Question

• Design plans for care specific to the older adult.

Consider the scenario below, then follow the instructions underneath it to complete the assignment.

Mrs. Y Mrs. Y is an 84-year-old client who was recently discharged from the hospital for an infected diabetic ulcer on her left leg. During her hospitalization, Mrs. Y required intravenous antibiotic therapy through a peripherally inserted central catheter (PICC) line. Due to Mrs. Y's long history of diabetes, her physician ordered that intravenous antibiotic therapy be continued at home. Subsequently, home health services were initiated, a home health nurse was assigned to Mrs. Y's case, and an initial home visit was scheduled. The home health nurse arrives at Mrs. Y's home and introduces herself to the client and the family. The nurse explains the home nursing services that will be provided, including the PICC line and intravenous antibiotic therapy treatments. During the initial home visit, the nurse assessed the physiological, psychological, functional, and safety needs of the client. The nurse's findings were as follows: Mrs. Y lives alone; however, her daughter checks on her frequently throughout the day. The client is noted to have moderate functional issues and ambulates with a cane. The client has several throw rugs in the main walking quarters and minimal lighting throughout the hallways. Mrs. Y states "I used to get around my house with ease, but now I get a little tired and have to sit down and rest frequently."

Consider Mrs. Y's current health status and functional decline, then address the following:

1. Download the Concept Map and Plan of Care worksheet below. An example is also provided for your reference.
   • File: Concept Map and Plan of Care worksheet
   • File: Concept Map and Plan of Care example
2. Identify three (3) priority nursing diagnoses for Mrs. Y. Consider using the resource below to assist you.
   • eBook: Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care - Chapter 5 Nursing Diagnoses in Alphabetical Order
3. Create a visual representation of the three (3) priority nursing diagnoses by incorporating them into the Concept Map (template in the worksheet). Be sure each nursing diagnosis includes the following elements:
   1. "related to (r/t)" -- description of the client's problem
   2. "as evidenced by" -- description of the client's symptoms
4. Complete the Nursing Plan of Care (table in the worksheet) describing what should be implemented for Mrs. Y.
   1. Goals: Establish at least one (1) goal for each of the nursing diagnoses you identified (for a total of 3 goals). Goals should be: patient specific, measurable, actionable, realistic, and time limited.
   2. Nursing Interventions: Describe at least three (3) nursing interventions for each of the goals (for a total of 9 nursing interventions). Each intervention should be in alignment with the goal it is supporting.

Answer 1

NURSING DIAGNOSIS 1: Activity intolerance related to functional changes accompanied by aging process as evidence by moderate functional issue and ambulate with cane.

Goal: Patient improve to fulfill the individual functional needs by performing daily living activities by self.

Nursing intervention:

- Assess the functional needs of the patient

- Provide assistance while doing the daily living activities.

- encourage the patient to perform the activities slowly by using the supportive equipment.

- Provide longer rest time.

NURSING DIAGNOSIS 2: Generalized weakness related to aging process as evidenced by verbalization of tiredness frequently.

Goal:

- Patient reduce the weakness by reducing the tiredness and saving the energy.

Nursing intervention

- Assess the condition of the patient

- Do not allow to do heavy work or exercise to save energy

- Provide adequate rest to the patient

- Encourage to take high nutritious diet.

NURSING DIAGNOSIS 3 : Risk for infection related to slow healing process due to uncontrolled blood glucose level.

Goal: The patient will be free from infection by maintain blood sugar level and maintaining hygiene.

Nursing intervention:

- Assess the skin of the patient for any cuts or wound present.

- Encourage to maintain roper personal hygiene to prevent infection

- Advice to use shoes or chapel while working and ensure to free from injury or cuts in the skin as much as possible.