Homework Lance
Grand Canyon University: NRS-410V
Ms. Sallie Mae is an eighty-two year old female who was recently discharged from the hospital after being treated for exacerbation of congestive heart failure. She has a history of four hospitalizations in the last six months for the same health issue. This paper will assess, identify the problems, and provide nursing and medical interventions to the identified problems listed in the paper.
The following are the identified problems of Ms. Sallie Mae according to the video. The first identified problem is lack of knowledge regarding her medical diagnosis of congestive heart failure. Ms. Sallie Mae’s discharge instructions included for her to use oxygen at two liters per nasal prongs PRN at home, during the home visit there was no oxygen found throughout the house. Ms. Sallie Mae also told the nurse’s that she did not need oxygen despite what the doctors have told her. Ms. Sallie Mae needs to be educated on the diagnosis of congestive heart failure and what to expect with this diagnosis. Oxygen therapy will allow Ms. Sallie Mae to receive more oxygen into her bloodstream thus creating less workload on her heart. It is known that oxygen therapy in CHF patients can help decrease shortness of breath and increase their quality of life. Ms. Sallie Mae needs to be well educated on her diagnosis and the benefits she will achieve from home oxygen use.
Another problem identified is the use of polypharmacy. During the home visit, Ms. Sallie Mae’s medications were scattered all over the table and she showed very little interest in taking them regularly. The physician should be doing medication reconciliation checks regularly with Ms. Sallie Mae. She has about fifteen medications and the physician needs to educate her on when to take which one and why taking these medications are important to her health and diagnosis. Regular medication reconciliation checks with allow the physician to keep track of what medications she is currently on to avoid any drug interactions that can be dangerous and potentially life threatening. Another intervention is a providing Ms. Sallie Mae with a pill organizer. This will allow her to know exactly when to take her medications and which ones to take by just opening up the little box on the specific day and time. A family member or home health aid/nurse can set up the pill organizer every week for her to make it easier and to help prevent her from being confused and taking more or less of a medication than prescribed.
A third problem identified is the lack of family support that Ms. Sallie Mae has. She lives alone and her daughter works full time and is unable to attend to her mother as often as needed. Ms. Sallie Mae admitted that she was not able to get her medications following discharge because she has no way of getting them. Ms. Sallie Mae’s daughter should be encouraged to visit her mother more often and try to help as best as she can. Contacting Mountain Top Home Health will be a great help to Ms. Sallie Mae to provide her with a home health aid, help around the house, take her shopping, and just be there to check in on Ms. Sallie Mae.
The final problem identified is the feeling of loneliness Ms. Sallie Mae is experiencing. She expresses that she is missing her late husband and have not been eating do to loss of appetite. Ms. Sallie Mae is showing signs of depression and that can be one reason why she is noncompliant with her treatment plan at this time. To overcome this feeling of loneliness, Ms. Sallie Mae’s values, faith, and religion will be included in her plan of care. Her church members, clergy or pastor, and friends can visit her and give her the encouragement she needs. Support groups and family involvement may help lessen the impact of depression and anxiety and encourage compliance with the treatment plan. According to a study listed by the JAMA Internal Medicine, depression is listed as a risk factor for noncompliance with medical treatment.
Ms. Sallie Mae will be encouraged to participate in the flu vaccination every year to prevent the flu. The flu is known to exacerbate chronic conditions such as heart and pulmonary conditions. According to the Centers for Disease Control and Prevention, flu vaccinations can be an important preventative means for patients with chronic health conditions. “Every year the flu vaccine reduces the risk of influenza infection by 50-60%” (CDC, 2017).
With the problems identified and the interventions listed above, this will help Ms. Sallie Mae become more compliant with treatment and hopefully will give a better quality of life. She needs to fully understand and be aware of the severity of her condition and that there is help available to her.
References
CDC, (2017). Vaccine Effectiveness – How Well Does the Flu Vaccine Work? Retrieved from, https://www.cdc.gov/flu/about/qa/vaccineeffect.htm
DiMatteo MR, Lepper HS, Croghan TW. Depression Is a Risk Factor for Noncompliance With Medical TreatmentMeta-analysis of the Effects of Anxiety and Depression on Patient Adherence. Arch Intern Med.2000;160(14):2101-2107. doi:10.1001/archinte.160.14.2101
GIPHY App Key not set. Please check settings