analyse this text and provide an academic title: NUR 315 Milestone Two


Shy one
Southern New Hampshire University
NUR 315: Pathophysiology
Dr. Rita Million
October 6, 2024






	Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disorder that has a life-altering effect on the motor neurons of the body, resulting in muscle atrophy and the inability to move. The world-famous theoretical physicist Stephen Hawking was diagnosed with ALS at the age of 21 and managed to live more than five decades with the illness. This care plan will focus on managing Hawking's ALS through the PIE (planning, intervention, and evaluation) format. The plan will include setting actionable short—and long-term objectives, defining crucial nursing issues, evaluating an intervention, and assessing overall care plan efficacy in terms of the set standards.
Planning for Care
Short-Term and Long-Term Goals  
	In Stephen Hawking's case, the short-term goals focus on maintaining his quality of life and reducing the progression of symptoms. The first short-term goal is to support respiratory function using mechanical ventilation to achieve an oxygen saturation level of more than 90% in two weeks (Fournier, 2022). The second goal is to teach him how to communicate using assistive devices, specifically enhancing his ability to participate in daily conversations within the next month.  
	For long-term goals, the first aim is to prevent complications associated with immobility, such as pressure ulcers, with a target of maintaining skin integrity over the next six months. The second objective is to control feeding through a feeding tube and ensure the maintenance of appropriate body weight through adequate caloric intake. These are quantifiable and time-bound goals and, as such, important when managing Hawking's ALS condition.

Nursing Concerns and Prioritization  
	The critical nursing concerns associated with ALS include respiratory failure, communication barriers, nutritional deficiencies, and risk for skin breakdown due to immobility. Respiratory failure tops the list due to the fact that the disease progressively affects the muscles used in breathing, which may cause hypoxia and possible respiratory arrest. Other important concerns include communication since it influences Hawking’s interactions with his caregivers and his research (Newell et al., 2022). The next are nutritional deficiencies and skin integrity problems, which are results of immobility and dysphagia. By addressing these concerns, nursing care is directed towards attaining the goals of avoiding life-threatening complications and improving Hawking’s quality of life.
Patient Care Technologies  
	Several technologies have been instrumental in managing Stephen Hawking's ALS symptoms. Oxygen, delivered by mechanical ventilators, is needed to assist patients as the disease advances and breathing becomes more laborious. Speech-generating devices helped Hawking speak, and he could continue with his work in physics. Further, an enteral tube feeding ensured that adequate feeding was achieved when he was unable to swallow food properly. Most of these patient care technologies were important in enabling the prolongation of Hawking's life and enhanced functioning.
Intervention
Nursing Interventions  
	Nursing care for the case of Hawking should involve the management of respiratory function, nutrition, skin integrity maintenance, and communication support. First, there should be a constant assessment of the patient regarding respiratory status to monitor the oxygen level and mechanical ventilation. Nurses are critical in preventing pressure ulcers, so frequent skin assessments and repositioning every two hours are essential. Research provides evidence that repositioning can be very effective for patients, comfort-wise, and overall improvement if done at substantial intervals. Enteral feeding to regain nutritional status is another aspect of nursing care provided to the patients. Research has shown that meeting nutritional needs, especially calorie needs, can strengthen healing and amplify overall health (Trojsi et al., 2020). These nursing interventions are vital in enhancing patient care and preventing complications. Regarding communication, the nurses should help Hawking use his speech-generating device, check whether it is working correctly, and make sure that he has access to the equipment all the time. These interventions are closely associated with his goals and objectives and are primarily focused on his quality of life.
Medication Management  
	Several classes of medications are used to manage ALS, focusing on symptom control. Riluzole is the only known medication for ALS since it has been determined to have a beneficial effect in the initiation of this disease because it slows down the damage of motor neurons. Muscle stiffness and spasticity can be managed using antispasmodic drugs, including baclofen and tizanidine (Masrori et al., 2020). Also, breathing problems may be treated using respiratory drugs such as bronchodilators. Pain is a significant concern, and non-opioid analgesics should be used for long-term pain management. These medications must be given in a prescribed potency and regimen, and the side effects must be watched in order to make sure that these drugs relieve pain without causing other problems.
Patient Care Technologies in Health Promotion  
	Patient care technologies play a crucial role in health promotion for ALS patients by enhancing their ability to perform daily activities and manage symptoms. In Hawking's case, using a mechanical ventilator also improved the patient's overall breathing ability, thereby reducing the risk of respiratory complications such as the development of respiratory failure. It was the primary tool for communicating with the rest of the world, crucial for enhancing psychological well-being. Studies indicate that communication technologies can significantly improve well-being by reducing loneliness and enabling affective expression (Smith et al., 2020). The ability to speak helps one to liberate oneself and contribute to an individual's general well-being, particularly within social networks. In addition, technologies were incorporated to manage pressure ulcers, protect skin integrity, and enhance comfort using specialized mattresses and wheelchair cushions. Hence, these technologies do more than build physical strength; they also foster mental and emotional strength by improving overall quality of life.
Patient Care Technologies and Safety  
	In addition to promoting health, patient care technologies help reduce medication errors and improve patient safety. Mechanical ventilation systems are fitted with alarm systems to warn caregivers to attend to problems like low oxygen levels or a faulty ventilator. A speech-generating device reduced the possibility of misunderstandings between Hawking and his healthcare professionals so that descriptions of symptoms and requirements would be precise (Mehta et al., 2022). In addition, enteral feeding systems are safe because they minimize the chances of aspiration and guarantee the delivery of the correct quantity of food. These technologies help improve patient safety through the identification of issues, which reduces the possibility of adverse events.

Evaluation
Measures of Success  
	The success of the care plan for the patient will be closely monitored by gathering data on critical aspects of his health, focusing on respiratory function, skin condition, nutrition, and communication abilities. Respiratory function will be assessed through oxygen saturation, which is frequently documented, to target 90% or more. This will be beneficial in confirming whether his type of mechanical ventilation is helpful or not. Daily checks on skin integrity will be conducted to detect pressure ulcers in immobile patients at an early stage. Early detection is crucial in preventing these ulcers, significantly affecting a patient’s quality of life. Addressing these issues promptly can avoid complications and help patients lead healthier lives. 
	Additionally, the patient’s body weight will be regularly monitored to ensure proper nutrition. This monitoring will help confirm that they receive enough calories through their feeding tube, ensuring their nutritional needs are being effectively met. This ensures that they do not develop malnutrition and that they are strong enough to go through different activities. Another way that the success of the series will be measured will be through Hawking's interactions using the specialized communication device (Mehta et al., 2022). This is because analyzing the interactions he has throughout the day will show whether the device is working appropriately and if modifications are required. The specifics, which encompass aspects such as respiratory health, skin condition, nutrition, and communication, will be used to determine the plan's success in the overall improvement of Hawking's quality of life.


Evaluation of Plan and Interventions  
	The care plan proposed for Stephen Hawking will lead to positive outcomes based on the identified measures. The services provided, which include respiratory care, nutrition, skin wellness, and communication, are all backed by extensive research. Mechanical ventilation has been proven to increase the life expectancy of ALS patients referring to respiratory support. Likewise, enteral feeding systems play a vital role in delivering the appropriate nutrients, especially when swallowing is compromised. Such interventions, provided selectively to Hawking, should avert standard troubles connected with ALS, ensuring that he stays stable.
	In addition, communication technologies such as speech-generating devices allow Hawking to stay connected with his environment, reducing isolation. Skin checks and repositioning schedules are also effective ways to avoid pressure ulcers, leading to other complications. Reviewing these factors continuously allows the formulation of corrective measures as early as possible (Boddy et al., 2021). It advocates for adherence to well-researched and generally accepted standards of practice in nursing. Among the key areas where the quality of life or possible health outcomes for Hawking will be significantly improved include respiratory health, nutrition, skincare, and communication interventions. 
Conclusion
	The care plan for Stephen Hawking's ALS condition is designed to address critical
nursing concerns, including respiratory failure, communication barriers, nutritional deficiencies,
and skin integrity. With specific targets and timely objectives on the short- and long-term
horizons, this plan seeks to ensure that Hawking leads a comfortable life and survives longer
through evidence-based interventions and state-of-the-art patient care technologies. The
evaluation measures will assist in assessing the plan, ensuring that the recommended
approaches effectively manage his ALS symptoms and improve his health outcomes.