Question

In: Nursing

Case 2 (Ms. Brown continued, I need answers typed please I posted case 1 in the...

Case 2 (Ms. Brown continued, I need answers typed please I posted case 1 in the end if you need it).

Patient: Brown, Francine

DOB: 04/25/44

Medical Record Number: 09052016

Allergies: NKA

Precautions: Fall

Height: 5’ 2”

Weight: 60.4 kg

Ms. Brown condition improves, and she is discharged home after her admission to the hospital for her CVA. She has residual right-sided weakness in her arm and leg and a right-sided visual field cut. Ms. Brown is prescribed the following daily medications: metoprolol, warfarin, simvastatin, and furosemide.

Ms. Brown lives alone in an apartment and was set up with visiting nurse services and home physical therapy. She uses a walker to ambulate. The nurse notices that Ms. Brown drags her right foot when ambulating. Ms. Brown reports that she tires easily has been unable to complete her ADL’s aside from toileting and brushing her teeth.

What is a priority nursing diagnoses for Ms. Brown?

Set an outcome (goal statement) for this diagnosis.

What interventions would you take to meet this nursing outcome?

Fast forward one week: Write an evaluative statement for your nursing diagnosis. (You can embellish the story however you’d like.)

if you need case 1 here it is

Case 1

Patient: Brown, Francine

DOB: 04/25/44

Medical Record Number: 09052016

Allergies: NKA

Precautions: Fall

Height: 5’ 2”

Weight: 60.4 kg

Your patient, Ms. Brown, is admitted to the hospital after a CVA (Stroke) secondary to irregular heartbeat. She also has a history of HTN and hyperlipidemia. Ms. Brown lives alone and was found down on the floor by her neighbor. It was estimated she had been down on the ground for around 14 hours.

Ms. Brown is unable to walk at this time and is confined to her bed. She has a poor appetite and eats only bites at each meal. She has several episodes of bladder and bowel incontinence daily.

What are your primary concerns for Ms. Brown? Word two of these concerns as nursing diagnoses (one actual & one risk for)

Nursing Diagnosis statement actual (3 parts):

Nursing Diagnosis statement potential or “risk for” (2 parts):

Select an outcome (goal statement) for one of the nursing diagnosis selected from above.

What nursing interventions would you perform to treat these concerns? What interprofessional team members could you involve in the care of Ms. Brown?

Solutions

Expert Solution

Nursing diagnosis and interventions for a patient admitted with CVA are :-

Nursing diagnosis - Risk for development of pressure sores related to bed ridden status

Outcome -to prevent the development of pressure sores related to immobility

Nursing interventions are:-

- Assess the vitals of the patient

- Assess the patient for any pressure sores mainly the prone areas as the patient is bed ridden chances of pressure sores are high

- Change the position of patient every two hourly

- Use of comfort devices for positioning to maintain the correct position.

- Avoid moisture as it increases chances of sores and a area for bacterial growth.

- provide back care with powder to avoid moisture and for prevent breakdown of skin

- provide diet rich in protein and vitamin C for proper and timely healing of tissues

- maintain hydration status of the patient.

- use of air mattress to avoid pressure sores

-appropriate use of Braden score,if any pressure sores are there and also providing prompt sore care to the patient

2. Nursing diagnosis- Impaired mobility related to stroke as evidenced by bed ridden status of patient

Outcome - to improve the mobility status of the patient

Nursing interventions are :-

- Assess the vitals of the patient

- Help the patient to change there position

- Help the patient in activity of daily living

- Use of devices for to enhance mobility

- Providing emotional support to the patient

- Assess the patient for bed sores related to immobility

3. Risk for development of DVT related to immobility

Outcome - to prevent development of deep vein thrombosis and early identification of thrombosis to avoid complications like Pulmonary embolism.

Nursing interventions are :-

- assess the vitals of the patient

- assess the legs and other sites for signs of thrombosis like swelling, warmth, redness,

- advice the patient to keep the legs elevated

- advice and help the patient in doing range of motion exercise to prevent thrombosis

- assisting the patient to change position two hourly

- use of compression stockings as advised

- use of intermittent pneumatic compression devices to avoid vein thrombosis

4. Risk of fall related to altered mobility and mental status related to cerebrospinal vascular accident

Outcome - to prevent fall and associated complications

Nursing interventions are:-

- Assess the vitals of the patient

- Make the patient orient to the surrounding environment by using calenders ,clocks, pictures

- Keep the side rails up all time

- keep the floors dry especially of washroom

- proper lighting of the patient's room

- keep the height of bed low

- Don't leave the patient alone

- Assisting the patient while getting off of bed and vice-versa for washroom etc

5. Nursing diagnosis- Incontinence (urinary and fecal ) related to trauma to the centres controlling Bowe and bladder movement

Outcome - to prevent complications related to incontinence such as bed sores , infections etc

Nursing interventions are :-

- Assess the vital signs of the patient

- Assess the voluntary and involuntary reflexes

- Catheterization of the patient to avoid bed wetting and infections and pressure sores

- Use of diapers as the patient is unable to walk to the washroom

- Providing perineal care once a shift and also after every voiding movement to avoid risk for pressure ulcers and infections

Therapeutic interpersonal relationships will be used within the team members and would involve doctors ,nurses dieticians physiotherapist , nursing assistant will be included in the care of the patient.


Related Solutions

Please I need clear and typed answers to these two questions: Q1)Explain the two types of...
Please I need clear and typed answers to these two questions: Q1)Explain the two types of file compression? Then determine the best compression strategy suited for: a- Photograph of sailboat on ocean. b- Journal article explaining nanotechnology. Q2)What are the advantages and disadvantages of Description-Based Encoding and Command-Based Encoding?
I need to make sure that my answers are correct please review. The Case as following:...
I need to make sure that my answers are correct please review. The Case as following: Focus Drilling Supplies has been growing steadily over the last 20 years. With increased exploration in the mining sector, the company has decided to expand their facilities for supplies and custom drill bit production to meet the increased demand. The expansion will occur over 4 years and is expected to require $2.8 million. Management has developed a payment plan for carrying out this expansion....
[Typed answers please] 1. Write a paragraph explaining why Seasons occur on the Earth. 2. In...
[Typed answers please] 1. Write a paragraph explaining why Seasons occur on the Earth. 2. In a short paragraph, explain how Newton’s Law of Gravity depends on mass and distance. Don’t just write the equation; explain what the equation means and give some simple numerical examples. 3. What is mass, and how does it differ from weight? Write a paragraph. 4. List Kepler's Laws of Planetary Motion and briefly explain what each means. 5. In a paragraph, describe at least...
please i need a detailed report on the industry dynamics of the aviation industry typed not...
please i need a detailed report on the industry dynamics of the aviation industry typed not had written please
-- please I need a typed answer, no photos. -- Pick a company to research. Make...
-- please I need a typed answer, no photos. -- Pick a company to research. Make sure that it is large enough to have enough data to make it easy to research. It is desired that this company should have a reasonable use of Internet/e-commerce technologies in its operations. *Do some background research on the company you chose. Their past and their present, when did they start incorporating e-business elements? Are they Using e-commerce in any aspect of their operations?...
I need this computer typed so I can read it and explained ASAP please!!! In Vienna,...
I need this computer typed so I can read it and explained ASAP please!!! In Vienna, Eliud Kipchoge became the first athlete to run a marathon in less than two hours. Kipchoge wore a special type of shoe developed by Nike called Vaporfly that is different than all previous running shoes. It has a much thicker midsole and has a layer of carbon fiber to bounce back as much energy as possible. Nike engineers claim that Vaporfly is significantly faster...
I need some one to do these questions 100%. Please provide me Correct answers in 1-2...
I need some one to do these questions 100%. Please provide me Correct answers in 1-2 hours. I already lost time due to wrong answers. 1.Calculate the present value of a $1,000 zero-coupon bond with 10 years to maturity if the required annual interest rate is 6.5%. 2.A lottery claims its grand prize is $25 million, payable over 25 years at $1,000,000 per year. If the first payment is made immediately, what is this grand prize really worth? Use a...
I need this computer typed so I can read it, and please show work. thanks! You...
I need this computer typed so I can read it, and please show work. thanks! You purchase an ABC 10%, 30 Year bond with a $100 face value for 109.72 What is the yield to maturity of the bond? What is the current yield on the bond? What is the duration of the bond? If you bought the bond today and sold it after 1 year at a YTM of 10% what is your cash flow yield? What is your...
I need this computer typed so I can read it, and please show work. thanks! Your...
I need this computer typed so I can read it, and please show work. thanks! Your current salary is $100,000 per year. Every year you save 10 percent of your salary and invest it in a 401K plan which provides you a guaranteed return of 6 percent per year. Assume the deposits will be made at the end of each year for the next 40 years. How much will you have at the end of 40 years if your salary...
I need case studies for case Asbestos encapsulation please
I need case studies for case Asbestos encapsulation please
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT