This assignment will explore the case study of David SIMM 8. It will identify David’s potential biological, psychological, and social determinant. It will go further to discuss the legal and ethical principles, which will focus on adult nursing practice. It will also focus on the legal and ethical principles (accountability) of adult nursing as a first year student. Moreover, it will demonstrate knowledge, skills and values that are commensurate with safe and evidence based of Nursing assessment and practice. It will also discuss the assessment of temperature in an adult. It will end up discussing the scope and limitations of your current role as a student nurse in safeguarding David SIMM 8.

The member of the SIMM family selected for this assignment is David SIMM 8. David is 79 year old, with a height of 5 feet 11 inches, 55 kg. This fall under the category of demographics. According to David ‘s medical information, David i0s suffering from Alzheimer’s and hypertension. David leaves with his wife, who happens to be his primary carer. David is married to SIMM1(Daisy). “Alzheimer’s” is a problem that leads to difficulties in solving problems, and many problems come in the form of critical thinking. The condition can be good enough to interfere with brain health, which can cause memory and language problems in individuals (Alzheimer’s Research UK 2020). It can also lead to psychological issues. Besides, people suffering from “Alzheimer’s” are unable to perform daily activities while that person’s behaviour changes. The disease can persist and progress with time. “Alzheimer’s” is a slow cause disease that occurs from the onset of mild memory loss to total loss of ability to respond to the environment, and to remember something the problem was caused by brain damage and impaired mental function as well as the study of memory, meditation, and problem solving issues Herrup, K. (2010). The nervous system is responsible for many functions in the body system., this includes communication; the nervous system receive date from the external and internal environment. Another way to examine condition is the lack of emotional control. After examining his medical history, he also found that David SIMM 8 was unable to take care of himself, and his difficulty in communicating increased with time (Alexander M. et al., 2006). Book referee the sign that is progressing to a more natural position. David’s current health is affected by his mental and physical health, causing cognitive problems (Alzheimer’s Society, 2020). Includes reducing the use of communication and reducing language comprehension.

A clear difference between David can is seen in terms of brain function. Reducing the power of critical thinking and controlling stressful events is one of the most important examples of “Alzheimer’s “disease on social behaviour. Due to this problem, the psychological issues were occurring, causing problems in the mental processing of David Pandharipande, G. et al., (2013). The psychological problem associated with David includes a lack of emotional control, as well as the deterioration of cognitive functioning. Lack of emotional stability is the leading cause of anxiety and depression. (Azermai, M., 2015). The condition of David also has a social effect on him as he is unable to go anywhere independently. He can have memory loss at any time. Also, he cannot care for himself and could not even drive a car. This has impacted on his social life, and it affects his privacy. (Innes, 2009).


It is important to practice different ethical and legal principles and implement appropriate nursing skills in other to be a good nurse (Lachman,2009). Royal College of Nursing (2016) accountability is a state of being accountable or witnessing to accept responsibilities. As a nurse, any unlawful act during delivering care or damages if negligence is implicated in the injury or death of a patient. Also, not complying with the employment law can result in disciplinary action against the employee. Rosser, M. et al. (2013) Caring is looking after someone in a way that they might not be able to do themselves, ensuring they are being looked after and their needs being provided. Good care is the provision of comfort, compassion, and empathy. Also, to ensure the service users’ values and preferences are put into consideration. (Nmc,2018). Nurses are accountable of any unsafe practice administered. For instance, a duty of conduct, any error while administering medication or injection, should be reported, investigated and actions taking to avoid similar occurrence and safeguard patients (NMC, 2019). As a student nurse, you are not accountable to make any professional judgment. Nurses have a significant role in students’ accountability for learning and, their ability to be adequately prepared for professional nursing practice. Positive behaviour will help impact on students’ approach to clinical placement can guide nurses in their approach to facilitate student learning. (Perry, et al., 2018).

David needs to feel safe, and his dignity should be recognized and well preserved. For instance, nurses need to know their task to safeguard patients and treat them with respect and their rights. It is vital as a nurse to practice good knowledge of nursing by using good communication skills to make a better understanding of patients personal and health needs. If patients find it challenging to understand a nurse, it will be essential to use both verbal and non verbal communication skills (NMC, 2018). Nevertheless, patients with Alzheimer usually face an emotional breakdown that is why interpersonal skills are required to promote the person centred approach and promote healthy behaviour. This nursing skills also aids in promoting healthy behaviour and the well being of the patient. (Hugo and Ganguli, 2014) However, to avoid misunderstanding, well interactive communication with the patient should be maintained.

Moreover, respecting the holistic needs of an individual is paramount (Storlie, 2015). For example, a holistic need could be by supporting patient’s meet their daily activity and psychological needs. Professional nurse should use their clinical experiences and professional judgements, local trust policies and procedures to help them using the research evidence and deliver effective care in a clinical setting (Aveyard and Sharp, 2013). Furthermore, another vital regulation that underpin Nursing and Midwifery Council is preserved safety of patients and service users (NMC, 2015b). Student nurse should learn how to work effectively to help them safely and the people they will be looking after. (Peate, I., 2012).

A key aspect of assessing patients is to have different values, practices, and skills should be considered, as to treat patients with proper care underneath different nursing approaches. Moreover, to assess the temperature in an adult, different nursing practices should be implemented to promote healthy behaviour in the patient. Temperature it is said that the definition of Normal body temperature is not clear. However, it is believed that the temperature is within individual gender and age group. The regular reading of temperature is generally 37.c’ (98.6°F) (Clinical net 2018a).

Nevertheless, the patients who have Alzheimer usually face fluctuations in body temperature. Temperatures above 100.4 ° F (38 ° C) mean that the patient sometimes has a fever caused by a virus or disease. Measuring Alzheimer’s fever is a much needed requirement of physical changes in temperature as a sign of the patient experiencing pain changes. Alzheimer’s disease and fever are linked to each other and change from one leader to another. Conditions in David’s brain are associated with changes in body temperature reason is the temperature measurement. The main reason for this study is because Alzheimer’s patients find an imbalance in physical problems and diseases and lack of an immune system are the leading causes of fever. Conditions that can also occur in the body and fight infections of the body temperature should be monitored, also, after 60 years of severe temperature changes

Furthermore, fluctuations assessment to body temperature is necessary to provide treatment to the patient. The main reason for this assessment is the fact that Alzheimer patients face difference immune system. The infections and imbalance of the immune system is the reason for causing increased temperature. Infections might also occur in the body and to fight against the infection body temperature must be checked. Besides, the temperature can also impact on the metabolism of the body. (Clinical Skills 2018b)

To measure temperature, the reading needs to be accurate an effectively monitored. In other to detect quickly and any necessary intervention to start. Several factors affect to assessing temperature. This includes body size, device type and the training d health care professionals. Patient with local infection require monitoring of temperature to assess development or regression of infection. Firstly, before starting anything with your patient, it is essential to require consent from the patient, it is also vital to wash and dry your hands to avoid cross infection. Check the patient’s ear to see whether there is any fluid, blood or ear drainage. The presence of this can affect the readings. Also, the thermometer needs to be cleaned. David can sometimes refuse to take his temperature due to not familiar with the staff to take his observation. It is essential to explain to him the benefit to take his temperature, and he might still refuse. The best approach is to let him be for some time, then document it and later try again. (Dougherty et al., 2015) book ref

The holistic approach will also help in the maintenance of the relationship between patient and nurse (Selimen, and Andsoy, 2011). Measuring both to the core temperature and surface temperature of dementia patients is necessary to promote better health of the patients. (Clinical net, 2017).

Alzheimer’s Society 2020 quoted by The Care Act 2014 states that Safeguarding; is protecting people’s right, health, and protecting people from being abuse, neglect, or harm. Safeguarding aims to protect the vulnerable adult from been abuse. There are many types of abuse that can affect vulnerable adult this include Financial abuse, physical abuse, emotional abuse and neglect, safeguarding aims to provide the patients with support and evidence based practice. The key stages that a nurse follows to safeguard the patient include identification, reporting, participation, and reflection. In several situations, the patient might also have to face abuse and harm; for example, David is vulnerable; sometimes, abuse can take place. One of the signs of Alzheimer’s is memory loss; David can be abuse sometimes without him knowing as a student nurse if any was suspecting abuse or witness any abuse. David can sometimes talk about what he is feeling; generally, it will be my concern as a student nurse to do my finding. Later involve my mentor and make sure that they investigate the matter. To help and prevent further harm or abuse, these principles include empowerment, prevention, proportionality, protection, partnership, and accountability. These principles would protect David if he suffered from any of the abusive stages. After informing the trust and nothing has changed as a student nurse, it will be essential to escalate the matter to the local safeguarding authorities (Handley et al., 2017). Physical abuse means the use of physical force that may result in bodily injury, pain. For example, Cuts, Bruises, Burns, Unusual behaviour, such as going to the hospital every time. Financial abuse means unlawful use of an adult ‘s resources through, theft, fraud, undue influence or other. Emotional abuse means intimidation through verbal or non verbal acts or threat. Neglect abuse means fail to provide primary necessary care or services which can lead to harm or risk of serious harm—for example, ignoring medical or physical care needs. Ignoring a person’s cultural, religious, or ethnic needs. (Social Care Institute for Excellence
SCIE, 2020).

The entire work is based on dealing with the patient who is suffering from Alzheimer’s along with practical nursing based and evidence practices. Different roles are also part of research based on the health care setting, along with the knowledge of values, skills, and practices. Different approaches are also part of providing the patient with treatment. Despite this, limitations, scope, and different evidence based practices are present in providing patients with care and assistance. Different roles to be implemented in the hospital settings are also present in providing the patient with care and support. Therefore, the assignment describes an entire knowledge about dealing with the case study of patients who have Alzheimer’s.


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