Nr305 Week 2: General Survey/Skin/Nutrition
Nr305 Week 2: General. This week’s graded discussion topic relates to the following Course Outcomes (COs).
CO1 Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1)
CO3 Utilize effective communication when performing a health assessment. (PO 3)
Your home health agency has received an order from a local hospital to evaluate and treat an elderly woman being discharged from its medical surgical unit.Nr305 Week 2: General
Millie Gardner, an 83-year-old female patient, is being discharged home today to the care of her husband Fred (87 years old) following a 9-day hospitalization for pneumonia, dehydration, and failure to thrive. She has a history of hypertension (HTN), Type II Diabetes, and cerebral vascular accident (CVA) with left-sided weakness. Patient is alert and oriented but does have periods of forgetfulness during the overnight hours. Patient has intermittent incontinence of bowel and bladder and requires assistance with all activities of daily living (ADLs).Nr305 Week 2: General
Medications:
Lopressor
Lisinopril
Plavix
Metformin
Novolin R per sliding scale *NEW*
Multivitamin
Colace
Zithromax *NEW*
Upon arrival you are greeted by Champ, the couple’s rambunctious miniature Doberman pinscher dog. Millie is in her wheelchair staring blankly out the window, and Fred is busy in the kitchen preparing the couple’s lunch.
Based on the scenario above, please use the general survey process to describe the areas that you would be observing immediately upon entry to the home.Nr305 Week 2: General
What, if any, concerns related to Millie’s skin and nutritional status do you have?
What nursing interventions will you include in the plan of care to address these concerns?
What teaching strategies will you use to educate Millie and Fred on the new medications?
Using the SBAR, please include the information that you will communicate to the physician’s office at the completion of the visit.
Nr305 Week 2: General Answer
Upon entering Millie’s home, my initial observations in the general survey focus on both her and the environment. Millie presents with a flat affect, gazing blankly out the window, seemingly unaware of my presence. This prompts an assessment indicating a lethargic level of consciousness, suggesting potential depression.
While the scenario lacks specifics, Millie’s age and history of CVA with residual weakness lead me to infer regular wheelchair use, possibly with assistance for transfers.
Examining her posture and position in the chair becomes pivotal—whether she sits upright with arms on the armrests or slumps with arms hanging loosely. Attention to general cleanliness is crucial, considering her reliance on assistance for activities of daily living (ADLs). I would delve into whether her husband, assumedly the caregiver, maintains regular bathing routines. Key assessments encompass Millie’s personal hygiene, the cleanliness and fit of her clothes, brushed hair and teeth, and the absence of foul body odors, indicative of recent self-care.
In such cases, comprehensive observations inform subsequent care strategies, ensuring a holistic approach tailored to Millie’s specific needs (Jarvis, 2016).
