Sallie Mae Fisher’s Health History and Discharge Orders
Observe the simulated “Home Visit With Sallie Mae Fisher” video (http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php).
Refer to “Sallie Mae Fisher’s Health History and Discharge Orders” for specifics related to the case study used to inform the assignment.
Using “Home Visit With Sallie Mae Fisher” and “Sallie Mae Fisher’s Health History and Discharge Orders,” complete the following components of this assignment:
Essay Portion
After viewing the home visit, write an essay of 500-750-words in which you do the following:
- Identify, prioritize, and describe at least four problems.( problems identify are as follows
Mrs. Fisher’s number one problem is dehydration. In the video her vital signs are: Heart rate 58, blood pressure 90/56, respiratory rate 24 and temperature 97.8F (GCU, 2017). Her physical assessment reveals poor skin turgor, tenting, dry mucus membranes, hypoactive bowel sounds, no bowel movement for three days and a 14 pound weight loss in one week (GCU, 2017). She admits to “not having an appetite.” She is taking Lasix, a diuretic further contributing to her fluid loss. All of these finding are consistent with dehydration. Dehydration can lead to a kidney injury, seizures and hypovolemic shock (Mayo Clinic, 2017).
The next problem is an unsafe living environment. In in video we see a loose rug on the floor, prescriptions on the table and mail on the couch. This lack of organization and Mrs. Fisher’s age put at risk for a fall. The Center for Disease Control and Prevention (CDC) states, “One out of five falls in an older adult causes a serious injury such as broken bones or a head injury” (CDC, 2017).
Then we look at her lack of understanding surround her discharge. She is supposed to be on home oxygen but didn’t have it delivered because she thinks she will, “Be in the poor house” due to cost of her medications and medical supplies. The final problem is her depression. Mrs. Fisher explains her husband died. She now lives alone and, “doesn’t even care, is so lonesome and misses him so” (GCU, 2017).
- Provide substantiating evidence (assessment data) for each problem identified.
- Identify and describe at least four medical and/or nursing interventions.
- Discuss your rationale for the interventions identified.
Prepare this step of the assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
