Question

Lindsay Baird is a 40-year-old woman who lives with her two children and husband in a rural community. Mrs. Baird presents at the clinic for a routine check of her hypertension. Upon reviewing the past medical/family history, it is noted that Mrs. Baird is Catholic and believes her spirituality to be a very important part of her medical care. Entering the room, Mrs. Baird greets the nurse gracefully and continues to respond to general health questions with ease. After proceeding through relevant medical history since the last visit, a 5-lb weight gain is noted with a correlating blood pressure notably higher than the last visit. Upon questioning the recent changes in her medical condition, Mrs. Baird responds, “I just haven’t felt like doing any exercise lately.” Continuing to draw information out, the nurse asks particular questions related to stress levels, time restraints, and motivation. Eventually Mrs. Baird begins to tell the story of her family falling away from attending church on a regular basis and the corresponding loss of support and motivation. She states, “I used to gain such strength going to mass. It was such an encouragement. One day during the week, my friends from church and I used to walk with one another and talk about what God is doing in our lives … now I just feel overwhelmed and busy all of the time … and I can’t talk with anyone.” Mrs. Baird’s case will be discussed throughout the chapter.

1) identify abnormal findings and clients strengths (subjective data& objective data)

2) Indentify cue clusters

3) Draw inferences

4) list possible nursing diagnosis

5)check for defining characteristics

6) confirm or rule out diagnosis

7)document conclusions

-nursing diagnosis that are appropriate for the client include

-potential collaborative problems include the following

Answer 1

1.The abnormal findings as subjective and objective data are

Subjective data

• Loss of support and motivation
• Lack of time due to busy schedule
• Decreased activity (walking)

Objective data

• Elevated blood pressure
• Increased weight
• Poor time management
• Anxious

2.The cue cluster are

Increased stress (feeling overwhelmed and busy)

Inability to cope ,poor time management (I can't talk with any one)

Increased weight (I used to walk)

Hopelessness(lack of support )

3.Inference

• Lack of motivation
• Hopelessness
• Hypertension
• Overweight

4.Nursing diagnosis

• Hopelessness related to loss of support, motivation decrease in spiritual support as evidenced by verbalisation
• Poor stress management related to lack of time as evidenced by verbalisation
• Decreased physical activity related to missing walk