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1.  

Exercise Recommendations

            Physical exercise is one of the things that promote a healthy life. It benefits people of all ages, including elderly people with no health complications as well as those with chronic health conditions such as high blood pressure, diabetes, and cardiovascular diseases. Physical exercise promotes both physical and mental health. For older people, being physically active puts them at a lower risk of mortality and developing chronic health conditions. For the older woman in the scenario, it would be advisable for her to engage in exercises that will strengthen her muscles, give her balance, promote flexibility, and generally promote her fitness (Taylor, 2014).

           According to Taylor (2014), the World Health Organization (WHO) recommends that people aged 65 years and older do at least 150-300 minutes of aerobic fitness with breaks in-between and muscle balancing exercises 2-3 days a week. Activities for improving her strength should include, but not be limited to dancing, swimming, brisk walking, light weightlifting, and cycling. Balance can be gained by participating in Tai Chi and Yoga. Flexibility exercises, including stretches and lunges, will help improve her stability and minimize the risk of falls and allow her to move around more comfortably. It is also helpful for older people to participate in daily activities as they will help them move around and can be said to be low-intensity exercises.

           Several precautions should be observed when engaging in physical exercises to reduce the risk of injury. First, since she has not been exercising regularly, it would be advisable that she starts exercising lightly, and as time goes by, she can gradually increase the intensity of the exercise. It is good for a person to check with the doctor if they feel dizzy, have shortness of breath, feel pain in the lower legs when walking, or feel pain in the chest (Mayo Clinic, 2021). Stretching before exercising and cooling down afterward helps to prevent muscle strains.

2.  

The Joint Commission (TJC) limits the use restraints to situations when it is clinically necessary to protect the physical safety of the patient, staff, or others (Meiner, 2015).

In this scenario, the patient should not be restrained because, it would be a matter of convenience and not a matter of safety.  The patient is not confused nor a significant threat to self or others.  I would also assess why the patient is agitated instead of making her more anxious with restraints.

Information to consider about the patient includes her poor vision.  I would make sure that the environment is free from clutter to prevent a fall.  The patient has functional urinary incontinence. I can place a bedside commode, so she does not have to walk far when she needs to sit on the commode.  The patient is diabetic.  If her blood glucose is high or low, it can cause behavioral changes, which may explain her agitation.

I would not request body restraints because less preventative measures must be taken to prevent falls.  I would use a bed alarm, tele monitoring service, and place a commode at the bedside.  We can assign the nursing aid as a sitter to monitor the patient if other measures fail. Further more, restraint can cause injury to an agitated patient if they keep struggling to break free.

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