December 11, 2016 at 7:22 AM #103997
Hi I am a student and we were presented a case study during our , but as I do not have any experience yet with working with older thoughts I am open for advice and suggestions from any knowledge you want to share..thanks :))
Ms X is 75 years old, admitted to hospital 5 days ago to an acute hospital due to a stroke. Very little movement is present in her right upper and lower limbs. She has speech and swallowing problems. She has been kept in bed and an indwelling catheter was inserted due to urine incontinence. She also required a course of antibiotics for a chest infection.
Before the stroke she was fully independent and on no regular medication. she has been widowed for the past 5 years and living alone. Her daughter wishes to look after her when the inpatient treatment is over.
How do you feel MS X should be managed from now on, keeping in mind to ensure quality of life.December 24, 2016 at 7:40 AM #104056
I am a long term care RN of 8 plus years, recently obtained my BSN.
I know what I would do with Mrs. X. The question is what would you do?
Start with your assessment, head to toe. It’s a brain thing. Think further clotting risk, stenosis, thrombi, emboli. Can she see, can she hear, can she turn her head? Does she neglect one side of her body? What is your plan for her diet? Are you asking for therapy evals in speech/OT/PT? What is the pt bed mobility? Does she use side rails, is she trying to squiggle out of bed and stand? How are you going to transfer her to a wheelchair and what kind of wheelchair: standard, high back, broda? Is there edema? Is there lymphedema?
She is your patient, your responsibility. She is your ADPIE. Assess. Document. Plan. Intervention. Evaluate. Your care plan is based on your ADPIE based on your assessment. Over and over.
And for the psychosocial aspect…quality of life is always determined from the pt/family perspective. If your pt always loved her bacon, but the new diet nixes the fat and grease, talk with the pt, her daughter, the doc, dietary, etc. Be a hero for this pt, not an antagonist.
God bless.December 26, 2016 at 6:49 AM #104058
Happy Xmas and Happy New Year 2017…thank you soooo much you were God sent:) No one else answered to my question I couldn’t believe it when I got you reply …you were a life saviour. Thanks, with your advice and experience I can learn and understand more and try make up for my present lack of experience. I really appreciate. Your answer was very detailed, I can now expand on it but be sure that I am on the right track as to not suggest negative treatment for the assumed patient.
I will soon have one last case of discussion if you are open to guide me once more. it s the last one 🙂
Thank you once again….have a great day
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