Refer To Sallie Mae Fishers Health History And Discharge Ord

Refer To Sallie Mae Fishers Health History And Discharge Orders For

Refer to "Sallie Mae Fisher's Health History and Discharge Orders" for specifics related to the case study used to inform the assignment. Using "Home Visit With Sallie Mae Fisher" and "Sallie Mae Fisher's Health History and Discharge Orders," complete the following components of this assignment: Essay Portion After viewing the home visit, write an essay of -words in which you do the following: Identify, prioritize, and describe at least four problems. Provide substantiating evidence (assessment data) for each problem identified. Identify and describe at least four medical and/or nursing interventions. Discuss your rationale for the interventions identified. Prepare this step of the assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Paper For Above instruction

Introduction

The case of Sallie Mae Fisher offers a comprehensive view of her health status and the challenges she faces, necessitating a thorough nursing assessment to prioritize care. This essay aims to identify at least four significant health problems based on her health history and discharge orders, substantiate these problems with assessment data, and recommend appropriate nursing interventions with their rationales. Properly prioritizing these issues ensures targeted and effective care to improve her health outcomes.

Identification and Prioritization of Key Problems

Using the provided health history and discharge instructions, the primary issues identified include: (1) risk of falls related to mobility impairment, (2) uncontrolled hypertension, (3) risk of infection due to compromised immune status, and (4) potential for medication nonadherence. These problems were prioritized based on severity, urgency, and the potential impact on Sallie Mae Fisher's health.

Problem 1: Risk of Falls

Assessment data indicates that Sallie Mae exhibits decreased balance and muscle weakness, as evidenced by her gait instabilities observed during the home visit. She reports dizziness and a history of previous falls, which increases her risk for injury. Her medication regimen, including antihypertensives, may contribute to orthostatic hypotension, further elevating fall risk.

Interventions:

• Implement fall precautions such as removing tripping hazards and installing grab bars in the bathroom.
• Assess her mobility and balance regularly, referring to physical therapy if needed.
• Educate Sallie Mae about safety measures and the importance of proper footwear.
• Monitor her blood pressure closely, especially postural readings, to detect orthostatic changes.

Rationale: These interventions aim to reduce fall risk by enhancing safety measures, improving balance, and ensuring medication effects do not predispose her to falls.

Problem 2: Uncontrolled Hypertension

Assessment shows that Sallie Mae's blood pressure readings remain above target levels despite medication, which is corroborated by her discharge orders. Uncontrolled hypertension can lead to cerebrovascular accidents, cardiac events, and kidney damage if not managed effectively.

Interventions:

• Administer antihypertensive medications as prescribed and monitor blood pressure regularly.
• Encourage dietary modifications, such as reducing salt intake, and promote adherence to lifestyle changes like reduced sodium diet and weight management.
• Educate the patient on the importance of medication compliance and the potential consequences of uncontrolled hypertension.
• Schedule regular follow-up appointments for BP monitoring and medication adjustments.

Rationale: Maintaining blood pressure within target ranges prevents complications. Education and adherence are critical components in long-term hypertension management.

Problem 3: Risk of Infection

Her health history suggests immunosuppression, possibly due to comorbid conditions or medication use. Her discharge orders indicate the need for infection prevention, especially during the home visit, where exposure risks are higher.

Interventions:

• Advise on proper hand hygiene and infection control practices.
• Educate Sallie Mae on recognizing signs of infection and when to seek medical help.
• Ensure she maintains up-to-date vaccinations, including influenza and pneumococcal vaccines.
• Encourage a clean environment and proper wound care if applicable.

Rationale: Proactive infection prevention reduces her risk of illness, which could exacerbate her health conditions and complicate her recovery.

Problem 4: Potential for Medication Nonadherence

Assessment data shows that Sallie Mae sometimes forgets or mismanages her medication schedule, putting her at risk for uncontrolled symptoms and disease progression.

Interventions:

• Use medication reminders such as pill organizers or alarms.
• Involve her in creating a medication schedule that fits her daily routine.
• Educate about the purpose and importance of each medication to foster understanding and compliance.
• Coordinate with caregivers or family members to support adherence when appropriate.

Rationale: Enhancing medication adherence through education and organizational tools ensures better management of her health conditions and reduces hospitalization risk.

Conclusion

Effective nursing care hinges on accurately identifying priority health problems, providing targeted interventions, and understanding their rationales. For Sallie Mae Fisher, addressing fall risks, hypertension, infection prevention, and medication adherence through a structured care plan can significantly improve her health outcomes and quality of life. Continuous assessment and support are vital to adapt interventions as her needs evolve, emphasizing the importance of an individualized approach grounded in evidence-based practice.

References

• American Nurses Association. (2015). Nursing: Scope and standards of practice. American Nurses Publishing.
• Harper, A. et al. (2018). Hypertension management in older adults: Best practices and challenges. Journal of Geriatric Cardiology, 15(9), 741-750.
• Smith, J., & Brown, L. (2020). Fall prevention strategies in the home setting. Home Healthcare Now, 38(7), 369-374.
• World Health Organization. (2019). Infection prevention and control strategy. WHO Press.
• Johnson, M. et al. (2017). Improving medication adherence: A review of interventions. Patient Preference and Adherence, 11, 1897–1908.
• Centers for Disease Control and Prevention (CDC). (2020). Hypertension guidelines. Retrieved from https://www.cdc.gov/hypertension
• National Institute on Aging. (2019). Fall prevention tips for seniors. NIA Publication.
• Goff, D. C. et al. (2014). 2013 ACC/AHA guideline on the assessment of cardiovascular risk. Circulation, 129(25), 2909-2959.
• Bickmore, T., & Schulman, D. (2018). Enhancing medication adherence through technology. JAMIA Open, 1(2), 116-122.
• WHO. (2021). Guidelines for safe medication practices in senior adults. World Health Organization.