CaseStudy You are working as an Enrolled Nurse in a large, p
CaseStudy You are working as an Enrolled Nurse in a large, public… Case StudyYou are working as an Enrolled Nurse in a large, public regional hospital. Your supervisor is Lauren, a Registered Nurse. Today Mrs Sophia Reynolds, an 85-year-old Italian widow is admitted to investigate increasing ill health and decreasing ability to self-care in her own home (a small one-bedroom unit in a regional city), despite receiving considerable services via a Local Government (City Council) ‘Care Package’ arrangement. Mrs Reynolds has a signed ‘advanced life directive’ and her daughter has “Power of Attorney’. Lauren asks you to undertake a comprehensive health care assessment and complete the admission for Mrs Reynolds. During the assessment, you notice the following issues about her.Mrs Reynolds has been very tired lately although she sleeps well and gets up late. Because of this, she stopped attending church and the local Senior Citizens club, which she used to enjoy. In addition, Mrs Reynolds’s husband and close friends all died, and her daughter only comes to visit Mrs Reynolds sometimes because she is very busy with looking after her children and grandchildren. Mrs Reynolds feels that she is very lonely and is a burden for her daughter. Mrs Reynolds is not eating as much as she did due to diabetes and old dentures. She can’t walk far because of the stiffness and pain of her knees and hips, and is very frightened to fall.In addition, she thinks getting a taxi is too expensive, so she does not go out too much. Mrs Reynolds has a strong sense of dignity but she is unable to function her activities of daily living well. She is struggling to dress, keep personal hygiene and manage her own medication. Mrs Reynolds has a ‘Home Help’ – Rosina who helps her clean house and give her a good company, but Rosina only comes once a week. Mrs Reynolds has difficulty in reading and hearing although she wears reading glasses and hearing aid. Her scalp, skin, mouth and lips are dry, and she has some halitosis and pitting oedema in both legs. She has a number of bruises both on her legs and arms, and fresh skin tears on her right arm and shin. Her feet and toes are always cold and painful sometimes.After completing the comprehensive assessment, you develop and document a nursing care plan for Mrs Reynolds. You also contact Mrs Reynolds’s daughter and arrange the referrals to multidisciplinary team members including Aged Care Assessment Team (ACAT) and other investigative tests. You ‘handover’ to Lauren. After staying at an acute care ward and rehabilitation ward, Mrs Reynolds is discharged home with increased regular community services including meals on wheels, home and community care (cleaning and shopping), and support and care planning by the local district nursing service. The Social Welfare Worker has arranged for Mrs Reynolds to receive a “half price taxi vouchers” to assist with transport and “Do Care” volunteers to visit Mrs Reynolds to increase social contacts. TaskDevelop a care plan for Mrs Reynolds. You need to identify and prioritise at least 5 of Mrs Reynold’s nursing diagnoses both in the hospital setting and when discharged to home, and their respective nursing interventions, rationales and evaluations according to her needs.In your care plan, you are to:(1) ensure that nursing interventions reflect Mrs Reynold’s needs and individuality including cultural, religious, age and gender factors and the person’s physical, psychological and social needs.(2) develop nursing interventions using respectful practices that also support the Mrs Reynold’s dignity and privacy(3) identify health literacy issues that potentially inhibit the Mrs Reynolds’s capacity to access, understand, evaluate and communicate information to maintain and improve her health, and identify at least three strategies to tackle those health literacy issues and at least three primary health care resources including health promotion programs and community and home care to improve Mrs Reynolds’s health and wellbeing.(4) identify nursing interventions which include collaboration with interdisciplinary health care teams and Mrs Reynold’s family to provide holistic care for her both in the hospital setting and when discharged to home. Describe what interdisciplinary teams you can work with to meet Mrs Reynold’s needs, and how you would encourage Mrs Reynold, family or carer to assist with Mrs Ronald’s self-care as appropriate.(5) identify the timeframe for evaluation of Mrs Reynold’s response to nursing interventions and their progress toward primary health goals appropriately.Health Science Science Nursing NURSING HLTENN015
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