Home Visit With Sallie Mae Fisher Grading Criteria Requireme

Home Visit With Sallie Mae Fisher Grading Criteriarequirementsessay P

Identify and prioritize at least four problems from the simulated home visit with Sallie Mae Fisher. Summarize each problem with evidence from assessment data. Discuss at least four medical and/or nursing interventions to address these needs, providing rationales supported by current evidence-based literature. Develop a scripted dialogue based on information from the home visit, health history, and discharge orders, addressing physiological, psychosocial, educational, and spiritual needs of the client. Follow APA guidelines for the essay portion, with clear academic writing, and present the dialogue in a solid narrative format without APA formatting requirements. Include appropriate references for all sources used in the analysis.

Paper For Above instruction

Introduction

Home visits are vital components of nursing practice, especially in managing chronic conditions such as congestive heart failure (CHF). Sallie Mae Fisher, an 82-year-old woman with a complex medical history, presents an opportunity to explore nursing interventions rooted in assessment data and evidence-based practice. This paper identifies four primary problems observed during her home visit, proposes interventions with rationales supported by current literature, and constructs a scripted dialogue addressing her holistic needs, including physiological, psychosocial, educational, and spiritual aspects.

Problems Identification and Evidence

The initial assessment of Ms. Fisher reveals several issues requiring targeted interventions. The first major concern is her risk of fluid overload due to CHF exacerbation, evidenced by recent weight gain of 8 pounds, dyspnea, and chest pain, consistent with her recent hospitalization. The second issue is potential medication non-adherence stemming from complex medication regimens, including diuretics, digoxin, and multiple other prescriptions. Third, her limited support system, given her recent widowhood and living alone with minimal family support, heightens her vulnerability to social isolation and possible neglect. Fourth, her environmental safety needs, particularly concerning home hazards that could precipitate falls or medication errors, are crucial, especially considering her age and health status.

Interventions and Rationales

Addressing fluid overload involves implementing strict monitoring of weight and edema and educating Ms. Fisher on recognizing early symptoms of volume overload, supported by literature emphasizing self-monitoring in CHF management (Kardas et al., 2018). Adjusting her medication includes ensuring adherence and understanding, guided by patient education strategies proven effective in improving compliance (Osterberg & Blaschke, 2005). The third intervention encompasses facilitating social support through community resources or telehealth services to reduce isolation, as evidence suggests social support improves health outcomes (Holt-Lunstad et al., 2015). Lastly, a home safety assessment by nursing staff would mitigate fall risks, aligning with established fall prevention protocols in geriatric care (Stevens et al., 2014).

Scripted Dialogue

A comprehensive, patient-centered dialogue is developed to address Ms. Fisher’s multifaceted needs. The nurse initiates conversation by assessing her current understanding of her condition and medications: "Ms. Fisher, how have you been managing your medications since your last visit? Do you feel confident taking all your prescribed medicines?" The dialogue explores her psychosocial state: "Living alone can be challenging. Do you have someone you can contact if you’re feeling unwell?" It incorporates her spiritual needs: "Are there spiritual or religious practices that bring you comfort?" The nurse offers education tailored to her cognitive state: "Since managing CHF involves monitoring weight and symptoms, I’ll show you how to check your weight daily and what signs to watch for, like increased shortness of breath or swelling." The culturally sensitive approach ensures her dignity and preferences are respected, fostering trust and adherence.

Conclusion

Effective management of Sallie Mae Fisher’s health requires a comprehensive approach grounded in assessment, evidence-based interventions, and empathetic communication. Prioritizing her physiological stability, medication management, social support, and home safety aligns with holistic nursing principles and improves her quality of life. Continued evaluation and tailored education are essential for sustained health outcomes.

References

  • Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), 227-237.
  • Kardas, P., Radowicz, B., & Szymanska, A. (2018). Self-monitoring and its role in chronic disease management: A systematic review. Patient Preference and Adherence, 12, 2323–2334.
  • Osterberg, L., & Blaschke, T. (2005). Adherence to medication. New England Journal of Medicine, 353(5), 487-497.
  • Stevens, J. A., Lee, R., & Schultz, A. (2014). Fall prevention in older adults: The impact of home modifications. Journal of Aging & Social Policy, 26(4), 261-272.
  • Yancy, C. W., Jessup, M., Bozkurt, B., et al. (2017). 2017 ACC/AHA/HFSA Focused Update of the 2013 Guidelines for the Management of Heart Failure. Circulation, 136(6), e137-e161.

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