Question

Lisa Rae is a 78-year- old Caucasian female who lives by herself in an assisted living facility apartment. Her husband passed away five years ago. She has one daughter who lives nearby. Mrs. Rae is a retired bus driver and has a history of hypertension and osteoarthritis in her right knee. She inadvertent took two doses of her antihypertensive medication this morning and suffered a fall in her bathroom. She was taken to the emergency department via ambulance and was diagnosed with hypotension. Since admission to the medical unit, she was experienced urinary incontinence and her incontinence pad is currently wet. During the scenario, Mrs. Rae is friendly and cooperative, but also embarrassed about the medication error and her urinary incontinence.

1. What do you suspect is going on with the client?

2. What is your nursing assessment of the client?

3. What is your nursing diagnosis based on your assessment?

4. What are your expected therapeutic interventions?

5. What community referrals should be made if any?

Answer 1

1. As Mrs Rae is having arthritis and hypertension, both are in risk for developing incontinence of urine. Hypotensive medications also leads to urinary incontinence. It is the reason in her and is not an error in medication.  

2. Nursing assessment of Mrs. Rae include

Monitoring of blood pressure of frequently, also assess the frequency , urgency and seveority of leakage and aggravating factors of incontinence .

3. Altered bladder elimination pattern related to decrease in muscle control and disease condition such as arthritis and hypertension.

4. Interventions of patient includes -

Use of absorbent pads which helps to prevent skin irritation.

• Inability to participate in behavioral programs, due to illness or disability

• Presence of an incontinence disorder that cannot be helped by medications

• Catheterization of patient may be required .

5.