To discuss:
How do you think you would respond in a similar situation? Why?
Case summary:
Mrs. P is a single, 88-year-old woman, was hospitalized for cardiac problems. She has been in her beginning of dementia. She lives alone in a small home along with her cats. When she was ordered for the discharge, the nursing student worried about Mrs. P’s ability to live safely on her own. The nursing student suggested her about moving to a retirement community or long-term care facility. But Mrs. P refused those options. The nursing student was worried about her safety and reported to the charge nurse. The charge nurse replied that we can do nothing if the patient is not willing to explore the other options.
Explanation of Solution
In a similar situation, the nursing student could first determine the patient’s needs for independence and safety. The nursing student then would work with the social services in order to investigate the possible community support resources that are available for this patient where the patient could maintain her independence. The nursing student then might suggest certain options that are suitable to Mrs. P. The patient’s wish for being independent and the nursing student’s concern on the patient’s safety might be fulfilled by doing so.
To discuss:
What does this tell about yourself and about the adequacy of your skills for professional practice?
Case summary:
Mrs. P is a single, 88-year-old woman, was hospitalized for cardiac problems. She has been in her beginning of dementia. She lives alone in a small home along with her cats. When she was ordered for the discharge, the nursing student worried about Mrs. P’s ability to live safely on her own. The nursing student suggested her about moving to a retirement community or long-term care facility. But Mrs. P refused those options. The nursing student was worried about her safety and reported to the charge nurse. The charge nurse replied that we can do nothing if the patient is not willing to explore the other options.
Explanation of Solution
The nursing student was found to be still in the learning phase and developing the skills for professional practice. On the basis of the answer provided in the similar situation, the nursing student seems to have adequate skills for the professional practice.
To discuss:
Can you think of other ways to respond?
Case summary:
Mrs. P is a single, 88-year-old woman, was hospitalized for cardiac problems. She has been in her beginning of dementia. She lives alone in a small home along with her cats. When she was ordered for the discharge, the nursing student worried about Mrs. P’s ability to live safely on her own. The nursing student suggested her about moving to a retirement community or long-term care facility. But Mrs. P refused those options. The nursing student was worried about her safety and reported to the charge nurse. The charge nurse replied that we can do nothing if the patient is not willing to explore the other options.
Explanation of Solution
The nursing student could seek counseling from the instructor. The nursing student could explore other resources and obligations of the caregivers to determine the realistic options for this patient.
To discuss:
What could the nursing student have done differently?
Case summary:
Mrs. P is a single, 88-year-old woman, was hospitalized for cardiac problems. She has been in her beginning of dementia. She lives alone in a small home along with her cats. When she was ordered for the discharge, the nursing student worried about Mrs. P’s ability to live safely on her own. The nursing student suggested her about moving to a retirement community or long-term care facility. But Mrs. P refused those options. The nursing student was worried about her safety and reported to the charge nurse. The charge nurse replied that we can do nothing if the patient is not willing to explore the other options.
Explanation of Solution
The nursing student might have convinced Mrs. P to choose any of the options without disturbing her autonomy. The nursing student might explain the disadvantages of being alone. The nursing student might suggest more options to the patient rather than the retirement community or long-term care facility.
To discuss:
What skills, knowledge, and attitude do you need to develop to continuously improve quality and safety when caring for patients like Mrs. P?
Case summary:
Mrs. P is a single, 88-year-old woman, was hospitalized for cardiac problems. She has been in her beginning of dementia. She lives alone in a small home along with her cats. When she was ordered for the discharge, the nursing student worried about Mrs. P’s ability to live safely on her own. The nursing student suggested her about moving to a retirement community or long-term care facility. But Mrs. P refused those options. The nursing student was worried about her safety and reported to the charge nurse. The charge nurse replied that we can do nothing if the patient is not willing to explore the other options.
Explanation of Solution
The nursing student should develop the knowledge of physiologic changes that are associated with aging. This could help in developing an appropriate plan care for this patient after her discharge. The nursing student should gain information about all the possible community resources that are available for this kind of patients. The nursing student should improve her interpersonal communication skills and increase knowledge in order to support services for aging adults.
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Chapter 23 Solutions
NU 231 CUSTOM NURSING BUNDLE
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- Module 4 - Interpreting Labs.pd X CB CastleBranch Login Merged-TDL-Files--2024103012280X 1k6uo8tbjf.cloudfront.net/68f85c32-16e5-11ef-925e-aaa4f1cd8999?response-content-disposition=inline DaVita Dietitian Reference Manual + 90% Module 4-Evaluating Laboratory Values CASE STUDIES Case 1 Steve has been on hemodialysis for 3 years. His medications include Nephrocaps, PhosLo (3 at breakfast, 2 at lunch, 3 at supper), Lisinopril, EPO and Venofer. Patient reports he has had the flu and not eaten much for the past 4-5 days, but has continued to take all medications as prescribed. Date PreBUN PostBUN URR KWV Creat Alb CO2 K+ Ca PO4 PTH- Hgb intact 12/01 54 01/02 55 02/02 40 18 17 12 68% 1.33 12.3 3.9 24 4.7 11.0 5.9 69% 1.39 12.2 4.0 23 4.8 11.0 5.2 70% 1.45 12.5 4.0 26 4.1 12.5 4.5 96 12.3 12.1 11.9 What are possible reasons for increasing hypercalcemia in February? Case 2 Barb has been on hemodialysis for 1½ years. She has diabetes, but is not currently taking an antiglycemic agent.…arrow_forwardzm Module 4 - Interpreting Labs.pd X CB CastleBranch Login X Merged-TDL-Files--2024103012280X marks Tools Window Help 100% E pl Dietetic Practitioners s://d3da1k6uo8tbjf.cloudfront.net/68f85c32-16e5-11ef-925e-aaa4f1cd8999?response-content-disposition=inline + 90% DaVita Dietitian Reference Manual Module 4-Evaluating Laboratory Values REVIEW QUESTIONS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. True False A patient who has a low bicarbonate level will also have a low potassium level. Causes of low albumin include low protein intake, infection, proteinuria and severe liver disease. Inaccurate handling of the blood specimen can result in a falsely low PTH. In a patient on hemodialysis, a potassium level of 6.0 is acceptable. An excessive intake of meat will result in higher levels of BUN, phosphorus and potassium. In a patient without kidney function, hyperglycemia will be accompanied by hypokalemia. A patient with access problems is likely to have increased levels of potassium, BUN, creatinine…arrow_forwardTools Window Help zm Module 4 - Interpreting Labs.pd X CB CastleBranch Login x Merged-TDL-Files--2024103012280X pl Dietetic Prac Halk6uo8tbjf.cloudfront.net/68f85c32-16e5-11ef-925e-aaa4f1cd8999?response-content-disposition=inlin - + 90% CASE STUDIES-DISCUSSION Case 1 His lower BUN, K+ and phosphorus are consistent with his reported decrease in intake due to the flu. His high calcium level is a consequence of taking his prescribed amount of PhosLo while eating less food. Thus, he absorbed more calcium from his phosphate binder. In this patient, with adynamic bone disease (low PTH without IV vitamin D therapy), he is unable to deposit calcium in his bones, so serum level rose quickly. PhosLo was held and the next week his calcium was 11.0 and phosphorus 5.8. Other possibilities for a rise in calcium might be that patient took Tums (or another calcium-containing antacid) because of the flu or heartburn; took phosphate binders between meals rather than with meals; was consuming…arrow_forward
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