Question

C.M. is an 89-year-old female who presents with her daughter to the provider’s office. The daughter is concerned because her mother has not been eating well. Subjective Data PMH: HTN, Hypothyroid 24-hour diet recall reveals approximately 1,100-calorie intake Lives alone, daughter nearby Does not drive Daughter shops Patient cooks light meals Objective Data Vital signs: T 37 P 72 R 12 BP 104/64 Weight: 105 lb Weight last visit, 3 months ago: 115 lb HT: 5 feet, 1 inch Medications: Metoprolol 12.5 mg per day, Synthroid 0.75 mg per day Oral mucosa dry, gums bleeding, dentures loose Poor skin turgor Questions

1. Develop a problems list from the objective and subjective data.

2. What nursing diagnoses can be derived from the problems list?

3. What should be included in the plan of care?

4. Calculate the patient’s body mass index.

5. How many calories a day does this patient need to maintain her current weight?

6. What laboratory studies would help determine the patient’s nutritional status?

Answer 1

1. The problem list including the subjective and objective data :-

- lonely

- hypothyroidism

- hypertension

2. Nursing diagnosis for the problems enlisted are :-

- Imbalanced nutrition less than body requirement relaed to less metabolic rate

- Altered body temperature

- Ineffective coping related to irritability , emotional istability.

- Low self esteem related to changes in appearance and weight gain.

- Deficient knowledge regarding the relationship between the treatment regimen and control of disease process.

- Non-compliance with therapeutic regimen related to side effects of prescribed therapy.

3.Plan of care includes:-

- Teaching the patient about the importance of drug Compliance.

- Teaching the patient how to adjust to changing body temperature.

- Providing emotional support and reliving anxiety

- Providing information regarding the near by day care to avail for some help when she is alone in the house

- Teaching the patient about the diet to be taken like less sodium diet ,less oliy food intake etc .

4.BMI is body mass index , its formula is :-

= Weight in kg / height in meter square

= Weight of the patient is 105lbs

1lbs =0.454kg

= 105×0.454kg = 47.6kg

Height of the patient is 5feet 1inch

= 1.549m

BMI = 47.6kg / 1.549m× 1.549m

= 19.9 kg / meter square