142x Filetype PPTX File size 1.17 MB Source: www.edupuentes.com
Scenario Mrs. Alicea is a 73-year-old woman who is at the senior health center for her routine 6-month checkup. She has been visiting the senior center on a regular basis for the past 8 years. Mrs. Alicea has lived alone since her husband died 1 year ago. She lives in a single-story, four-room home a few miles from the health center. Her son, Rico, lives 5 minutes away. Rico drives Mrs. Alicea to her visits. Six months ago, Mrs. Alicea reported progressive hearing loss. Today she reports “having trouble seeing.” Peter Morris, a 33 year old nursing student assigned to the senior center, is learning to conduct assessments and to develop health promotion plans for patients. For the past month, Peter has been attending his clinical rotation and participating in teaching health promotion activities . He is enjoying this rotation because he is learning more about geriatric patients and is finding that they are very independent and capable of having productive lifestyles. Mrs. Alicea reports that at her last visit to the ophthalmologist, she was told she had a cataract. Peter learns that Hispanic/Latino individuals in the United States have higher rates of visual impairment and blindness compared with members of other ethnic groups. Visual field loss has a negative impact on health related quality of life: driving, distance and peripheral vision activities, and a sense of independence. 1. What are some possible nursing assessment steps for Peter to use with Mrs. Alicea ? Answer Nursing Assessment : Review with Mrs. Aliceaat each visit the importance of early intervention through regular vision examinations. Provide information about side effects of visual impairment, and encourage the use of visual and adaptive devices when possible. Ask Mrs. Aliceahow she is coping with visual alterations. Ask Mrs. Aliceaabout her social networks and supportive relationships. Assess for changes in mood and depression. Determine whether Mrs. Aliceahas experienced new limitations of activities of daily living or a change in participation in leisure activities. Refer her to community resources and activities. Case Study (cont’d) Mrs. Alicea states, “I’m having difficulty reading and moving around the house. I cannot judge the steps clearly. I have difficulty judging distances between objects, which is worse at night.” Results of a home hazard assessment show that Mrs. Alicea’s home has dim lighting, stairs without handrails, and numerous throw rugs on the floor. Goal/Outcome: Mrs. Alicea’s home environment is safe and free of hazards within 4 weeks. 2. What other expected outcomes would you include? Answer Mrs. Alicea will report an increased sense of home safety and independence within 2 weeks Mrs. Alicea and her son will make recommended changes to home environment within 4 weeks 2. What fall prevention interventions would Peter choose? Answer • Help Rico identify potential trip hazards, such as throw rugs, and suggest that they be modified or removed. • For fall prevention, teach Rico methods to improve environmental safety, such as installing handrails along stairs, securing carpeting, removing throw rugs, and painting stairs. Suggest that Rico place a nonslip surface such as a nonskid mat in the bathtub and shower.
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