Physiological adaptation

Physiological adaptation

The purpose of this assignment is to identify individual assessment trends to determine the highest priority concept, conduct a research study of the topic outline in relation to the NCLEX-RN test plan and provide evidence-based research regarding nursing practice. Based upon the category of physiological integrity, the topic of greatest opportunity is “physiological adaptation” which focuses on the client needs category. According the NCLEX-RN test plan (2019), Physiological adaption the nurses manage and provide care for the clients with acute, chronic, or life-threatening physical health conditions. The primary goal of “physiological adaptation” category is to interpret clinical findings, analyze nursing actions as it correlates with the client’s care and take immediate action when needed and evaluate client’s outcomes based on the priority decisions (NSCBN, 2019). This category requires entry level nurses to demonstrate their knowledge, skills, and abilities for the successful completion of the NCLEX-RN test plan into the nursing practice. Physiological adaptation


It is crucial for entry level nurses to apply normal physiological changes across the life span and understand the disease alterations and the negative effects across the lifespan. The nursing process and Maslow of hierarchy of needs guides nurses through the care with a systemized approach to meet the client needs. (Macedo at el, 2016). Erikson’s stages of development allow for analysis of developmental considerations when planning care and nursing (Orenstein & Lewis, 2020). The nurse should use clinical judgment to process data and interpret data which identifies safe nursing interventions. If a nurse fails to take in life-span considerations amongst her clients when implementing client care can cause life-threatening problems. Electrolyte imbalances fall under the clients need category of physiological adaptations (NCSBN, 2019). Nurses must understand the pathophysiology and the difference in lifespan considerations as caring for older adult clients and knowing when to intervene to provide effective care. In older adults’ clients, total water content decreases which causes a higher risk for dehydration and fluid and electrolyte imbalances in this population (Kear, 2017). Nurses must identify clinical findings and apply knowledge of the unresolved issue as clients are prone to prolonged readmission and increase hospital stays (Yilmaz at el, 2016). Physiological adaptation

Healthcare Disparities, Inequalities, and Interventions

This population targets clients with sepsis, diuresis from AKI, respiratory acidosis, burns, and excessive gastrointestinal or wound loses (Kear, 2017). Older Clients with chronic conditions are susceptible to pressure ulcers due to their decrease sensation, cardio output, perfusion, activity, mental status, and fluid and electrolyte imbalances (Macedo at el, 2016). As a client ages their kidney function and structure declines and loses their ability to function properly. The older population experienced polypharmacy. Medication regimens places the client at risk for electrolyte imbalances (Kear, 2017). 60% of institutionalized older adults are effect by nutritional disorders which increase their susceptible to pressure ulcers and fluid and electrolyte imbalances. (Macedo at el, 2016). The nursing process guides nurses through the care with a systemized approach to meet the client needs. (Macedo at el, 2016). Nurses must monitor for hemodynamic alterations that occurs with the normal physiological changes across the lifespan. Priority interventions in caring for clients with fluid and electrolyte imbalance, comfort, vital signs, and physical assessments (Yilmaz at el, 2019). Nurse use data collection to diagnosis and management care for clients with fluid and electrolyte imbalances. The nurses use interpretation to identify the signs and symptoms for clients with fluid and electrolyte imbalances, apply knowledge to the disease process, and manage care, and evaluate care to the client’s outcomes. According to Dean (2016), “Nurses are intuitive to recognize signals of unspoken needs of the client”. The nurse should consider a through medication reconciliation and review medications to clients and families. Diuretics, cardiac medications, electrolyte supplements and laxatives require patient teaching for safety concerning this population (Kear, 2017). Physiological adaptation


Legal & Ethical Considerations and Intervention Challenges

When providing care for this vulnerable population group it is important to know the barriers that older adults’ clients face with chronic diseases or disabilities. Lack of access to health care, finances, and limitation to community resources, functional and cognitive decline are contributing factors that results to ethical dilemmas (Shuman & Owen, 2016). The Patient-Self-determination act is a federal law that requires all healthcare professionals to obtain informed consent for treatment. Legal implication arises in the older adult population because of cognitive and sensory impairments that the elderly population may experience when consenting to care and decision-making capacity (Shuman & Owen, 2016). According to Altawalbeth et al (2019), conducted a research study to establish barriers and strategies to improve the inform consent process with the older adult’s population. The researchers reported hearing and vison impairment associated with aging prolonged the consent process due to inconsistency of answers and frequent repeated questions while obtaining informed consent from older adults. It is crucial for nurses to be aware of the deficits that impact older adults and ensure that the individual client needs are met. An older client may feel they have no control over decisions as they age but age does not determine whether the client can make decisions autonomously. A strategy in the prevention of a legal dilemma is to identify if the client is competent to make decisions to care and treatment, understand the risks and benefits; consequences of refusing care (Altawalbeth et al, 2019). One ethical strategy used is to incorporate the client into his care, allows the clients to make decision-makings choices regarding their health impedes the consent process (Altawalbeth, 2019). Allowing older adults more time in compensation an Physiological adaptation

Participants and Interdisciplinary Approach

The interdisciplinary teams that will be involved in the implementation process related to the priority concepts will be the patient. If the nurses are unable to obtain informed consent because of Cognitive decline; informed consent stilled be applied to perform care due to out of respect (Shuman, 2019). The nurse will be advocates for the client and ensure that all individual needs are met. The providers implement care to adjust to older adult’s client hemodynamics associated with fluid electrolyte imbalance or end-of-life wishes. OT helps to regain ADLs and PT will ensure the safety and use of assistive devices. Social workers coordinate plan of care in the community and case management. Physiological adaptation


Altawalbeh, S. M., Alkhateeb, F. M., & Attarabeen, O. F. (2020). Ethical issues in consenting older adults: academic researchers and community perspectives. Journal of Pharmaceutical Health Services Research11(1), 25–32.

Dean, P. J. (2016). Nursing Considerations for an Emerging and Enlarging Symbiosis Between Technology and Integrative Human Health: Need for a Systematized Base for Caring Science. International Journal for Human Caring20(4), 171–175. Physiological adaptation

Guedes Macêdo, P. K., Fonseca Anízio, B. K., Medeiros Brito, F., de Medeiros Batista Freire, F. R., & Lopes Costa, M. M. (2016). Data Collection Instrument for Pressure Ulcer Prevention in Institutionalized Elderly. Journal of Nursing UFPE / Revista de Enfermagem UFPE10(11), 3977–3988.

Kear, T. M. (2017). Fluid and Electrolyte Management Across the Age Continuum. Nephrology Nursing Journal44(6), 491–497.

National Council of State Boards of Nursing (2019). NCLEX-RN Examination [PDF file], (2019). Retrieved from Physiological adaptation

Orenstein GA, Lewis L. Eriksons Stages of Psychosocial Development. [Updated 2020 Nov 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from:

Yilmaz, S., Uysal, H. B., Avcil, M., Yilmaz, M., Dağlı, B., Bakış, M., & Ömürlü, I. K. (2016). Comparison of different methods for measurement of electrolytes in patients admitted to the intensive care unit. Saudi Medical Journal, 37(3), 262–267. https://doi Physiological adaptation

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