Question

Baxter, 39 with unexplained weight loss, treated for hyperthyroidism.

Recently married with 1 child. Lives with family in a private home. Employed as a night worker in a factory. Pays out of packet for health services. Resides in zip code 11233

A client scheduled for discharge back to their community New York, Brooklyn, Zip code 11233 from the acute care setting. As the Community Health Nurse assigned to be the Case Manager for this client, you will be required to prepare a discharge plan of care for the client (template provided). Plan of care must focus on Primary, Secondary and Tertiary levels of prevention for management of the client while in the community, resources and knowledge of the resources available within the community. Students provided with a discharge plan template.

Points allotted as follows:

• Identification of 3 Priority Nursing Diagnoses for care in the community – 12%
• Identification of Primary, Secondary and Tertiary levels of prevention appropriate for age, gender and diagnosis – 6%
• Setting S.M.A.R.T objectives for continuity of care in the community setting – 2.0%
• Using the Function Health Status Approach to Community Health Assessment (Chapters 11 and 13), identify the health care agencies within the community ( 11226) that you would most likely collaborate with to ensure that your client receives optimal care in the community setting – 5.0%

Priority Nursing Diagnoses	Primary Prevention needs	Secondary Prevention needs	Tertiary Prevention needs	S.M.A.R.T Objectives for each Diagnosis	Based on the diagnoses, list the resources needed to care for this client in their Community (11233)
Nursing Diagnosis 1
Nursing Diagnosis 2
Nursing Diagnosis 3

As the Community Health Nurse for this client, use the Functional Health Status Approach method for Community Assessment list the agencies available in the zip-code area to facilitate partnering for care of the individual in their community:

Answer 1

Nursing diagnosis should be made base on the sign and symptoms of the patient. Primary prevention is focused on the prevention of disease before occurring. Secondary prevention is focused on early diagnosis and treatment. Lastly, tertiary prevention is focused on the rehabilitation of the patient to prevent further complications of the treatment.

Nursing diagnosis	Primary prevention	secondary prevention	Tertiary Prevention	objectives	resources need
Imbalanced nutrition less than body requirement related to hypermetabolism as evidenced by unexplained weight loss	- Educate regarding the hyperthyroidism - Educate regarding the importance of maintaining a properly balanced diet	-Screening for the hyperthyroidism - Check the BMI of the patient to see malnutrition	- Admit the patient in a hospital - Provide a high-calorie diet - Reduce activities of the patient - Continue treatment for hyperthyroidism	The patient will maintain normal body weight	- proper nutrition - check of BMI frequently
Risk for activities intolerance related to fatigue secondary to excessive energy use during hypermetabolism	- Educate regarding the sign and symptoms of hyperthyroidism	- Screening for the Hyperthyroidism - Observe the activities of the patient that he can perform himself or not.	- admit the patient in a hospital or nursing home - assist the patient in daily activities - Continue treatment for hyperthyroidism	The patient will able to perform daily living activities	- Family support - Assist in daily activities - High-calorie diet
The risk for impaired comfort related to heat intolerance and profuse diaphoresis	- educate regarding the disease condition hyperthyroidism	-Screening for the hyperthyroidism - Identify for any sign of discomfort because of heat intolerance and diaphoresis	- Admit the patient in the hospital - Provide care to prevent the symptoms - Continue treatment for hyperthyroidism	- The patient will be free from discomfort by decreasing discomfort symptoms	- Maintain good environmental temperature