Reference no: EM133623976

A nurse is caring for George Crusader, an 84-year-old client with moderate stage diagnosed 4 years ago by a family physician. George has a history of hypertension, hypercholesterolemia and atrial fibrillation, George worked in a local factory for many years, retiring 15 years ago. His wife Mary is his primary caregiver. George and Mary had one son that died many years ago. Kristina is a niece that lives nearby that checks in routinely with George and Mary. Mary has recently been hospitalized for heart failure and a fall. Mary shares that she made a promise to George that she would never place him in a nursing home. With her own health failing, keeping this promise is becoming more difficult. Both George and Mary have been devout Catholics, but due to their health condition, have not been able to attend church functions. Mary shares that she misses her church friends but is now unable to leave George home unattended. George was recently hospitalized following a change in mental status and episode of delirium. Home care services has been ordered that include nursing, nurse aide, social work, PT and OT. As George has become more resistant to personal care. He has been refusing personal hygiene assistance for a week. He is also refusing to take prescribed medications. George has become increasingly more difficult to manage in the evening hours including attempting to leave the home to "go to work" (sundowning). Mary has called the home care information line 3 times in the past 24 hours. A home health visit is ordered to reassess George and assess how the family is coping with the care of George. Current medications: Donepezil 10 mg daily. Memantine 5mg BID, Captopril 5mg daily, Seroquel 100 mg at HS, Aspirin 81 mg daily. Memantine is new medication recently added.

1. Identify the relevant subjective and objective assessment information related to the client's condition. (Recognizing Cues; assessment)

2. Based upon assessment information, identify, and prioritize the top 3 client problems. (Analyze Cues; Analysis and Prioritize Hypothesis; Planning)

3. For each client problem, determine and enter the relevant assessment information that supports the identified client problem. (Analyze Cues; Analysis and Prioritize Hypothesis; Planning)

4. Identify important nursing interventions that should be taken to address each client problem. (Take Action; Implementation)