There are several issues which manifest themselves at Ms. Fisher’s home. These include, home safety, not complying with medication, imbalanced nutrition and depression as discussed bellow.
Home safety
The present conditions show she is likely to fall and injures herself. From our assessment, we find poorly arranged mats which almost tripped her. The way items like newspapers have been arranged on the seats may also compromise her ease of mobility. The lighting is poor which might result in her knocking herself on items inside the house. Finally, there are chances of strangers gaining access into her premises.
In maintaining safety, her house has to be properly arranged to avert any risks of injuries. Proper lighting is also essential to boost her slowly fading vision capabilities. It is vital her door remains closed always to keep away intruders. The rationale for this intervention is to ensure her wellbeing is given the required attention.
Not Complying with Medication
It is evident that Ms. Fisher is not ready to take her medication. She is also of the opinion that there is no need for her using supplementary oxygen supply (Grand Canyon University, 2016). The medications prescribed are supposed to address her health needs but she prefers not using them.
Ms Fisher needs to be given health education on the significance of using the oxygen since it will manage and control of her chronic heart failure due to constant exacerbation (Davidson et al., 2016). Secondly, it is imperative she learns the importance of sticking to her prescribed medication. Also, there is the need for the charge nurse to properly arrange and label her medicine to avert any possibilities of medication mix ups.
Imbalanced nutrition. Ms Fisher has had a weight gain of 8 pounds three days after leaving hospital. Additionally, she has got dry mucous membranes and a skin with very poor turgidity. She informs the visiting nurses that she does not cooking anymore since her husband passed on (Grand Canyon University, 2016). She states that she feels sick in the stomach. In addition, she has not had bowel movements for three days. This indicates her fluid intake and nutrition status are poor.
In this case her knowledge regarding low sodium diet needs to be assessed. It is also vital that her diet comprises of enough fluids to address the problem of poor skin turgor and dehydration effects (McMurray et al., 2012). It is necessary that her daughter be informed on the importance of balanced meals for her mother.
Depression. Loss of appetite, social withdrawal, defiance, loneliness and sadness indicate psychological issues and depression. The situation is further worsened by the fact that she is widowed. It is essential that she be provided with proper education on the need for taking physical exercise to boost her self esteem levels. She ought to be advised on the need for joining elderly support groups
Dialogue
Nurse: Morning Salle, my name is Mrs. T and I will be your nurse today. Do you know how to manage your health now? Ms Fisher: Thank you. My doctor gave me several medications. However, I have not taken them.
Nurse: Ms. Fisher, kindly understand we want you to achieve your full health. The medication prescribed is for this objective. Ms. Fisher: I understand Mrs. T. I will ensure that I stick to my medication.
Nurse: I have also noticed that you are focusing more on fluids like soup and soda rather than taking solid foods, what could be the problem madam? Ms. Fisher: Ever since my husband died, I have been having problems adjusting to this new status of staying alone. Therefore, I find very little pleasure in preparing proper meals.
Nurse: It is important that you stick on a diet which will effectively auger well with your current situation. Therefore, vegetables and fruits should form the bulk of your nutrition as they have been proven to improve the outcomes of patients with Chronic Heart Failure. It is important that you involve yourself with other elderly around this community since this will help you develop a feeling of belonging. Exercise will boost your mental and physical strength. I will also advise you to be attending the local church for spiritual nourishment. Finally, always make sure your house is properly arranged with enough lighting to avert possible accidents. Ms. Fisher: Thanks, the information you have provided is valuable. I intend to stick to your advice to boost my quality of life. Nurse: Goodbye Ms. Fisher.
References
Davidson, P. M., Newton, P. J., Tankumpuan, T., Paull, G., & Dennison-Himmelfarb, C. (2015). Multidisciplinary management of chronic heart failure: principles and future trends. Clinical therapeutics, 37(10), 2225-2233.
Grand Canyon University. (2016). Grand Canyon University | Digital Resource. Retrieved from http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php
McMurray, J. J., Adamopoulos, S., Anker, S. D., Auricchio, A., Böhm, M., Dickstein, K., & Jaarsma, T. (2012). ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. European journal of heart failure, 14(8), 803-869.
