He gets tired while eating so Goofy has been serving him food that doesn’t require a lot of chewing. Most days for dinner Mickey will eat a small bowl of cream of mushroom soup or some mashed potatoes. Yesterday, Mickey didn’t eat anything since he said he was feeling nauseous and didn’t have an appetite. Mickey coughs a lot while eating his soup and drinking his coffee. Goofy also reports that he has been having trouble getting Mickey to the bathroom. He seems to be short of breath before he even gets there. Some days he can barely stand and Goofy puts him in a wheelchair and lifts him onto the toilet. Goofy has started putting adult briefs on Mickey since sometimes there are incontinent episodes. He has not had a BM in 4 days and his last BM was dark brown and described as “small firm pebbles”. His urine is very dark and maybe urinates a small amount 3 times per day. You start your assessment on Mickey. You note he has rhonchi in all lung fields and some crackles in the bases. Respiratory rate 30 and Sp02 85% RA. He has a cough which sounds wet but is unable to bring up any mucous. He has some open sores in his mouth and some are bleeding. There is dried blood in his mouth as well. His mouth is dry and his lips are cracked. His peripheral pulses are weak. Loose skin turgor. While talking to Mickey, it is clear to you that he knows him name but he thinks he is at work and that he is stuck at work due to a blizzard. He is saying he wants to go home since Goofy is cooking dinner but his car is buried in the snow. The more he talks about this the more upset he becomes and says it feels awful to feel trapped at the office. His phone battery is dead and is afraid Goofy will be worried when he isn’t home on time. Goofy reports this confusion isn’t new. Some days Mickey gets confused and calls Goofy, Pluto. Sometimes he thinks he is at Disneyland and waiting in line for a rollercoaster. He keeps asking for cotton candy even though Goofy keep telling him he doesn’t have any cotton candy. Goofy tries to remind him that he is at home but it doesn’t seem to make a difference. Sometimes, he doesn’t seem to know how to use a spoon so Goofy gives him the soup in a cup with a straw. You notice that he has limited ROM in the lower extremities. When you try to bend his knee, he yells and grimaces in pain. Goofy tells you that Mickey has had arthritis in his knees for many years and struggles with pain daily. He said the pain has gotten worse since Mickey’s mobility has declined. The ibuprofen he takes daily doesn’t seem to be helping anymore. Goofy and Mickey used to enjoy daily walks and working in their vegetable garden together. When he is having a more lucid moment, he tells Goofy that there is no point in living and wishes he would die right now. He doesn’t even want to watch his favorite TV shows anymore. He often refuses to talk to family members when they call to check on him. Health Science Science Nursing NURSING 101 Share QuestionEmailCopy link Comments (0)