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Fundamentals Of Nursing

Fundamentals Of Nursing

The Health Care Delivery System
1. You are a home health care nurse scheduled for a home visit to your patient, a retired account payable clerk who is 7 days postsurgical with a new colostomy. Your patient lives with her husband who is involved in her care; they compile a list of questions between visits to ask upon your arrival at their home. During this visit, the patient has questions regarding her colostomy equipment and stoma care; her husband has questions regarding his current medication regimen. Both of them express concerns over recent changes in their health care coverage.  Fundamentals Of Nursing

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a. What data in the scenario are pertinent?
b. Outline your nursing care responsibilities, as the home health care nurse, in this scenario. Compare and contrast these responsibilities with those found in the acute care setting.
c. What would be your recommendation for the husband’s medication questions?
d. What is the home health care nurse’s role and responsibilities related to the challenges of health care reform?
2. You are a nursing student attending clinical at a large, urban university hospital where you engage in direct patient care with clinical instructor supervision. At the nurses’ station, you overhear various nurses addressing patient care needs, including an RN requesting consults with a physical therapist, a respiratory therapist, a dietitian, and a social worker. Another nurse discusses the potential

need for palliative or hospice care consults for a patient. You observe a physician assistant approach the nurse with a list of written orders.
a. Outline the roles of the various licensed health care workers mentioned in this scenario.
b. Compare and contrast palliative and hospice care. What is the major difference between the two?
c. As a nurse, what is your responsibility regarding physician assistant (PA) orders?

Fundamentals Of Nursing

 

Fundamentals Of Nursing

Fundamentals Of Nursing

Case Study

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Daniel is a 16 year old boy who is an identical twin. He and his brother Jeff are very close and do most things together. While Daniel excels at sports he believe his brother is much better at most everything. Daniel, his brother, and their two sisters live with their parents in the Midwest. Recently Daniel has been feeling more tired than usual. He thought it was because of his schedule and school work, which he is fairly good at. He gets mostly Bs, but his grades have been slipping of late. One day he fainted while getting ready for a game. His coach called his parents to let them know Daniel was taken to the Emergency Room. While there the doctor decided to admit Daniel to the hospital for observation. At the time he was running a slight fever, his breathing was shallow, and he was sweating. He was also very sleepy and his blood pressure was high. He did have some abnormal laboratory work, but his doctor was not too concerned at present. Daniel also stated that he felt achy.

You are assigned to take care of Daniel today and when you walk into his room, his mother and brother Jeff are there. Daniel appears to be sleeping. In your written assignment, respond to the following questions applying the nursing process:

Assessment: What type of objective and subjective data can you collect with what you know? How will you collect these data? What further evidence do you need?

Analysis and Identification of the Problem: What do you believe Daniel’s problem(s) are? What might be the nursing diagnoses? Use the following for identification.

Planning: Identify two goals and one nursing intervention for each, based on your nursing diagnoses.

While you will not be able to implement or evaluate, how well do you think your nursing interventions might help with Daniel’s care.