CLC YELLOW GROUP: HOME VISIT WITH SALLIE MAE FISHER
HOME VISIT WITH SALLIE MAE FISHER
Introduction
The authors of this paper will isolate complications based on the nurse’s interview with Sallie Mae Fisher. Upon reviewing the objective and subjective aspects of the interview we will offer assessment information that supports the problem, along with interventions and rationales to help the patient achieve the best possible outcome.
Using a series of five phases we will begin the nursing process: Assessment, Diagnosis, Planning, Implementation, and Evaluation. In the assessment we will include the subjective and objective data. Based on this information we make our nursing diagnosis and identify what the priority problems our patient is dealing with. Once a diagnosis is made we develop a plan based on priorities with set goals and outcomes. We implement this by activating the plan. This can be done by the nurse, physician or a combined effort of both. The final step is evaluating if we have achieved the goals that were set forth. If the patient’s outcome did not meet the goal, we must reevaluate and readjust our goals to suit the patient’s current needs. Critical thinking is used by the nurse throughout this entire process.
Upon viewing the video provided of the home visit with the nurse and nursing student, the following was observed: Sallie Mae Fisher lost her husband last year; she appears to still be grieving. She has a history of congestive heart failure (CHF), atrial fibrillation (AF) and hypertension. Ms. Fisher was recently hospitalized with chest pain, SOB and a several pound weight gain,( most probably due to her CHF and water retention). She was discharged from the hospital last Saturday. When the nurses came from Mountain Home Health to evaluate Sallie Mae, she revealed that she has not been hungry, and she feels run down and tired. She mentioned that she really has not taken care of herself since her husband’s passing. She appears to be non-compliant she refused delivery of the home oxygen she was prescribed to be on 2L per nasal cannula PRN. She said “she did not need it and was worried about the cost”. Her daughter Thelma Jean is identified as her contact and support system. Thelma however works full time and has a family so her availability to her mother appears limited; she was not able to pick up her mother’s prescriptions until a few days after she was discharged. Sallie’s vital signs that were taken during the home visit were: BP 90/56, HR 58 and R24. She was prescribed medications upon discharge; however it appears she is continuing to take her old prescriptions as well. This could cause possible interactions and runs a risk of over medicating the patient (About Health, 2014).
Her diuretic was prescribed Lasix 80 mg BID, however she was already taking 40 mg per day. She should be on a total of 160 mg per day and she is taking 200 mg per day. This could contribute to weakness and nausea (RXList, 2015).This also could cause and imbalance in her electrolyte levels causing arrhythmias. Sallie weighed 136 lbs upon discharge and her current weight is 122 lbs, which constitutes a 14 pound weight loss which is alarming. Her physician should be notified immediately.
Ms. Fisher was prescribed Digoxin 0.25mg once daily for her ( AF ) upon discharge, at home she was already taking Lanoxin 0.125mg every other day. These are also the same medication. This medication is not to be taken if HR is less than 60 BPM. Sallie’s HR was 58 BPM. Ms. Fisher’s weight is 55kg based on that she can take 3.4-5.1mcg/kg which is 0.25mg per day (Drugs.com). The safe dose for this drug is being exceeded, which could lead to toxicity. She should have her Digoxin levels tested with a blood test (U.S. National Library of Medicine, 2015). This could further contribute to her fatigue.
Using both subjective and objective information that was gathered from the home visit with Sallie Mae Fisher, The Yellow Group identifies the following issues that need to be addressed along with interventions and rationales.
First problem, intervention and rationale
Ms. Fisher is a fall risk. Given her low BP, HR, medications, lack of appetite, as well as low energy level, There is a loose scatter rug in the Living room and she is wearing improper shoes, newspapers are laying all over the sofa and floor which poses a hazard of tripping and falling. The nurses need to go through her entire home and identify potential risk factors. Clutter needs to be removed and proper lighting needs to be in place (Ackley & Ladwig, 2011). Having client wear non-slip shoes instead of slippers would help prevent falling. Wearing appropriate footwear in the house would prevent her from slipping. Evaluate failure to use assistive aids such as a cane or walker, due to her weakness this would help her navigate through her house(Potter, Perry, Stockert, & Hall, 2011).
Second problem, intervention and rationale
Third problem, intervention and rationale
Fourth problem, intervention and rationale
Conclusion
References
Ackley, B., & Ladwig, G. (2011). Nursing diagnosis handbook: An evidence-based guide to
planning care (9th ed.). St. Louis: Mosby, Elsevier.
About Health. (2014). What is polypharmacy? Retrieved from
http://longevity.about.com/od/agingproblems/f/polypharmacy.htm
Potter, P., Perry, A., Stockert, P., & Hall, A. (2011). Basic nursing (7th ed.). St. Louis, Missouri:
Mosby, Elsevier.
RxList. (2015). Lasix. Retrieved from
http://www.rxlist.com/lasix-drug/indications-dosage.htm
U.S. National Library of Medicine. (2015). Digitalis toxicity. Retrieved from
/orders/www.nlm.nih.gov/medlineplus/ency/article/000165.htm
ASSIGNMENT
I need you to use this video website: http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php. and the document attached bellow to respond this assignment. This is a group assignment and I need you to:
Identify, prioritize, and describe one problem.
Provide substantiating evidence for the identified problem.
Identify and describe medical and / or nursing interventions.
Discuss your rationale for the interventions identified.
The identified problem, as well as the nursing interventions and rationales by the interventions must be added to the aggregate document
TO ACCESS TO VIDEO WEBSITE PLEASE ENTER TO MY STUDENT PORTAL
GO TO: gcu student portal
USERNAME: iespinosa2
PASSWORD: Cartagena5
NAME OF THE ASSIGNMENT: Collaborative learning community
ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS
Who We Are
We are a professional custom writing website. If you have searched for a question and bumped into our website just know you are in the right place to get help in your coursework.
Do you handle any type of coursework?
Yes. We have posted over our previous orders to display our experience. Since we have done this question before, we can also do it for you. To make sure we do it perfectly, please fill out our Order Form. Filling the order form correctly will assist our team in referencing, specifications, and future communication.
Is it hard to Place an Order?
ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT
1. Click on the “Order Now” on the Main Menu and a new page will appear with an order form to be filled.
2. Fill in your paper’s requirements in the “PAPER INFORMATION” section and the system will calculate your order price/cost.
3. Fill in your paper’s academic level, deadline, and the required number of pages from the drop-down menus.
4. Click “FINAL STEP” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
100% Reliable Site. Make this your Home of Academic Papers.
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Who We Are
We are a professional custom writing website. If you have searched for a question and bumped into our website just know you are in the right place to get help with your coursework.Do you handle any type of coursework?
Yes. We have posted our previous orders to display our experience. Since we have done this question before, we can also do it for you. To make sure we do it perfectly, please fill out our Order Form. Filling the order form correctly will assist our team in referencing, specifications, and future communication.Is it hard to Place an Order?
- 1. Click on “Order Now” on the main Menu and a new page will appear with an order form to be filled.
- 2. Fill in your paper’s requirements in the “PAPER INFORMATION” section and the system will calculate your order price/cost.
- 3. Fill in your paper’s academic level, deadline, and the required number of pages from the drop-down menus.
- 4. Click “FINAL STEP” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
- 5. From there, the payment sections will show, follow the guided payment process and your order will be available for our writing team to work on it.
SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS –
We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.
- Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.
- Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
- APA Format and Writing Quality
Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.
- Use of Direct Quotes
I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.
- LopesWrite Policy
For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.
- Late Policy
The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
- Communication
Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
- Guarantee
- Zero Plagiarism
- On-time delivery
- A-Grade Papers
- Free Revision
- 24/7 Support
- 100% Confidentiality
- Professional Writers
- Services Offered
- Custom paper writing
- Question and answers
- Essay paper writing
- Editing and proofreading
- Plagiarism removal services
- Multiple answer questions
We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.
Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper