PLANNING STATION- Alzheimer's scenario.

Please Kindly note : instead of using a level he can cope with use within the limit of his condition.
Nursing Problem: James is experiencing memory impairment with 6CIT score of 10/28.
Aim: To assist James to cope with cognitive impairment within the limit of his capacity or condition.
Re-evaluation : James will he re-evaluated today (date) daily, weekly, monthly as clinical condition changes for community scenario.
Alzheimer's is an irreversible disease condition. Planning Station NMCUK OSCE is a silent written station. This is just a sample guide. Kindly read your scenario and make relevant decisions as regards the nursing problem. This is a plan on Alzhiemer's scenario, allotted time of 14 minutes. The Plan of Care must meet professional standards.
Kindly visit www.nhs.uk/conditions/alzheim... for more information on Alzheimer's disease.
Please like and subscribe. Thanks for watching.

[@unifiedosce5580]

Please Kindly note for your reevaluation for Alzheimer's (To be re-evaluated today (Date of your exam) ongoing based based on clinical condition. Sooner if clinical condition changes does not apply because it is an irreversible disease condition. In addition for the Aim: it can be stated as James will demonstrate coping mechanism to deal with cognitive impairment. Please do not include a level he can cope with based on the new update. Thanks

[@jessysunny9138]

Thank you..can we write the second problem as increased confusion or disturbed thought process?

[@unifiedosce5580]

Hi, confusion will be fine.

[@neethuchandran8455]

@@unifiedosce5580 frequency of monitoring of observation in the community scinario what can we write .if it is 4 to 6 hourly as per news score of 4 .is it possible to check every four hourly in the community

[@unifiedosce5580]

Hi, In Assessment you based your monitoring frequency as stated in the NEWS chart policy even if it is community. But for Re-evaluation, it will depends on the problem you are addressing.

[@bosedeamoran9498]

Good afternoon. Thanks for all you are doing. Please I have a resit in this planning of alzheimer's disease. I planned for headache because my patient said she is experiencing headache with a pain score of 5/10. I got a feedback that it is not based on the needs of my patient. My 2nd plan was cognitive Impairment. Aim was patient cognitive Impairment will improve to the level he can cope with. Got a feedback that the aim of the plan is not appropriate. My patient is 42 years old, and that alzheimer's disease is a chronic health condition that deteriorate gradually. Please help me oo.

[@funkeawoku9628]

Well done sis❤️❤️

[@PreciousSibanda-vq5so]

Thanks dear

[@favouredfola]

Calm and articulate mentor

[@DFA969]

Great job sis

[@unifiedosce5580]

Thank you! Cheers!

[@omololavictoria8913]

Thanks so much. Renewed strength in Jesus name

[@soumyamolphilip3406]

You are such good teacher 😊

[@unifiedosce5580]

Thank you! 😃

[@soumyamolphilip3406]

Hi my friend,could you please share daily videos for assessment for each case and planning for each cases…it would be very helpful..Thank you

[@brendaday5157]

You are really good wish I found you earlier I'm doing my exam in two days

[@unifiedosce5580]

Hi, Go in confidence follow the marking criteria. Unified OSCE wishes you success. Thanks

[@samuelndubueze3678]

❤️

[@theshadowjack1366]

🎉🎉🎉🎉

[@anniewhite3989]

First can I say you are an absolutely brilliant teacher, by far the best I have found on KZbin. My question is, can nurses use the 6CIT tool? And if not, can we still include assessing the patient using this tool as a nursing intervention?

[@unifiedosce5580]

Hi Annie, yes the tool use is more applicable with Mental health Nurse. In OSCE, it will be prefilled and do a scoring over 28. Yes 6CIT can be applied as an assessment tool for your intervention. Appreciate the comment on Unified.

[@imaharrison3803]

Hi, Video is very helpful. Please in a situation where the patient mentions a different nursing problems during assessment from the already filled health questionnaire e.g PHQ-9. Which one do we plan with? Thank you.

[@folorunshoboseodunayo3744]

For the patient to have a PHQ9 CHART filled and based on the total score, you already have one nursing problem which is depression with PHQ9 score of ---- The second nursing problem can come from the questions on the chart, but you need to confirm from the patient. E.g, if on the chart, the patient have a highest score on loss of appetite or overeating, you ask the patient if it is loss of appetite he/she is having, then you can use it as your 2nd nursing problems. Nutrition is also part of the questions to be asked under physical questions but once it is addressed on PHQ9 chart, no need to ask again under physical questions.

[@memyself3726]

@@folorunshoboseodunayo3744 IF YOU CHOOSE LOSS OF APPETITE FOR EXAMPLE AS ONE OF THE NURSING PROBLEMS, DO YOU NEED TO WRITE ABOUT THE MALNUTRITION UNIVERSAL TOOL (MUST) IN INTERVENTION?

[@kosisochukwuemmanuellanw-io1tc]

Lovely video! Please this question is quite unrelated to Alzheimer's. In the case of post op planning, can you say "Mr. X is experiencing ineffective breathing pattern related to effect of anesthesia evidenced by..."? can that nursing diagnosis be used generally?

[@unifiedosce5580]

Hi, in all planning your plan can not be generalised, it needs to be relevant to the history or complaints given. In post-operative scenario , if the patient is not having difficulty in breathing it will not be applicable. You can go for pain related to surgical incision, risk for bleeding or risk for infection. Hope this helps.

[@kosisochukwuemmanuellanw-io1tc]

​@@unifiedosce5580 God bless you! Thank you so much!

[@olajumokeowojaiye3222]

@UNIFIED OSCE please in evaluation which vital sign is the recent one… is it the one in our question paper or the one that was done during assessment…Thanks

[@unifiedosce5580]

Hi, the recent one is the one you have in the Evaluation question.

[@kansengachpili7876]

How about Risk of compromised skin integrity due to urinary incontinence

[@sabinadhakal9781]

Please do in skin integrity due to immoblize

[@HellJovit]

hi question as you stated for re evaluation can you actually write today (date of exam) and ongoing based on clinical conditions?

[@unifiedosce5580]

Hi, this is a suggestion due to the fact that Alzheimer's is irreversible. Please carry out more findings and reach a conclusion based on your clinical judgement. Thanks

[@HellJovit]

@@unifiedosce5580 for example 6cit score of 17.

[@lindaamoahkroduah476]

How would you write a problem. Like bursting into tears

[@unifiedosce5580]

Hi, you can go for Mood Alteration

[@eunicearyeh6861]

Hello please who used risk for care self care deficit as a problem for the alzheimers scenario when doing planning and had it right. Pls help a sister

[@unifiedosce5580]

Hi, it is advisable to go for related problems that is easy to solve. However, you can say -Self care deficit related to inability to carry out Activities of daily living or Self Care deficit related to cognitive impairment (as applicable to the given scenario) Aim:To assist / support with Activities of daily living or “A’s’ will be supported with activities of daily living to a level he can cope with.

[@bosedeamoran9498]

@@unifiedosce5580 please planning for self care deficit, can the aim be j will participate in his activities of daily living within the limit of his disease condition?

[@unifiedosce5580]

​,Hi, Yes that's OK. It can also be To assist J with Activities of daily living

[@HellJovit]

Hi I have to resit for my Alzheimers scenario, my nursing problem will be Frankie is experiencing significant cognitive impairment with a 6CIT score of 16, what will be my aim? Frankie will show no deterioration or able to remember things with 6CIT of 16. please I need help :(

[@unifiedosce5580]

Hi, sorry to hear that. Suggestion : To be re-evaluated today (Date of Exam) 2 weekly or as clinical condition changes. Please do apply your clinical judgement. All the best.

[@HellJovit]

@@unifiedosce5580 thank you so much for help god bless you

[@bosedeamoran9498]

Hi please have you gotten the correct aim for this Nursing problem?

[@unifiedosce5580]

Hi,@@bosedeamoran9498you can state it as Aim: J will demonstrates coping mechanism to deal with cognitive impairment. This is a suggestion, please carry out more findings, waiting for your success story.

[@emernelson]

@@unifiedosce5580 My 2nd care plan was cognitive Impairment. Aim was cognitive Impairment will improve to the level he can cope with. Feedback was that alzheimer's disease is a chronic condition that deteriorate gradually and patient is 42years---- This is a comment in other youtube videos - i just copy and paste it - aim is the same

[@anilaraveendran9739]

Hi... I failed planning stations . I have written memory loss and nutritional imbalance . My feedback is inappropriate care plan. But I don't know which one i write in resit . When I assessed My patient Frankie has no other problem. Can I write other care plan according to scenario. Please help me 🙏

[@unifiedosce5580]

Hi, si sorry to hear that. I will suggest that you go for relevant problems based on the scenario . As you said the problems you identified were not appropriate. Read through some of the comments, have a look at the updated video on Alzheimers planning and go for the most relevant. All the best.

[@maryamyaqoob5207]

Hi anila, i failed in this station with same patient Frankie and same scenario. Could you please help me what you write in your resit?

[@samuelndubueze3678]

If this is a community scenario why are we putting 2 hours in evaluation instead of weekly or 2-4 weeks

[@unifiedosce5580]

Hi, Planning needs to be personalized based on the specific needs. Even though it is a community scenario, he lives in a care home- a problem of Urinary incontinence can not wait for a week. You are advised to based your judgement on the relevant timing that best fits in your scenario.. For example, in the past NEWS chart is not applicable in community scenario.

[@samuelndubueze3678]

@@unifiedosce5580 thank you ver much. Cheers

[@kosisochukwuemmanuellanw-io1tc]

Please I have another question oo😢😢 I'm a little confused about this 6CIT score of a thing. Is it compulsory? Must it be included in your assessment and planning for Alzheimer's disease? What if you don't see such document on your table, can you just go on without it?

[@unifiedosce5580]

Hi, don't be confused please, it will be prefilled do a sum up and talk about your intervention and referral plan. 😊

[@kosisochukwuemmanuellanw-io1tc]

@@unifiedosce5580 Thank you for your prompt response. But Is it all alzheimer's assessment that uses a 6CIT?

[@unifiedosce5580]

Yes

[@jessysunny9138]

I have written increased memory loss and risk for falls, but the feedback showed that risk for falls is inappropriate and reevaluation date, every visit is wrong. Could you please tell me what will be the appropriate reevaluation date in community setting?

[@unifiedosce5580]

Hi, have a critical review of the scenario, for example if patient is mobile and independent, risk for fall will be inappropriate. You can re-evaluate today, ongoing based on clinical condition. All the best.

[@folorunshoboseodunayo3744]

@@unifiedosce5580 Re-evaluation date for community scenario is usually 2 weekly or sooner if clinical condition changes.

[@jessysunny9138]

@@unifiedosce5580 Thank you.. Please note that in my scenario , the pt has impaired memory, confusion, chronic headache, anxiety, depression, behavioral issues and inability to perform daily activities. So, could you please tell me what two problems can be proritised from this list?

[@unifiedosce5580]

Hi Jessy, based on the problem stated, you can choose to go for either confusion or Memory Impairment, Anxiety, difficulty in performing Activities of daily living. This is just a suggestion, have a critical review as well. Hope to hear good news soon.

[@ritans5125]

@@jessysunny9138 I think u can use depression too, pain due to the chronic headache but u need to score the pain, anxiety. I think not being able to complete ADLs may be too wide to plan upon.

[@harmanpreet5723]

I also did same thing in aim as she explained but I got failed...they said I need to write treat or manage symptoms not improve memory coz itz not possible

[@unifiedosce5580]

Hi , the pinned message is to help guide on the update, wishing you success .

[@athiraannu7208]

Hai I got a feedback that we cannot write (when the clinical condition changes) for Alzheimer's disease.

[@funkeawoku9628]

Thanks for your response.You can still write if clinical condition changes but this depends on the nursing problem itself, if it's dehydration,pain......of course the clinical condition can change but if it's a problem like memory loss , behavioral issues.... you can't write if clinical condition changes cause it's irreversible.

[@unifiedosce5580]

Hi Athira, your comment is valuable and appreciated. Unified will pin a comment as regards this. Re-evaluation: J. S will be re-evaluated today(Date of Exam) ongoing as condition requires, no need to include sooner if clinical condition changes for confusion or Memory Impairment

[@jessysunny9138]

Hi, I got same scenario. Mine also reevaluation date was wrong. Can you please tell in which university you have attempted the exam?

[@athiraannu7208]

@@jessysunny9138 Northumbria... What did you write?my problems were pain and impaired memory..

[@jessysunny9138]

@@athiraannu7208 Mine also @ Northumbria. I have written impaired memory and risk for falls. But in the feedback they mentioned that risk for falls is inappropriate.

[@binilgeorge1]

What will be the re-evaluation time in community scenarios for confusion and weight lose

[@unifiedosce5580]

Hi, for weight loss you are likely to have a Malnutrition Universal Screening Tool (MUST), the score needs to be considered. It can be today (the date of your exam) weekly or bi-weekly or sooner if the clinical condition changes depending on the level of Risk. For confusion, it can not be a generalised approach, the scenario will need to be considered.

[@zinachinedu1164]

Do you have Osce tutorial class in London

[@unifiedosce5580]

Hi Zina, no but feel free to ask questions on this channel or via Unified OSCE email.

[@folorunshoboseodunayo3744]

No