Reference no: EM133562031

Case Study: Retired nurse 83 years old living alone in an apartment daughter requested her to move one year ago as she does not see her daughter as she would like she talks about regretting leaving everyone she knew behind her main social contact are what the personal support workers PSWs and nurses who care for her in her home. Mrs, W has macular degeneration severe arthritis and COPD the visiting nurse has observed that Mrs. W is overall functioning has become more compromised in the last two-month Shes struggling to go about her daily life and because of worsening arthritis she mobilizes much less than she used to. The PSW reported to the nurse that when he arrives in the late morning to help with personal care Mrs. is still in bed with the curtains drawn the apartment is quieted cluttered and disorganized with unpacked boxes still piled up in the living room the nurse has asked Mrs. several times if she has called to inquire about community resources and activities she might want to gets involved in Mrs. says she keeps forgetting the numbers the nurse also knows that last month the superintended had to remind her to pay her rent the nurse notice Mrs.W has lost weight over the last several months her fridge is almost empty there are uneaten meals scattered around the kitchen concerned she asks mrs.w about it mrs.w tells them that the money spend in food is largely a waste because of her stomach problems she quietly whispers that she need to eat less anyway because she afraid she won't have enough money to last for the rest of her life her mood has changed that she doesn't wants to do anything anymore. The nurse and PSW both recognize sign of depression

Questions:

Assessment (Recognizing Cues)

Which patient information is relevant? What patient data is most important? Which patient information is of immediate concern? Consider signs and symptoms, lab work, patient statements,

H & P, and others. Consider subjective and objective data.

Analysis (Analyzing Cues)

Which patient conditions are consistent with the cues? Does the cues support a particular patient condition? What cues are a cause for concern? What other information would help to establish the significance of a cue?

Analysis (Prioritizing Hypotheses)

What explanations are most likely? What is the most serious explanation? What is the priority order for safe and effective care?

Planning (Generate Solutions)

What are the desirable outcomes? What interventions can achieve these outcomes? What should be avoided? (SMART Planning- specific, measurable, attainable, realistic/relevant, time-restricted- Goal setting)

Implementation (Take actions)

How should the intervention or combination of interventions be performed, requested, communicated, taught, etc? What are the priority interventions? (Mark with asterisk)