Case Scenario: Mrs. Maryam is a 75-year-old woman who lives independently in her own home with her husband. She volunteered to assist in community activities 2 days a week at a local community center and remained an active member of the community. Three days back, she began to feel weak and tired. She thought these symptoms are as the beginning of a cold and went to bed early. The next morning, she could not get out of bed to perform her activities of daily living; she was confused as to place and time and was short of breath. Her daughter brought her to the Accident and Emergency (A/E) department. Past medical history: Chronic obstructive pulmonary disease (COPD); Gastroesophageal reflux disease (GERD); Congestive Heart Failure (CHF) 2 years ago. Upon admission: Subjective Data • Has increasing shortness of breath and fatigue • Verbalizes decrease of weight by 6 pounds in the last 2 weeks. • The daughter expressed her worries that her mother was on antihistamines and cough suppressants, which is discontinued now. • Also verbalizes that my mother had a shot of influenza vaccine last month, and now prescribed for pneumonia vaccine. Objective Data: Physical Examination • Malnourished • Conscious but Confused • Dyspnea with respiratory rate 25 bpm • Orthopnea, cyanosis • Cough with purulent sputum • Febrile with chills- temperature 37.8 C • Mild pleuritic chest pain Diagnostic / Laboratory values: • White blood cell count (WBC)- 12,000cu mm • Chest X-ray- Partial consolidation of both lung field • Albumin- 3g/dL Management: • Claforan IV • Respiratory therapy • NSAIDs • Pneumonia vaccine Write a PATIENT-CENTERED case study with the following components: 1. Identify the normal changes of aging that attribute to Mrs. Maryam’s condition. (2 Marks) 2. What critical changes in function and cognition were present in Mrs. Maryam as symptoms of her disease? (2 Marks) 3. How common is the presence of pneumonia in the older adult population? (1 Mark) 4. What risk factors did Mrs. Maryam have for developing pneumonia? (3 Marks) 5. What is the role of the pneumonia vaccine in preventing the presence of this disease in the older populations? Plan a health education session to teach older adults about influenza and pneumonia vaccine. (1 + 6=7Marks) 6. How do you respond if the clients’ daughter asks you why the physician advised to discontinue antihistamine and cough suppressants? (2 Marks) 7. Based on the assessment data presented, write two priority nursing diagnoses. (2 marks) 8. Make Nursing Care Process of the first priority nursing diagnosis. Use the correct NCP format.