Question

To complete the information below, please reference your Potter and Perry Fundamentals of Nursing book and Nursing Diagnosis Handbook.

Case Scenario
“Help, someone help.” Mrs. Bohne’s voice was weaker now. She had been calling for almost an hour, hoping her neighbor would hear, but she was still by herself, lying on the kitchen floor where she had fallen. She rested her head down and began to pray for someone to find her.

Nursing Assessment Including the Client Story
Mrs. Bohne is an 85-year-old woman who was a schoolteacher for 40 years of her life. She is now widowed and lives at home with her son. She uses a walker to ambulate, but her mobility is limited. Mrs. Bohne spends most days in a recliner watching television. Her son provides three meals for her and snacks as requested, but her intake has been decreasing. Her son has been providing “soft” foods because of her complaints about her dentures hurting and slipping. When he would question her about her intake, she always responded, “I’m just not that hungry” and promised to eat more later.

Her son stated that he returned home after work to find his mother on the floor complaining of right-side pain. When the paramedics lifted her off the floor, a red spot on her right hip was evident. In the emergency department, Mrs. Bohne was diagnosed with a broken hip and dehydration. Her laboratory results were mostly unremarkable with the exception of her serum albumin at 3.2 g/dl. Mrs. Bohne is in pain but takes pain medication sparingly. She is often unwilling to change position in bed. Her son was surprised and embarrassed to learn that his mother’s weight had decreased from approximately 140 pounds a year ago to 124 pounds, which was determined from bed scales in the emergency department. Mrs. Bohne stated her height to be 5’5”. Her son said he knew she had lost weight but did not realize how much.

A.   ASSESSMENT
1.   Identify a minimum of 5 the significant subjective symptoms by underlining them in the scenario above and then list them below.

Answer 1

· Decreasing food intake

· Hurting and slipping dentures

· Unwilling to change position in bed

· Right sided-pain

· Weight loss

Subjective symptoms are apparent to the affected individual but they are not observable by other people. Pain is the most common example of subjective symptom. Pain in the dentures and pain after the fall are both subjective symptoms. Further, decline in the food intake represent an abnormality which is distinctive to the patient hence it is a subjective symptom. Weight loss is another common example of subjective symptom and unwillingness to change position in the bed represent any form of discomfort. A physically invisible discomfort to the observer which can only be felt by the patient is considered as the subjective symptom.