Mrs. Y Mrs. Y Is An 84-Year-Old Client Recently Discharged

Mrs Ymrs Y Is An 84 Year Old Client Who Was Recently Discharged From

Mrs Ymrs Y Is An 84 Year Old Client Who Was Recently Discharged From

Mrs. Y, an 84-year-old woman, was recently discharged from the hospital following treatment for an infected diabetic ulcer on her left leg. During her hospitalization, she received intravenous antibiotic therapy via a peripherally inserted central catheter (PICC) line. Due to her long-standing history of diabetes, her physician ordered that this intravenous therapy continue at home, leading to the initiation of home health services. A home health nurse was assigned to Mrs. Y's case and conducted an initial assessment.

During the initial home visit, the nurse introduced herself to Mrs. Y and her family, explained the nature of the home nursing services, and focused on the management of the PICC line and ongoing intravenous antibiotic therapy. The nurse assessed Mrs. Y’s physiological, psychological, functional, and safety needs. It was noted that Mrs. Y lives alone but receives regular visits from her daughter throughout the day. She exhibits moderate functional impairment, ambulating with a cane, and faces environmental hazards such as several throw rugs in main walking areas and minimal lighting throughout hallways. Mrs. Y reported increased fatigue and difficulty moving around her house, stating, “I used to get around my house with ease, but now I get a little tired and have to sit down and rest frequently.”

Given her current health status and signs of functional decline, it is crucial to identify priority nursing diagnoses, develop a visual concept map, and establish a comprehensive plan of care targeting her needs. This includes setting realistic, measurable, and time-sensitive goals, along with appropriate interventions to support her recovery and safety in her home environment.

Paper For Above instruction

Introduction

The health and functional status of elderly patients like Mrs. Y necessitate comprehensive nursing care planning, especially when transitioning from hospital to home settings. Mrs. Y's recent hospital discharge following treatment for a diabetic ulcer and ongoing intravenous therapy exemplifies the importance of individualized nursing diagnoses and targeted interventions. Her age, chronic illness, and environmental hazards pose significant risks that require careful assessment, prioritization, and management by nursing professionals.

Priority Nursing Diagnoses

Based on Mrs. Y's assessment, three primary nursing diagnoses are identified:

  1. Impaired Physical Mobility related to muscle weakness, fatigue, and environmental hazards, as evidenced by her use of a cane, fatigue, and reports of difficulty moving around her house.
  2. Risk for Falls related to environmental hazards (throw rugs, poor lighting), decreased mobility, and fatigue.
  3. Impaired Skin Integrity related to her recent infected diabetic ulcer and limited mobility, which may impair wound healing and increase risk of further skin breakdown.

Each diagnosis reflects critical aspects of Mrs. Y's current health needs, focusing on mobility, safety, and skin integrity to prevent further decline and promote optimal recovery.

Concept Map Representation

The concept map visually links the three diagnoses with their related factors and evidence:

  • Impaired Physical Mobility as related to muscle weakness, fatigue, and environmental hazards, with evidence including reports of tiredness and difficulty ambulating.
  • Risk for Falls as related to environmental hazards and decreased mobility, evident in the presence of throw rugs and minimal lighting.
  • Impaired Skin Integrity as related to her diabetic ulcer and limited mobility, supported by her recent wound history.

Plan of Care

Diagnosis Goals Interventions
Impaired Physical Mobility Mrs. Y will demonstrate improved mobility with reduced fatigue and increased independence in ambulation within 2 weeks.
  1. Develop and implement a tailored range-of-motion and strengthening exercise program.
  2. Assist Mrs. Y with activities of daily living and mobilization during nursing visits to promote activity and prevent deconditioning.
  3. Encourage the use of assistive devices as prescribed and educate Mrs. Y on energy conservation techniques.
Risk for Falls Mrs. Y will ambulate safely, with no falls, and reduce environmental hazards within 1 week.
  1. Evaluate and modify the home environment to remove tripping hazards, such as throw rugs, and improve lighting.
  2. Educate Mrs. Y and her family about fall prevention strategies and safety measures.
  3. Assess and reinforce proper use of assistive devices and ensure footwear provides adequate support.
Impaired Skin Integrity Mrs. Y's diabetic ulcer will show signs of healing within 2 weeks, with no additional skin breakdown.
  1. Monitor the wound site regularly, ensuring proper wound care and dressing changes per protocol.
  2. Maintain glycemic control as per medical orders to facilitate wound healing.
  3. Encourage adequate nutrition, including protein and nutrients essential for tissue repair.

Conclusion

In conclusion, the comprehensive nursing care plan for Mrs. Y underscores the importance of addressing mobility, safety, and skin integrity in elderly patients managing complex health conditions at home. Prioritizing interventions that improve function, prevent falls, and promote wound healing, coupled with measurable goals and family involvement, can significantly enhance her recovery trajectory and quality of life. Continuous assessment and adaptation of the plan will be necessary to respond to her evolving needs and ensure safe, effective, patient-centered care.

References

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  • American Geriatrics Society. (2019). Practice guideline for prevention of falls in older adults. Journal of the American Geriatrics Society, 67(9), 1739-1747.
  • Dobbs, D. E., & Watson, S. M. (2017). Wound management and care. Journal of Wound Care, 26(8), 448-455.
  • Galik, B., & Finkel, S. (2018). Environmental safety and fall prevention in older adults. Journal of Gerontological Nursing, 44(5), 22-29.
  • Malone, M., et al. (2020). Diabetes management and wound healing in elderly patients. Diabetes Spectrum, 33(2), 123-130.
  • National Institute on Aging. (2017). Falls prevention for older adults. NIH Publication No. 18-XXXX.
  • Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. (2017). Fundamentals of nursing (9th ed.). Elsevier.

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