Question

PLEASE READ THE CASE STUDY AND ANSWER THE QUESTIONS TO THE BEST OF YOUR ABILITY:

Mr. Jackson is 86 years old. He is admitted to HUMC for congested heart failure. He also has a history of renal failure and goes for dialysis on Mondays, Wednesdays and Friday. He has an AV fistula in his right hand. He also has a history of diabetes, hypertension and depression.

He is allergic to shrimp. He is a nonsmoker. He lives with his wife and two sons.

He is on a renal, low sodium, low cholesterol diet.

He is positive for clostridium difficile.

He suffered a stroke while he was in the hospital and now has left sided weakness.

11. List as many nursing diagnoses as possible with interventions to promote quality care for Mr. Johnson?

Answer 1

NURSING DIAGNOSIS:Decreased CO related to an ineffective ventricular pump,Risk for infection,fluid volume excess,hypothrmia,Activity intolerance,Acute pain,Imbalanced nutrition,Risk for unstable blood glucose,Risk for infection related to clostridium difficile and lack of knowledge about prevention and transmission.    NURSING INTERVENTION:1.Monitor for signs respiratory distress 2.Monitor for signs of altered cardiac output including pulmonory edema,arrythmias 3.Evaluate fluid status 4.Assess for signs of hyperglycemia 5.monitor the patient's HbA1c-glycosylated hemoglobin   6 .Monitor for signs of hypoglycemia 7.Checking the abdomen for distension or tenderness 8.Evaluating stool for presence of blood