Question

I would like to know the answer for this case study questions and explanations. Thank you. 1. You are a home health care nurse scheduled for a home visit to your patient, a retired accounts payable clerk who is 7 days postsurgical with a new colostomy. Your patient lives with her husband who is involved in her care, they compile a list of questions between visits to ask upon your arival at their home. During this visit, the patient has questions regarding her colostomy equipment and stoma care; her husband has questions regarding his current medication regimen. Both of them express concerns over recent changes in their health care coverage.

(a) What data in the scenario are pertinent?

(b) Outline your nursing care responsibilities, as the home health nurse, in this scenario. Compare and contrast these responsibilities with those found in the acute care setting.

(c) What would be your recommendations for the husband's medication questions?

(d) What is the home health care nurse's role and responsibilities related to the challenges of health care reform?

2. You are a nursing student attending clinical at a large, urban university hospital where you engage in direct patient care with clinical instructor supervision. At the nurses' station, you overhear various nurses addressing patient care needs, including an RN requesting consults with a physical therapist, a respiratory therapist, a dietitian, and a social worker. Another nurse discusses the potential need for palliative or hospice care consults for a patient. You observe a physician assistant approach the nurse with a list of written orders.

b. Outline the roles of the various licensed healthcare workers mentioned in this scenario.

c. Compare and constrast palliative and hospice care. What is the major differnce between the two?

d. As a nurse, what is your responsibility regarding physician assistant(PA) orders?

Answer 1

A)In this scenario the doubts for the medication and care for the patient is relevant.These should be clarified.

B)In colostomy a opening made by surgery and brings a piece of intestine or bowel to the outside of the abdomen.

Nursing responsibilities

a)Skin care: Assess the skin for the irrigation or break down, apply skin barrier paste.

b) Psychosocial adaptation:The nurse should help the patient to accept the colostomy and teach about care and management.

c)Teach about nutrition:light low residue diet.

d)Tell the patient about the medication time ,also some medications that will change the colour ,odor, consistency of the stool.

Control the odor by changing the bag, cleaning.

Teach the patient about how to empty and clean the bag.

Provide psychological support.

Make them comfortable by answering for their doubts.

C)Tell the patient about the medication action,time,and need for taking medication in correct time.

Some medications will change the odor , colour and consistency of the stool.

Medication that should not skip and have to take in time.

D)Tell the people or patient and family about the disease condition and reach them about medication and care.

Educate them about to prevention of disease and how to prevent the disease.

Educate regading hand hygiene and importance of hygiene during the care.

Improve the quality of care by education and practice also by education to patients.

2)b: Role of a health care workers

Doctor:The role of the docters is for the care and safety of the patients.Engage with colleagues. To improve the quality and safety of the patient care.discussions will improve the quality and outcome.

Nurses: Nurses are the person who is spending more time with the patient.

Nurse should provide total care of the patient and assist them to do the daily activities.Medications are given by nurses by oder from the doctors.Nurse should assess and observe for any change in patients conditions and act in every situation .she should provide psychological support to the patient and make them comfortable.

Physical therapist: Who examine each person and develop a treatment plan to improve their move , reduce,or manage pain, restore function and prevent disability.

Respiratory therapist:They work under the supervision of doctors,and treat a range of persons from premature infants whose lungs are not fully developed to elderly people with lung disease.They give patient oxygen,manage ventilaters,and administer medication to the lungs.

Dietitian: Advice people and help them to make informed and practical choice about their food and nutrition.assess ,diagnose,and treat nutritional problems.Teach public and health professionals about their diet.

Social worker: support individuals and families in difficult times,and ensure that vulnerable people including children and adults and safeguarding from harm.help the people to improve living outcomes.They guid the people and act as advocate.

C) Palliative and hospie care.

Palliative care that improve quality of life of patient band their families facing the problem associated with life threatening illness, through the prevention vand relief of suffering ,by means of early identification treatment of pain and other problems.

Hospice care is a type of health care that focus on the palliation of a terminally ill patients pain and symptoms and attending their emotional and spiritual needs at the end of life. hospice care prioritise comfort and quality of life by reducing pain and suffering.

Both palliative care and hospice care provide comfort.But palliative care can begin at diagnosis,and at the same times treatment.

Hospice care begins after treatment of the disease is stopped and when it is clear that the person is not going to survive the illness.

Hospice care most often offered only when the person is expected to live 6 months or less.

D) When the physician assistant orders are receiving nurse have to do the things what is orders and ask for any doubts.Nurse should administer the medication and provide care according to the order.Before that have to tell them to provide written order in case of any medication.