III. Nursing Assessment1. Personal History1.1 Patients Profile Name: Mrs.

Torralba,

LourdesAge: 89 years oldSex: FemaleCivil Status: WidowReligion : Roman CatholicDate

and time of admission; March 13, 2008 at 10:10 amRoom No.: Room 425, Cebu Doctors

University HospitalCompla ints: Pain the right hipImpression or Diagnosis: Fracture Close-

Comminuted: Femoral Right Neck General OsteoporosisBr east Cancel (Right)Diabetes Mellitus Type

IIPhysician: Dr. F. Vicuna, Dr. E. Lee, Dr. N. Uy, Dr. RamiroHospital No: 216 4261.2. Family and

Individual Information, Social and Health History Mrs. Torralba, Lourdes

who resides in 8 Acacia St. Camputhaw Lah ug, Cebu City,Cebu Province with 9 successful

children ( 6 boys and 3 girls) was admitted to CebuDoctors U niversity Hospital for

further management of the condition.Mrs. Torralba is a college graduate and

shes previously working as an assistant of her husband ( Mr. Rodrigo Torrralba ) a

doctor.The patient was diagnosed to have Breast Cancer (Right) last 2006 with bonemetastasis

and on chemotherapy with aromasin.4 Two days prior to admission, the patient was standing and

was about to open uphe umbrella when she got out of balance and landed on her right hip.And

had experiencedlimi tation of movement on the right hip. The patient was then

admitted due to the persistence of pain.The patient was previously hospitalized due to infected

wound at the right anklelast 2002. No familial history of hypertension and bronchial asthma but is

positive todiabetes mellitus of paternal side. Has no known food and drug allergies. The

patient isnonsmoker nonalcoholic beverages drinker.1.3. Level of Growth and

Development1.3 .1. Normal Growth and Development at particular stage Older Adult ( 65Years old to

death)Physical DevelopmentPe rception of well-being can define quality of life. Understanding

the older adults perceptio n about health st atus is essential for accurate ass essment and dev elopment of clin

ically relevant interventions. Older adults concepts of health generally depend on personal perc

eptions of functional ability. Therefore older adults engaged in activ ities of daily

living usually c onsider themsel ves healthy, wherea s those whose activities arelimited by

physical, emotional or social impairments may perceive themselves as ill.There are

frequently observed physiological changes in order adults that arecalled normal. Finding

these normal changes during and assessment is not an expected.These physiological changes are not

always pathological processes in themselves, butthey may make older adults more

vulnerable to some common clinical conditions anddiseases. Some older adults

experience all of these physiological changes, and others onlyexperience only a few.

The body changes continuously with age, and specific effects on particular

older adults depend on health, lifestyle, stressors and environmental conditions. 5

Cognitive DevelopmentInt ellectual capaci ty includes per ception, cogniti ve, memory, an d learning.Perc

eption, or the ability to interpret the environment, depends on the acuteness of thesenses. If the

aging persons senses are impaired, the ability to perceive the environmentand react

appropriately is diminished. Perceptual capacity may be affected by changes inthe nervous system

as well. Cognitive ability, or the ability to know, is related to the perceptual ability.Changes

in cognitive structure occur as a person ages. It is believe that there is a progressive

loss of neurons. In addition, blood flow to the brain decreases, the meaningesappea r to thicken, and

brain metabolism slows. As yet, little is known about the effect of these physical

changes on the cognitive functioning of the older adult. Older people needaddition time for

learning, largely because of the problem of retrieving information.Mo tivation is also important.

Older adults have more difficulty than younger ones inlearning information they do not

consider meaningful. It is suggested that the older person m entally active to maintain cogniti

ve ability at the highest possible level. Lifelong mental activity, particularly verbal activity, helps the older

person retain the highlevel of co gnitive functio n and may help maintain a lon g-

term memory. Cognitiveimpai rment that interferes with normal life is not considered part of normal

aging. Adecline in intellectual abilities that interferes with social or occupational functions

shouldalways be regarded as abnormal.Psych osocial DevelopmentAc cording to Erikson,

the developmen tal task at this time is ego integrity versusdespair. People who attain ego

integrity view with a sense of wholeness and derivesatisfacti on from past accomplishmen t. They view

death as an acceptable completion.Acc ording to Erikson, people who develop

integrity accept ones one and only life style. By contrast, people who despair often believe they

have made poor choices duringlife and wish they have made poor choices during life and wish

they could live life over.Robert Butler sees integrity and bringing serenity and wisdom, and

despair as resulting in6 the inability to accept ones fate. Despair gives rise of frustration, this

couragement, and asense that ones life has been worthless