Resources: Flaherty, E., & Resnick, B. (Eds.). (2014). Geriatric nursing review syllabus: A core curriculum in advanced practice geriatric nursing (4th ed.). New York, NY: American Geriatrics Society. Geriatric patients have many nutritional and hydration concerns that impact their health and ability to acquire sufficient nutrients. Advanced practice nurses evaluating these patients must be able to account for all barriers that prevent elders from obtaining adequate nutrition, including medical conditions, transportation, finances, physiologic changes, and functional abilities. When evaluating patients, it is important to consider how they eat, what their diet consists of, and whether they have any special dietary needs that are not being met. Assessment tools, such as the Lawton Instrumental Activities of Daily Living (IADL) Scale, are an integral part of this evaluation process as they help providers identify potential obstacles for patients. In this Discussion, you assess a patient at your current practicum site and consider strategies for improving any nutrition or hydration issues.To prepare:Review this week’s media presentation, as well as Chapters 28 and 29 of the Flaherty and Resnick text.Assess a patient using tools for inpatient and long-term patient care, such as the Lawton IADL Scale.Note: You should coordinate this opportunity with the Preceptor at your practicum site.Consider whether nutrition and/or hydration might be impacted by the patient’s functional abilities. Reflect on whether the patient is able to go out and get food to eat, cook meals, safely use the stove, etc.Consider the patient’s diet and whether they have any special dietary needs due to medical conditions, such as congestive heart failure, end-stage kidney disease, diabetes, oral health issues, etc. Reflect on whether or not the patient is attempting to compensate for a medical issue and thus creating a deficiency or excess in his or her diet.Based on your patient assessment, think about strategies for improving any nutrition issues that might have presented (e.g., nutritional supplements, community resources such as Meals on Wheels, referral to a nutritionist or dietician, etc.).By Day 3Post a description of the patient assessment you performed using a tool for inpatient and long-term patient care, such as the Lawton IADL Scale. Explain whether nutrition and/or hydration might be impacted by the patient’s functional abilities. Then, describe the patient’s diet and whether he or she has any special dietary needs due to medical conditions. Address whether or not the patient is attempting to compensate for a medical issue and thus creating a deficiency or excess in his or her diet. Finally, explain strategies for improving any nutrition issues that might present during the patient assessment. **Please use at least to references and site within the paper in apa format

 
Review emerging standards of culturally competent care. Here are possible resources to use:
DHHS Office of Minority Health
National Center for Cultural Competence
AHRQ
Annie E. Casey Foundation
question; Write a 2,800- to 3,500-word paper that explores the following topics in your workplace or a setting that you select for this discussion:
Define culturally competent care appropriate for your own workplace, based on your perusal of the assigned readings.

Identify the populations served and any issues of population vulnerability.

Comment on standards of cultural competence that appear to be met and any that are not met.
Identify how delivery of nursing care could be affected where standards are being met and where they are not being met.