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In: Nursing

Case Scenario: The patient is a 72-year-old widowed Native American woman named Rose Smith.  Mrs.Smith lives alone...

Case Scenario:

The patient is a 72-year-old widowed Native American woman named Rose Smith.  Mrs.Smith lives alone near Traverse City.  Her son, daughter-in-law, daughter and their children all live outside of Michigan.  

Her income is $15,000 per year and her healthcare coverage is traditional Medicare (Parts A, B and D).  She does not have access to a car.   Mrs. Smith is diabetic and routinely receives care at the local health clinic.  For hospital care she must travel to Traverse City.

Mrs. Smith tripped in her home and broke her left hip.  A surgical repair was necessary and was performed at Munson Medical Center for surgery with a 7-day inpatient stay.  After Mrs. Smith’s inpatient stay, she was discharged to Munson Health and Rehabilitation for short-term rehabilitation stay of 14 days.  Upon discharge from Munson, in-home physical and occupational therapy was scheduled for a period of 2 months.  The discharge plan for Mrs. Smith anticipates that she will be able to be discharged from home care post evaluation.  After that date, it is anticipated that she will live independently and care for herself at home.

1. Please identify the main case issues/concerns of this case.

2. Recommendations regarding effective solutions/strategies to address identified issues/concerns.

Solutions

Expert Solution

1. main case issue:

  • self care deficit (fracture)
  • activity intolerance (fracture)
  • ineffective health maintenance (diabetes)
  • ineffective role performance (long distance travel)

2. effective solutions:

1.self care deficit (fracture):

  • appoint a maid or home nurse for help
  • get assistance in activities of daily living
  • position every 2 hours

2. activity intolerance (fracture):

  • nurse has to involve patient in passive exercises
  • assist in daily actiivties and personal hygiene practices
  • use comfort devices while in bed to prevent complications of immobility

3. ineffective health maintenance:

  • check blood glucose frequently
  • watch for signs of hyperglycemia or hypoglycemia
  • monitor intake output chart
  • monitor vital signs

4. ineffectve role performance:

  • inform family about the condition
  • let any of the children shift with the mother until she is well
  • help the children understand how to take care of her needs

Nightingale answered 1 year ago
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