Question

Scenario: Susan is a 65-year-old school nurse who has recently retired from an elementary school. She is beginning to feel rather lonely now that she is no longer working. She is a widow with adult children living out of the area. Her children have suggested that she may want to move to their city and be closer to her grandchildren. She has been avoiding these discussions with her family and tells them all is fine. Moving seems like a major upheaval to her. Although she has been in fair health physically, at her last visit to the health care provider, she had lost 10 pounds and is just below her desired weight. See the link to the Overview of the Nursing Process document to assist with this assignment. Initial Discussion Post: Select a developmental theory presented in this module and apply it to the scenario above. Use the chosen theory to address the following: Explain her behavior. State two (2) priority nursing concerns and related nursing interventions for her.

Answer 1

Solution:

Susan is a 65 year old who was just retired, she is having difficulty adapting to her new life style. She has been worked as a nurse throught her life, she has developed integrity, she doesnt want to be dependent on anyone as shehas been taking care of other lives, she feels capable enough to take care of heself, but there are other areas of her life probably she is dissatisfied with , and most basic for any widow would be loss of her partner, hence she is having "Despair" which is leading to depression and inturn leading to her weight loss and She doesn’t want to move because it seems like it would be an “upheaval” to her. She is in denial and isn’t willing to talk about this with her children. She has no health issues except for she lost 10 pounds since her last checkup. She is now just below her desired weight and if she loses more weight she could start to have health problems.

Nursing concern:

1. First prioty concern would be Nutrition Patten

should evaluate ans assess Susan's nutrition pattern, one of the major reasons for elderly people to loose weight is because of their diet pattern and simply because their internal organs have started to degenerate and their metabolism has reduced Nursing Interventions:

a. Assess her eating pattern, her likes and dislikes about her food

b. Once assessed, evaluate the total calories required per day by the diettician

c. Plan a proper diet for her so that it will nurish her as well she can metabolize it easily, most often a small ans frequent diet will always help

d. add diet which she likes as muich as possible , make it more tasty as possible

2. Activity

a. Susan is person who has working all her life she require to be invovled in activities

b. she can participate in help groups which involves activities that are simple and are easily achieved for her age

c. can well assess her intrests and could help her out to be involved in those activities

d. getting her to read her favourite novels or in activities she is more involved in

3. Regular Lab tests

This will help her to keep a tab on all her vitals and degenration

Spiritual Distress:

May be related to life changes, self-alienation, sociocultural deprivation (Treas, Leslie S., and Judith M. Wilkinson.,2014).

Possibly evidenced by lack of interest, questions meaning of own existence, expresses feelings of hopelessness and helplessness, refuses to interact with family, friends or religious leaders.

Nursing Interventions and Rationales:

Encourage patient to write a journal expressing her thoughts and reflections daily. This will help the patient to identify her thoughts and feelings.

If she is unable to write provide her with a tape recorder. Speaking out loud helps a person clarify thinking and explore issues.

Ask the patient what has given her comfort and meaning in the past. When depressed a patient is having a hard time searching for meaning in life and reasons to go on when feeling hopelessness and despondent.

Provide information or referrals when needed for spiritual information, readings programs, tapes and community resources. While in the hospital spiritual tapes and readings might be useful for the patient. When the patient is in the home find ways to get her connected with a spiritual advisor or priest (Hinkle, Janice L., and Cheever, Kerry H., 2014)

Desired outcomes:

Patient will feel connected with others to share thoughts, feelings, and beliefs.

Patient will feel connected with inner self.

Patient will discuss with a nurse two things that gave her life meaning and concern within 3 days.

Patient will keep a journal for tracking her thoughts and feelings.                                                

Patient will state she wants to participate with her children.

Imbalance Nutrition: less than body requirements, related to stress, notwanting or forgetting to eat, or losing interest in daily activities (Kluwer, W., & Williams & Wilkins, L. 2013).

Nursing Interventions and Rationales:

Monitor food intake every day, making sure she eats all the calories she needs for one day. This will help provide information about the patient nutritional status.

Monitor the patient weight daily. This will provide information om whether the patient is starting to gain weight again.

Encourage patient to consume high-calorie diet while taking in adequate fluid intake. Snacks should be recommended for the patient. Higher calorie intake is what the patient needs until reaching the desired weight set by the doctor.

Create a pleasant dining experience, such as dinner with friends or family. This may create a feeling of wanting to eat.

Desired outcomes:

Patient will be at the appropriate weight for her age and size.

Patient will be able identify nutritional requirements for herself.

Patient will understand the need for consuming adequate nourishment and demonstrate this to the nurse.

Patient will be free of signs of malnutrition.

References:

Hinkle, Janice L., and Cheever, Kerry H., (2014). Brunner & Suddarth’s: Textbook Of Medical-Surgical Nursing. Philladelphia, PA: Lippincatt Williams and Wilkins, 2014. Print.

Treas, Leslie S., and Judith M. Wilkinson., (2014). Basic Nursing: Concepts, Skills, & Reasoning. Philadelphia, PA: F.A. Davis, 2014. Print.

Kluwer, W., & Williams & Wilkins, L., (2013). Nursing Care Planning made Incredibly Easy (2nd ed.). Ambler, PA: Lippincott Williams and Wilkins, 2013. Print.