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 HospitalComplaints: Pain the right hipImpression or Diagnosis: Fracture CloseComminuted: Femoral Right Neck General OsteoporosisBreast 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 Lahug, Cebu City,Cebu Province with 9 successful children ( 6 boys and 3 girls) was admitted to Cebu Doctors University 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 experiencedlimitation 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 isnon-smoker non-alcoholic 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 DevelopmentPerception of well-being can define quality of life. Understanding the older adults perception about health status is essential for accur ate assessment and development of clinically relevant interventions. Older adults concepts of health generally depend on personal perceptions of functional ability. Therefore older adults engaged in activities of daily living usually consider themselves healthy, whereas 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 are called 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 DevelopmentIntellectual capacity includes percep tion, cognitive, memory, and learning.Perception , or the ability to interpret the environment, depends on the acuteness of the senses. 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 meaningesappear 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.Motivation 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 mentally active to maintain cognitive abilit y at the highest possible level. Lifelong mental activity, particularly verbal activity, helps the older person retain the highlevel of cognitive function and may help ma intain a long-term memory. Cognitiveimpairment 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.Psychosocial DevelopmentAccording to Erikson, the developmental task at this time is ego integrity versusdespair. People who at tain ego integrity view with a sense of wholeness and derivesatisfaction from past accomplishment. They view death as an acceptable completion.According 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