Question

scussion Board 5 0 Ms. C, 72 years old, has diabetes mellitus, hypertension, rheumatoid arthritis (RA), and coronary artery disease. She lives alone. She recently was discharged from the hospital after treatment for an acute myocardial infarction. She had been doing well before this admission. You are the home health nurse assigned to visit Ms. C. Ms. C's son tells you he is concerned that his mother will not follow up with all the medications she is supposed to take. He states that she has not been very compliant with treatment in the past. As the home health nurse, how would you approach Ms. C? What risk factors might interfere with Ms. C's plan of care? What must you evaluate to include in the plan of care?

Did I answer correclty question 2 and 3 based on the scenario given?

Answer 1

HOME HEALTH CARE

Home health care services include nursing care; physical, occupational, and speech-language therapy; and medical social services.

GOAL

The goals of home health care services are to help individuals to improve function and live with greater independence; to promote the client’s optimal level of well-being; and to assist the patient to remain at home, avoiding hospitalization or admission to long-term care institutions.

1 The homecare health nurse should approach the patient to give a psychological support first. because already she is suffering with more than three disease so she might be psychologically depressed as a result of these the nurse should firstapproach with psychological support

as a second part of her care the nurse should assess the priority medical condition and chart her care plan and goals and implementation and the nurse should take care of the following areas

• Medication management

• Fall prevention

• Unplanned hospital admissions

• Nurse work environment

• Functional outcomes and quality of life

Wound and pressure ulcer management

2 The patient was recently discharged with acute myocardial infraction, but the patient having already hypertension and diabetic mellitus history, acute coronory disease, these are one of the major risk factors of acute MI.( THE ANSWER WRITTEN IN THE 2 ND QUESTION IS RIGHT)

3 PLAN OF CARE ( ADD THIS POINT ALSO IN 3RD QUESTION)

• Assess for chest pain not relieved by rest or medications.
• Monitor vital signs, especially the blood pressure and pulse rate.
• Assess for presence of shortness of breath, dyspnea, tachypnea, and crackles.
• Assess for nausea and vomiting.
• Assess for decreased urinary output.
• Assess for the history of illnesses.
• Perform a precise and complete physical assessment to detect complications and changes in the patient’s status.

• Morphine administered in IV boluses is used for MI to reduce pain and anxiety.
• ACE Inhibitors. ACE inhibitors prevent the conversion of angiotensin I to angiotensin II to decrease blood pressure and for the kidneys to secrete sodium and fluid, decreasing the oxygen demand of the heart.
• Thrombolytics. Thrombolytics dissolve the thrombus in the coronary artery,allowing blood to flow through the coronary artery again, minimizing the size of the infarction and preserving ventricular function.

Relief of pain or ischemic signs and symptoms.

Prevention of myocardial damage.

Absence of respiratory dysfunction.

Maintenance or attainment of adequate tissue perfusion.

Reduced anxiety.

Absence or early detection of complications.

Chest pain absent/controlled.

Heart rate/rhythm sufficient to sustain adequate cardiac output/tissue perfusion.

Achievement of activity level sufficient for basic self-care.

Exercise. Exercising at least thrice a week could help lower cholesterol levels that cause vasoconstriction of the blood vessels.

Balanced diet. Fruits, vegetables, meat and fish should be incorporated in the patient’s daily diet to ensure that he or she gets the right amount of nutrients he or she needs.

Anxiety reduced/managed.