pathophysiology and nursing managemrnt of client's health

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Question Description

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 findings” and “Sallie Mae Fisher’s Health History and Discharge Orders,” complete the following components of this assignment:

After viewing the home visit findings, 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.

Sallie Mae Fisher’s Health History 
and Discharge Orders

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:
    • Digoxin 0.25 mg once a day
    • Lasix 80 mg twice a day
    • Calan 240 mg once a day
  • Order written to continue other home meds.
  • 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 visit findings

  • area rug on the floor- fall hazard
  • Door unlocked, she doesn’t answer it, just tells person to “come in” without looking to see who is there- safety hazard
  • Dehydrated- tenting present, dry mucous membranes, BP 90/56
  • No appetite- eating canned soup- lost 14 pounds in 1 week
  • Not using prescribed O2- resp rate 24,
  • No BM for 3 days, likely due to dehydration
  • Lonely, widowed and her daughter is “busy