Question

Ms. C, 72 years old, has diabetes mellitus, hypertension, rheumatoid arthritis (RA), and coronary artery disease. She lives alone. She recently was discharged from the hospital after treatment for an acute myocardial infarction. She had been doing well before this admission. You are the home health nurse assigned to visit Ms. C. Ms. C’s son tells you he is concerned that his mother will not follow up with all the medications she is supposed to take. He states that she has not been very compliant with treatment in the past. As the home health nurse, how would you approach Ms. C? What risk factors might interfere with Ms. C’s plan of care? What must you evaluate to include in the plan of care?

Answer 1

As a home nurse, my priority is to understand the difficulties faced by Ms. C and help her in overcoming them. There needs to be an aggressive management of risk factors and optimization of theraphy to achieve disease control.

Some of the risk factors common to all of these disease are:

• Age:Increased age affects alll disorders.
• Hypertention, Diabetis Mellitus and physical inactivity contribute to rheumatoid arthritis.
• Inflammation due to RA factor.
• Obesity as well as accelerated atherosclerosis can increase risk of coronary artery disease.

Care plan must include the following things to be evaluated:

• Check regularly patients glucose level, blood pressure level, Rheumatoid arthritis factor.
• Risk factor assessment is required.
• Evaluate patient response to medications.
• Observe for any clotting of blood taking place.
• Check if there is any colour change in patients extremities to know if blood supply is less in patients body or not.
• Observe for any wound formation in patient body.If so regularly clean it so that the wound will not develop into gangrene as patient is diabetic.
• Monitor patient regularly for symptoms and also if any complications exist because of these diseases.