Reference no: EM133260456
Answers to Nursing Study Critical Thinking Questions
Does Mrs. Svold Need a Calcium Supplement?
Mrs. Sv?ld is an 80-year-old woman of Scandinavian descent. She is a very petite woman who moved to a nursing home several years ago. She is dependent on others for her mobility. She is only able to get outside at the rare times her sister visits. As you review her medication list you notice that she is not taking any supplements, including calcium and vitamin D. She does, however, take Fosamax.
Since she already takes Fosamax, does she need to take supplements?
Is your patient at risk for osteoporosis?
Chapter 27 - Pain and Comfort
Ms. P. was a 66-year-old diabetic and, after a stroke, had to relocate to a nursing facility. In a short time, her diabetes began to have uncontrollable fluctuations with blood glucose ranging from 20 to 800 mEq/mL. Some of this was caused by erratic eating habits, almost no exercise, frequent urinary tract infections, and considerable stress related to her condition and her future. She bumped her toe while being assisted into her wheelchair after occupational therapy. In a few days, the bruise had sloughed skin, and an open sore was evident. Despite appropriate treatment, the sore became necrotic and was debrided. Ms. P, who rarely complained, began to moan while she was sleeping and cry a lot during the day. She complained of a continuous burning sensation and said that it felt as if her toe was "on fire." One day she threw her coffee cup across the room complaining that it was not hot enough. Various pain medications were given by mouth on an inconsistent basis, but the relief she experienced was minimal. She began to beg to die. The nurses thought perhaps she was right-after all, her general condition was poor, and life held little satisfaction for her.
Discuss Ms. P.'s situation and her probable prognosis.
What could be done, based on the information you have, to improve Ms. P.'s condition?
Do you think nurses are concerned about addiction in cases like Ms. P.'s?
Chapter 28 - Mental Health
Bipolar Disorder
Myra is a 71-year-old white woman who was admitted to the geropsychiatry inpatient unit for alcohol abuse and noncompliance with her lithium, which had been prescribed for a diagnosed bipolar disorder. Myra's primary mode of coping with her depression and mood swings has been to drink alcohol, meet abusive men, and play bingo. However, when she stops taking her dose of lithium, she begins to have flights of ideas, argues with her daughters, and tries to pick up men in her apartment complex. After seeing her at home, you discover that she has a long history of being physically abused by her husband, now deceased for 8 years, and has been living with one daughter who also has emotionally and physically abused her, causing Myra to be hospitalized. Myra's ability to test reality is compromised because of years of denial and low self-esteem. She says, "I used to have lots of times when I felt really good in between the depressions. Now I feel depressed most of the time." She tells you that her daughters harass her and interfere in her life. Your goals as a community-based nurse are to facilitate her independence (being able to live in her own apartment), to assist her with medication compliance, and to intervene with Myra to improve relationships with her daughters. Home visits are approved through Medicare for 1 month after hospital discharge.
What are two possible nursing dx?
What type of issues do you see occurring when she is home?