Home Visit with Sallie Mae Fisher (NRS 410V)
As a group, observe the simulated "Home Visit With Sallie Mae Fisher" video (http://lc(dot)gcumedia(dot)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: 1.Identify, prioritize, and describe at least four problems. 2.Provide substantiating evidence (assessment data) for each problem identified. 3.Identify and describe at least four medical and/or nursing interventions. 4.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. Scripted Dialogue Portion Utilizing the information learned from the home visit, health histories, and discharge orders, write a scripted dialogue in which you provide Sallie Mae with education that describes her problems and the interventions identified to improve her condition. Consider Sallie Mae's physiological, psychosocial, educational, and spiritual needs when developing your dialogue. Your dialogue should resemble a script. The following is an example of a few sentences from a scripted dialogue: Nurse: "Good morning, Salle Mae, my name is ______ and I will be your nurse today. I understand you are experiencing problems with ________." APA format is not required for this part of the assignment, but solid academic writing is expected. Refer to "Home Visit With Sallie Mae Fisher Grading Criteria." Entire Assignment You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin. NRS410V.R.HomeVisitWithSallieMaeFisherGradingCriteria_Student_02-11-13.docxHome Visit WithSallie Mae Fisher Grading Criteria REQUIREMENTS: Essay Portion 1) Identified and prioritized at least four problems from the simulated home visit with Salle Mae. 2) Summarized each problem identified with evidence to substantiate findings (assessment data). 3) Identified and discussed at least four medical and/or nursing interventions to meet client needs. 4) Provides rational for interventions identified. Discussion of rationale includes support from outside resources (current evidence-based literature). Scripted Dialogue Portion 1) Utilizes information learned from the home visit, health history, and discharge orders presented in the simulation to develop a patient dialog. 2) Dialog addresses physiological, psychosocial, educational, and spiritual needs of the client. Format/Style 1) Essay Portion 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. Information is paraphrased and not copied/pasted from other sources, including dictionaries, textbooks, e-books, and electronic links. 2) Scripted Dialogue Portion APA format is not required for this part of the assignment, but solid academic writing is expected. Total______pts / 100 x 200=_______% of grade Possible NRS410V.R.SallieMaeFishersHealthHistoryandDischargeOrders_Student_02-11-13.docx Sallie Mae Fisher Health History Ms. Fisher is an 82-year-old female with a history of chronic congestive heart failure (CHF), atrial fibrillation, and hypertension. During the last 6 months, she has been hospitalized four times for exacerbation of her CHF. She was discharged home last Saturday from the hospital after a 3-day stay to treat increased dyspnea, an 8-pound weight gain, and chest pain. Ms. Fisher is recently widowed and lives alone. She has a daughter, Thelma Jean, who lives in town but works full time and has family issues of her own. Therefore, family support is limited. Hospital Discharge Instructions • Mountain Top Home Health to evaluate cardio-pulmonary status, medication management, and home safety. • Medical Equipment Company to deliver oxygen concentrator and instruct patient in use. O2 at 2 liters per nasal prongs PRN. • Prescriptions given at discharge: o Digoxin 0.25 mg once a day o Lasix 80 mg twice a day o Calan 240 mg once a day • Order written to continue other home meds. Sallie Mae’s Home Medication List • Zocar 50 mg once a day • Minipres 1 mg once a day • Vasotec 10 mg twice a day • Prilosec 20 mg once a day • Furosemide 40 mg once a day • Effexor 37.5 mg at bedtime • Lanoxin 0.125 mg every other day • Multivitamin once a day • Potassium 40 mEq once a day • Ibuprofen 400 mg q 4 hours as needed for pain • Darvocet N 100 mg q 4 hours as needed for pain • Nitroglycerin ointment, apply 1 inch every day
Home Health Assessment: Home Visit with Sallie Mae Fisher
Name
Course: NRS 410V
Instructor
Date
Problems identified
Addressing spiritual care is now a top priority in healthcare as this facilitates a more objective and holistic approach (O’Brien, 2011). Effective communication and listening to the needs of patients improves healthcare. Spirituality is a personal matter and care should be exercised to address the patients’ concerns. Mrs. Fisher is widowed and though her daughter Thelma Jean lives in town, it is not possible for her to take care of Mrs. Fisher. Thus, Sallie is lonely and isolated, and since there is limited mobility, the patient is unlikely to interact with other people and this may negatively affect her psychological wellbeing Patient education also plays a critical role in the patient’s health as this imparts knowledge and helps to change the patient’s behavior (Redman, 2007). To facilitate education and improve compliance, it is important to build a rapport with Mrs. Fisher. At the moment, Ms. Fischer has attained her physiological needs, but her deteriorating health condition might negatively impact her ability to adequately cover for all needs. The patient’s health deterioration influences outlook in life, and with no one to share her life with, the patient is lonely.
Substantiating evidence for identified problems
Spiritual wellbeing is associated with improved quality of life and typically reduces incidences of distress in patients (O’Brien, 2011). Furthermore, an improved social support system and social interactions will reduce isolation and improve coping. Social isolation is one of the stressors, and the experience of hospitalization also influence patient care, and assessment of spiritual need will help to align the patient needs and improve communication after intervention (Neno et al., 2008). This is shown by the patient’s social exclusion and support from friends and immediate family members impacting negatively on her coping strategies. The patient did not divulge all information on medications to the previous nurse, and this shows that there is a need to focus on patient education. Increase in the patient’s weight coincided with treatment of dyspnea, this improved breathing and there is need for more patient sensitization. To manage pain the use of medication is necessary besides focusing on coping mechanisms, and hence pain management has been accompanied with Ibuprofen 400 mg q 4 hours and Darvocet N 100 mg q 4 hours as needed for pain. Both of these opioids are effective for pain management and hence suitable for Mrs. Fisher in community learning community.
Identify and describe at least four medical and/or nursing interventions.
Through providing spiritual information to Mrs. Fisher, it is possible to improve coping, but the intervention will support the patient’s spiritual views. Active listening, instilling hope and conveying acceptance are nursing interventions that improve communication and influence patient education on spirituality. Understanding the p...