Another care plan question !!!

i am not sure where you are. use of the word "whilst" in your post suggests you are not in the u.s. so i don't know if your program is teaching the use of nursing diagnosis. here in the u.s. the nursing process is used to determine problem identification in care planning. even if you do not use nursing diagnosis, nursing process needs to be used to determine p (problem) - e (etiology) - s (symptoms) which is actually how a nursing diagnostic statement is constructed. i tell students that when they read a properly constructed nursing diagnostic statement it should create a visual picture of the patient's nursing problem and explain what the problem is, what is causing it and what the symptoms of it are.

• problem - this is expressed as the nursing diagnosis. a nursing diagnosis is actually a label. to be clear as to what the diagnosis means, read its definition in a nursing diagnosis reference or a care plan book that contains this information. the appendix of taber's cyclopedic medical dictionary has this information.
  
• etiology - also called the related factor by nanda, this is the cause of the nursing problem and resulting symptoms. pathophysiologies of the patient's medical diseases need to be examined to find these etiologies. however, it is considered unprofessional to list a medical diagnosis as an etiology of a nursing problem so a medical condition must be stated in generic physiological terms. you can sneak a medical diagnosis in by listing a physiological cause and then stating "secondary to (the medical disease)" if your instructors will allow this. etiologies, if they are other than of a medical source, are often the focus of outcomes and long term goals.
  
• symptoms - also called defining characteristics by nanda, are the abnormal data items that are discovered during the patient assessment. they could be signs and symptoms of the medical disease the patient has, their responses to their disease, problems accomplishing their adls. they are evidence that prove the existence of the problem. if you are unsure that a symptom belongs with a problem, refer to a nursing diagnosis reference. these symptoms will be the focus of your nursing interventions and goals.
  

we use the nursing process to determine the patient's nursing problems, their causes and how to do something about them. . .

• a health history (review of systems) - this information has been given to you. the patient has alzheimer's disease. he had a heart attack in 1984 and aortic valve replacement in 1992. in 2004 he became incontinent of urine and in 2005 he lost bowel continence. recently very forgetful with bouts of confusion and disorientation and has been gradually losing his capacity to communicate with wife of 27 years.
  
  
• performing a physical exam - other than incontinence and a communication problem, this information is not provided
  
  
• assessing their adls (at minimum: bathing, dressing, mobility, eating, toileting, and grooming) - not really provided except that wife has said that she knew she could not continue to physically care for patient at home
  
  
• reviewing the pathophysiology, signs and symptoms and complications of their medical condition - patient was diagnosed with alzheimer's disease so you should look up this disease, its pathophysiology and signs and symptoms. also, look up heart disease:
  
  
  • http://www.merck.com/mmpe/sec16/ch213/ch213c.html
    
    
  • http://www.medicinenet.com/alzheimers_disease/article.htm
    - alzheimer's
    disease
    
    
    
    
  • http://www.nlm.nih.gov/medlineplus/alzheimersdisease.html
    - alzheimer's disease weblinks at the nih
    
    
    
    
  • http://www.fpnotebook.com/neuro/cognitive/dmnt.htm
    - ad, thumbnail list of types/signs and symptoms/diagnostic tests
    
    
    
    
  • http://www.webmd.com/alzheimers/default.htm
    - alzheimer's health center on webmd
    
    
    
    
  • http://www.medicinenet.com/alzheimers_disease_patient_caregiver_guide/article.htm
    - alzheimer's
    disease patient caregiver guide
    
    
    
    
  • http://www.merck.com/mmpe/sec07/ch069/ch069a.html
    - approach to the cardiac patient
    
    
    
    
  [*]reviewing the signs, symptoms and side effects of the medications/treatments that have been ordered and that the patient is taking - none listed

• incontinent of urine
  
  
• incontinent of bowel
  
  
• confusion and disorientation
  
  
• difficulty communicating
  
  
• self-care problems (not really elaborated on)
  
  

• total urinary incontinence r/t neurological dysfunction secondary to alzheimer's disease aeb incontinence of urine
  
  
• bowel incontinence r/t neurological dysfunction secondary to alzheimer's disease aeb incontinence of bowel
  
  
• acute confusion r/t neurological dysfunction secondary to alzheimer's disease aeb confusion and disorientation
  
  
• impaired verbal communication r/t neurological dysfunction secondary to alzheimer's disease aeb losing capacity to communicate
  
  

i don't know much more about what you are required to do for this assignment. the above is general information based on what you posted. normally, there would be a lot more specific abnormal data that would be assessed about the patient which would give more specific symptoms for diagnosing the nursing problems. step #3 of the nursing process is where you apply nursing interventions and rationales. the interventions target each of the symptoms that the patient is exhibiting. goals, if you are required to develop them, are the predicted results of your nursing interventions.

other threads on alzheimer's disease care planning:

• https://allnurses.com/general-nursing-student/new-student-need-383928.html - new student-need help with my nursing diagnosis!
  
  
• https://allnurses.com/nursing-student-assistance/care-plan-assistance-377446.html - care plan assistance