The topic this week asks you to apply what you have learned to the following case study.
As the school nurse working in a college health clinic, you see many opportunities to promote health. Maria is a 40-year-old Hispanic who is in her second year of nursing school. She complains of a 14-pound weight gain since starting school and is afraid of what this will do to both her appearance and health if the trend continues. After conducting her history, you learn that she is an excellent cook and she and her family love to eat foods that reflect their Hispanic heritage. She is married with two school-age children. She attends class a total of 15 hours per week, plus she must be present for 12 hours of labs and clinical. She maintains the household essentially by herself and does all the shopping, cooking, cleaning, and chauffeuring of the children. She states that she is lucky to get 6 hours of sleep per night, but that is okay with her. She lives 1 hour from campus and commutes each day. Using Healthy People 2020 and your text as a guide, answer the following questions.
1. What additional information would you like to gather from Maria?
2. What are Maria’s real and potential health risks?
3. Why is Maria’s culture important when obtaining the health assessment?
4. Pick one of Maria’s health risks. What would be one reasonable short-term goal for this risk?
5. What nursing interventions would you incorporate into Maria’s plan of care to assist her with meeting your chosen goal? Please provide rationale for your selections..
Your home health agency has received an order from a local hospital to evaluate and treat an elderly woman being discharged from its medical surgical unit.
Millie Gardner, an 83-year-old female patient, is being discharged home today to the care of her husband Fred (87 years old) following a 9-day hospitalization for pneumonia, dehydration, and failure to thrive. She has a history of hypertension (HTN), Type II Diabetes, and cerebral vascular accident (CVA) with left-sided weakness. Patient is alert and oriented but does have periods of forgetfulness during the overnight hours. Patient has intermittent incontinence of bowel and bladder and requires assistance with all activities of daily living (ADLs).
Medications:
• Lopressor
• Lisinopril
• Plavix
• Metformin
• Novolin R per sliding scale *NEW*
• Multivitamin
• Colace
• Zithromax *NEW*
Upon arrival you are greeted by Champ, the couple’s rambunctious miniature Doberman pinscher dog. Millie is in her wheelchair staring blankly out the window, and Fred is busy in the kitchen preparing the couple’s lunch.
• Based on the scenario above, please use the general survey process to describe the areas that you would be observing immediately upon entry to the home.
• What, if any, concerns related to Millie’s skin and nutritional status do you have?
• What nursing interventions will you include in the plan of care to address these concerns?
• What teaching strategies will you use to educate Millie and Fred on the new medications?
• Using the SBAR, please include the information that you will communicate to the physician’s office at the completion of the visit.