Question

Rosa was a 78-year-old woman who lived alone in a large city. She had been widowed for 10 years. Her children were grown, and all were successful. She was very proud of them because she and her husband had immigrated to the United States when the children were small and had worked very hard to establish and maintain a home. She had only a few years of primary education and still clung to many of her “old country” ways. She spoke a mixture of English and her native language, and her children were somewhat embarrassed by her. They thought she was somewhat of a hypochondriac because she constantly complained to them about various aches and pains, her knees that “gave out,” her “sugar” and “water” problems, and her heart palpitations. She had been diagnosed with mild diabetes and heart failure. She was a devout Catholic and attended mass each morning. Her treks to church events, to the senior center at church, and to her various physicians (internist; orthopedic, cardiac, and ophthalmic specialists) constituted her social life. One day the recreation director at the senior center noticed her pulling a paper bag of medication bottles from her purse. She sat down to talk with Rosa about them and soon realized that Rosa had only a vague idea of what most of them were for and tended to take them whenever she felt she needed them.

a. What is your primary nursing diagnosis for this patient? Utilize the PES format (problem, etiology, S&S)

b. What would be the top three assessment you would do and why?

c. What would be your top three interventions and why?

d. What is your goal for this patient? Goal must be S.M.A.R.T (Specific, Measurable, Attainable, Realistic, and Timely)

Answer 1

A) Primary nursing diagnosis for this patient is :-

- Deficiency of knowledge about the disease condition and medication related to her primary education as evidenced by vague idea of what most of the medications were for and tended to take them whenever she felt she needed them.

B) Top three assessment :-

- Understanding

- Knowledge about disease

- Support system

C) Top three interventions :-

- Provision of knowledge about disease and medicines

- Involvement of children in her care

- Enrollment in the diabetic patient group

All this will help her to manage her disease by herself without dependent on others and help in avoiding complications

D) SMART goal :-

She will monitor her blood sugar each morning before breakfast and record the results daily for next 7 days .