Question

Immobility Ms. Cavallo, 97 years of age, has been a resident at the rehabilitation unit for 6 weeks. She has been receiving rehabilitation therapy following the repair of her fractured left hip. The nursing assistive personnel (NAP) tells you that Ms. Cavallo has not been finishing her meals over the past 2 days because of poor appetite. As you enter her room with a food tray today, she states, “Go away and take that tray of food with you. I'm tired of all of this, and I just want to stay in bed today.” You explore why she feels this way. You discover that she does not like the foods that are being prepared for her and she does not feel strong enough to use her walker. She states, “I'm afraid that I'm going to fall because I don't feel strong enough to get out of bed and use my walker.” 1. On the basis of these data, you develop a nursing diagnosis of Deficient Knowledge (Imbalanced Nutrition: Less Than Body Requirements) related to lack of information. Identify one goal, two expected outcomes, and three related nursing interventions with rationales that will help her meet the identified goal and outcomes. 2. You finish teaching Ms. Cavallo about the importance of a balanced diet and how it will help her regain strength to ambulate. As you are doing her morning assessment, you notice that she has a reddened area on her coccyx. a. Which risk factors contribute to this finding? b. In addition to a balanced diet, which other nursing interventions would be good to include in her plan of care? 3. You convince Ms. Cavallo to eat a balanced diet of three meals and two snacks high in protein. Describe the decision-making process you use to ensure that Ms. Cavallo continues to recognize the importance of a balanced diet. Include essential assessment data that you need to ensure that she continues to have an intake of proper foods.

Answer 1

1)goal:::patients understanding about the importance of nutrition in healing process and how it effects whole health.

outcome:::1)patient takes adequate amount of calories or nutrients

2)she is able to walk as she feels more stronger than before

nursing interventions::1)assess patient skill to get and use essential nutrients-patient should know about the nutrients that can help her to make strong to stand by her self

2)take the nutritional history of the patient so that we can understand which should she likes or dislikes-if we know about her eating habits that food can be added to her diet.

3)find out patients view and feeling towards eating food-different factors such as physical,mental,religious can effect patients food habits.thus,it is indeed to find out them.

Part 2::;

1)red area on the skin indicates beginning of pressure sore.it is due to the decreasing blood flow to the bony prominence

nursing interventions:::

1)assess for any wrinkles in bed sheet-inorder to avoid friction it should be checked.

2)change the position of patient every 2 hrly .use pillows or rolled sheets under bony prominence to avoid further complications -this will help to improve blood flow to tissues and prevent tissue injury

3)assess the mobility of patient and give aid if necessary-inorder to relieve pressure points patient require assistance

3)add more protein into her diet-it will help to cure the pressure sore by strengthen the tissue

Part 3:to evaluate that patient is following well balanced diet make an intake out put chart every day

2)diet should be provided according to dietitian and check every time is she eat the whole food or waste it?

3)ask patient some questions to know whether patient understand or not the importance of healthy diet for her easy recovery

4)check the ability of the patient to stand by herself

5)check the healing process of her bed sore to make sure that she takes nutritious food