Review The Nursing Process In Practice: Formulating A Family
Review the Nursing Process In Practice: Formulating a Family Care Plan
Review The Nursing Process in Practice: Formulating a Family Care Plan , chapter 13, page 364. Make sure to use all of the VI steps of the assessment. Case Study: page 364 The Nursing Process in Practice Formulating a Family Care Plan Mr. R., an 80-year-old retired pipe fitter, lives with his wife; he has had diabetes for 15 years. Although his diabetes has been moderately controlled with diet and daily insulin, some complications have occurred.
He experiences arteriosclerotic cardiovascular disease and peripheral neuropathy, and he recently spent 2 months in the hospital due to circulatory problems in his left leg. The progressive deterioration of circulation resulted in an amputation below the knee. Although fitting him with a prosthesis would be possible, he has refused this and is wheelchair bound. Mr. R. currently depends on someone else to help with transfers.
He is cranky, irritable, and demanding to almost everyone. He recently has stopped following his diabetes regimen because he claims, “It just doesn't matter anymore.” Mr. R.'s wife, Doris, is a 74-year-old woman who has been a homemaker most of her life. She has always been the “watchdog” for Mr. R.'s health.
Mostly through her changes in food preparation and her lifestyle adjustments, Mr. R.'s diabetes has been managed. She schedules his physician appointments, buys his medical supplies, and administers his insulin. He is now refusing to accept her help, and she is anxious and angry about his behavior. They frequently have arguments, after which Mrs. R. retreats to her room.
Mr. and Mrs. R. have three children and four grandchildren who live in the same city. The eldest daughter, Patricia, calls or stops by about once a week. The other children, Tom and Ellen, are busy with their families and see their parents mostly on holidays; they have very little communication with Patricia or their parents.
When the children do come to visit, Doris tries to put on a happy expression and pretend that everything is going well to avoid worrying them. She is also embarrassed about Mr. R.'s behavior and does not want anyone from outside the family to see what is happening. On her initial home visit to this family, the community health nurse notes that Mr. R. appears somewhat drowsy and unkempt.
Mrs. R. looks anxious and tired, her skin color is slightly ashen, and she has circles under her eyes. When the nurse asks them what they hope to get out of the nursing visits, Mrs. R. says, “Actually, you don't need to keep visiting. In a few weeks we'll be back to normal and doing fine.” Based on a thorough assessment of the family, the community health nurse may begin to develop a mutually acceptable plan of care with the family.
Paper For Above instruction
Introduction
The nursing process is a systematic method that guides nurses in delivering patient-centered care through assessment, diagnosis, planning, implementation, and evaluation. Applying this process in family care plans involves a comprehensive understanding of both individual health status and family dynamics, particularly in complex cases such as elderly patients with chronic illnesses. This paper explores the nursing process in practice by analyzing a case study involving Mr. R., an elderly man with diabetes and multiple complications, and his family, highlighting the importance of each of the six assessment steps and how they inform the development of an effective family care plan.
Assessment: Collecting Comprehensive Data
The first step involves gathering detailed information on both Mr. R. and his family members using all six dimensions of assessment: biological, psychological, social, spiritual, cultural, and environmental. Biologically, Mr. R. has longstanding diabetes complicated by arteriosclerotic cardiovascular disease, peripheral neuropathy, and recent limb amputation, indicating severe vascular compromise. His mental status appears slightly drowsy and unkempt, suggesting possible metabolic imbalance or mood disturbance. Psychologically, his irritability and withdrawal signify emotional distress or depression, common among amputees adjusting to significant changes.
Socially, Doris plays a vital caregiving role, managing Mr. R.'s routine and medical needs. She appears exhausted and emotionally drained, reflecting caregiver burden and stress. The family dynamics reveal limited communication with other children, which may influence support availability. Environmentally, the home setting shows signs of neglect, with physical indicators of fatigue and neglect. These data points form a comprehensive picture required to identify immediate and long-term needs.
Analysis and Diagnosis: Identifying Priority Nursing Problems
Based on the assessment data, potential nursing diagnoses include ineffective coping related to chronic illness and recent health complications, caregiver role strain due to overburdened spouse, risk for social isolation given limited family interaction, and risk for compromised skin integrity or infection at the amputation site. Emotional responses such as depression or feelings of futility should also be considered. Prioritizing these issues helps tailor interventions that address safety, emotional well-being, and caregiver support.
Planning: Developing a Family-Centered Care Plan
Effective planning involves setting realistic, achievable goals collaboratively with the family. For Mr. R., goals may include improving adherence to his diabetes regimen, managing pain and psychological distress, and preventing further complications. For Doris, objectives could involve reducing caregiver burden through education and support systems. Strategies include educating both about disease management, wound care, and coping techniques, as well as facilitating access to community resources or support groups. Family involvement ensures the plan aligns with their values and circumstances, fostering adherence and positive outcomes.
Implementation: Executing the Care Plan
During implementation, nurses engage in teaching, advocacy, and coordination of resources. For example, the nurse might educate Doris on wound care and diabetes management, discuss the importance of emotional support for Mr. R., and connect the family with local support groups or home health services. Psychosocial support may include counseling referrals or initiating communication channels among family members to improve support. Consistent follow-up ensures adjustments are made as needed to meet set goals.
Evaluation: Monitoring and Adjusting the Plan
The final stage involves ongoing appraisal of the effectiveness of interventions. If Mr. R. begins adhering to his diabetes management after education, the plan progresses positively. Conversely, if family members continue to experience stress or neglect is evident, further assessment and modifications are necessary. Regular communication and reassessment help sustain progress and address emerging challenges, ensuring family health and functioning improve over time.
Significance of Family-Centered Care
Implementing a family-centered approach recognizes the interconnectedness of individual and family health. It facilitates holistic care, enhances support networks, and promotes sustainable health behavior changes. The case underscores the importance of assessing all family members' perspectives and capabilities to develop tailored interventions that foster resilience and improve health outcomes.
Conclusion
The application of the nursing process—assessment, diagnosis, planning, implementation, and evaluation—within a family context enhances the quality and effectiveness of care. In complex cases such as Mr. R.'s, a thorough family assessment is critical to developing a mutually acceptable, culturally sensitive, and sustainable care plan. Recognizing family dynamics, caregiver roles, and emotional health are integral to achieving positive health outcomes and improving the overall well-being of the family unit.
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