Question

Novel Coronavirus Disease (COVID-19) Family Dilemma: Part II

Glenda Taylor, 67 years old (John’s spouse)

STUDENT-COVID-19-UNFOLDING_Reasoning-Part-1.pdf

STUDENT-Part-II-COVID-19-Family_Dilemma.pdf Scenario

2. What data from the history is RELEVANT and must be NOTICED as clinically significant by the nurse?

(Reduction of Risk Potential) RELEVANT Data from Present Problem: Clinical Significance:

3. Current Concern: Since Glenda has not been updated on John’s change of status, you call Glenda and communicate his critical condition and his need to be intubated and placed on a ventilator. Glenda is clearly upset and states, “I need to see him! I need to be there! We’ve been married for 48 years and nothing has separated us! He needs me now more than ever!”

What data from the current concern is RELEVANT and must be NOTICED as clinically significant by the nurse? (Reduction of Risk Potential) RELEVANT Data from Current Concern: Clinical Significance:

4. Caring and the “Art” of Nursing: what is John’s spouse likely experiencing/feeling right now in this situation? What would you specifically communicate to his spouse under these circumstances? (NCLEX: Psychosocial Integrity)

What Patient/Family is experiencing: What to Communicate:

Resolving the Dilemma

1. Interpreting RELEVANT clinical data, what is the essence of this clinical dilemma? (Management of Care)

2. What additional information is needed by the nurse to clarify the dilemma? (Management of Care)

3. What additional members of the healthcare team could be used in this situation if Glenda was able to be in the hospital? Why? (Management of Care)

4. What psychosocial/holistic care PRIORITIES need to be addressed for this patient? (Psychosocial Integrity/Basic Care and Comfort)

Answer 1

As Glenda is 70 years old she is at high of affecting and having complications of Covid-19. This must be noticed as clinically significant by the nurse. So she should be kept away from hospital atmosphere and ICU where Covid patients are admitted. Glenda's spouse is in critical condition and needed to be ventilated. This must be noticed and its relevance should be concerned by the nurse because of its clinical significants.

1. Glenda is hopeless anxious and agitated due to her husband's illness. The nurse should keep the psychological integrity that is she should be emotionally balanced enough to support the patient and significant others. Reassure them in such kind of scenarios. There are 5 stages of emotions while there is a loss or grief ie denial, anger, bargaining, depression & acceptance. Mrs.Glenda may be in any of this stages of denial or bargaining. So the nurse should assist her to cope up with the current circumstances.

2. The nurse should check for additional information while handling this dilemma.

Availability of PPE if Glenda is allowed to stay in the hospital. Assess whether she is immuno compromised or not. Hisotry of comorbidities should be assessed.

3. A Counselor should be included in the healthcare team.

4. Holistic approach

(1) Alleviating dyspnea and hypoxemia.

(2) Ensuring effective coughing, breathing gradually becoming stable and lung sounds clear.

(3) Controlling body temperature effectively.

(4) Relieving diarrhea.

(5) Reducing the chance of developing pressure injury during hospitalization.

(6) Detecting and handling complications effectively.

(7) Ensuring patients have a stable emotion and gaining effective cooperation from patients when implementing therapeutic nursing interventions and rehabilitation programs.

(8) Ensuring a gradual return to a normal diet and maintaining the desired body weight at a standard level.

(9) Maintaining patient comfort during hospitalization and satisfying their needs timely.

(10) Improving patients’ activity endurance.

(11) Ensuring high compliance with isolation and effective self-protection among patients.