Question

Scenario: H.S. is a 65-year-old male recently admitted to the long-term care facility for rehabilitation after a two-week hospitalization for exacerbation of COPD. He is receiving physical therapy (PT), medical social work (MSW), registered nutrition (RD), and nursing services. His length of stay is expected to be two months or less and then he is to be discharged home. The patient’s spouse talks with the RN, saying: “I thought things would calm down after his hospital discharge. He still needs so much care. I am not sure if we will be able to do it at home.” Initial Discussion Post: 1.Consider the situation, the interprofessional team and identify what the RN might say to the spouse. 2.What action would the Rn take to assist the patient and wife with a successful rehabilitation and eventual discharge? Consider the QSEN competencies and explain how the RN interventions align with them.

Answer 1

Q. No. 1. Answer :

The registered nurse say to the spouse regarding,

* he needs physiotherapy, nutritional supplementation, and nursing care, at home up-to recovery.

* you can arrange one physiotherapist at home and by taking instructions from the dietitian you can provide diet to the client.

* and you have to provide nursing care like appropriate position that is semifowlers or Fowlers while feeding and ect.

* steam inhalation and mobilization should be done, for this and all if you have capacity and help ful persons , we can send the patient to home by advising treatment.

* for these home care also can arrange like that we can educate to the spouse.

Q. No. 2. Answer :

The actions should taken by the registered nurse :

* providing comfortable position to the client,

* early ambulation,

* providing nebulization and steam inhalation.

* regular suctioning.

* educating regarding deep breathing and coughing exercises.

* avoid exposure to dust and smoke.

By maintaining of these the patient can discharge early.

QSEN means quality and safe education for nurses.

According to this the nurse can provide the patient centered care.

Evidence based practices like what ever the care providing there must be a rationale.

For example semifowlers position can improves the breathing capacity by increasing space in thoracic cavity.

Team work must be there, including physio therapy, nursing, and physical, lab technicians and pharmacist ect.

While providing care safety must be there to wards to clients care and as well as to wards nurse.

All the work recording and reporting must be there.