Question

This week's graded discussion topic relates to the following Course Outcomes (COs).

• CO1 Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1)
• CO3 Utilize effective communication when performing a health assessment. (PO 3)

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.

Se

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  Jul 14 at 9:0

Answer 1

*The observations immediately upon entry to the home,might be greetings by the Doberman pinscher dog was warm and it was showing uncontrollable love and affection towards the couple by jumping over them.

*As Millie is having type II diabetes,there is a chance of damaging the skin by the scratching through the nails of the Doberman pinscher dog.salt restricted and low sugar diet is preferred for her Nutritional concern.
*Fred is having pneumonia ,at his health point, dogs hair,fur also allergic and more risk of becoming severe pneumonia.

*Nursing interventions related to diet plan,preventing skin infections,avoid exposure to irritants like dog fur to reduce risk of reccurence of pneumonia.

*Education on Sliding scale for blood glucose and adjustment of insulin dose is necessary.
-educate about posssible side effects like diarrhea,dizziness,fainting,itching,nausea,dark urine,clay colored stool and sever skin reactions.consult physician if develops any.

*SBAR(Situation,background,assessment and recommendations) must includes,
-on couple's health concern ,they must keep the Doberman dog away from them to avoid skin infection and pneumonia
-diet plan is needed and follow up by dietitian is necessary
-physiotherapists follow up also recommended