Question

Baxter, 39 with unexplained weight loss, treated for hyperthyroidism.

Recently married with 1 child. Lives with family in a private home. Employed as a night worker in a factory. Pays out of packet for health services. Resides in zip code 11233

A client scheduled for discharge back to their community New York, Brooklyn, Zip code 11233 from the acute care setting. As the Community Health Nurse assigned to be the Case Manager for this client, you will be required to prepare a discharge plan of care for the client (template provided). Plan of care must focus on Primary, Secondary and Tertiary levels of prevention for management of the client while in the community, resources and knowledge of the resources available within the community. Students provided with a discharge plan template.

Points allotted as follows:

• Identification of 3 Priority Nursing Diagnoses for care in the community – 12%
• Identification of Primary, Secondary and Tertiary levels of prevention appropriate for age, gender and diagnosis – 6%
• Setting S.M.A.R.T objectives for continuity of care in the community setting – 2.0%
• Using the Function Health Status Approach to Community Health Assessment (Chapters 11 and 13), identify the health care agencies within the community ( 11226) that you would most likely collaborate with to ensure that your client receives optimal care in the community setting – 5.0%

Priority Nursing Diagnoses	Primary Prevention needs	Secondary Prevention needs	Tertiary Prevention needs	S.M.A.R.T Objectives for each Diagnosis	Based on the diagnoses, list the resources needed to care for this client in their Community (11233)
Nursing Diagnosis 1
Nursing Diagnosis 2
Nursing Diagnosis 3

As the Community Health Nurse for this client, use the Functional Health Status Approach method for Community Assessment list the agencies available in the zip-code area to facilitate partnering for care of the individual in their community:

Answer 1

nursing diagnosis	primary prevention	secondary prevention	tertiary prevention	objective	List of resources needed to care for the patient
Imbalance nutrition less than body requirement related to excessive metabolism as evidence by unexplained weight loss	-Educate the patent regarding the hyperthyroidism - Explain the nutritions that can be taken by a hyperthyroidism patient to prevent weight loss	- Screening for hyperthyroidism -Advice the patient to come for follow up on time - check the weight and height of the patient - calculate the BMI of the patient to understand the weight loss	- Advice to take treatment on time. - Explain regarding the medication should be take in an empty stomach early morning. - Advice that it should be taken for life long.	The patient will demonstrate the stable weight by increasing to normal body weight	- A nutritionist to give a proper plan for the diet - The diet should be from locally available food items - The nurse is needed to assess the patient on time for any malnutrition - Doctor is needed to check any further complications or the body is improving.
Risk for decreased cardiac output related to inadequate blood pump by the heart to meet the need for high metabolism demand of the body	-Educate the patient regarding the sign and symptoms of the hyperthyroidism - Demonstrate how to identify the signs of palpitation if occurs at home	-Screening for hyperthyroidism -Early screening for any cardiac problem during the follow-up visit to the doctor. - Check or test the metabolic rate. - Check the vital signs	- Give the medication if decrease cardiac output present in the patient body - Admit the patient in the hospital for proper treatment.	Patient will be free from decrease cardiac output as evidence by stable vital signs palpable peripheral pulse.	- Quite and calm environment is needed - Free from stress environment is needed - Maintain a balanced diet
Risk for fatigue related to the hypermetabolic state with increasing energy consumption.	Educate the patient regarding the disease condition, sign, and symptoms of hyperthyroidism - Advice to take a healthy diet.	- Screening of the patient for hyperthyroidism should be done on time - Observe the patient for any weakness or fatigue	- Provide a high-calorie diet - administered medication for hyperthyroidism - provide adequate bed rest to the patient - Admit the patient in the hospital and provide IV treatment for maintenance	The patient will increase the ability to participate in the desire activities	- Proper rest - family support in doing activities - A calm and quiet environment to take rest - Good nutrition with a high-calorie diet is needed.