Reference no: EM133396949

Case Study: Mrs. Jones is a 68 year- old male who has a male life partner, married for 5 years. He was admitted for right hip replacement. He does not have medical insurance and he is concerned that he cannot pay his bills if he cannot work. He has multiple co-morbidities which include a history of: cigarette smoking for 40 years, COPD, Congestive Heart Failure and kidney failure. Post- op his pain has not been managed properly, he has also refused physical therapy due to the pain. Every time he requests pain meds he states it is 10/10 but he is laughing while reporting pain level and vital signs are always stable. He is also only eating 10-15% of his meals, states he does not like the food. His hospital stay has been extended for 1 week due to the lack of participation with PT and pain management. Discharge home may not be a realistic option due to his physical limitations with his lack of mobility.

Questions: As the nurse caring for the client how would you respond to the following questions?

1. The client has multiple medical conditions how will these conditions impact the clients care? What questions would you want to ask pertaining to the clients' health history and what areas of the physical assessment would also be of concern.

2. Are there any social and economic factors that will affect the care of the client? What stage of Erickson's psychosocial development is this client in and what could this client be potentially dealing with based on his age?

3. How can the physicians and doctors better manage the client's pain? Could his pain be related to other conditions?

4. In order for the client to be released home safely what assistance would be needed and how would those arrangements be made? Is a Skilled Nursing Facility a more reliable option? What is the role of the RN in discharge planning and when does discharge planning begin?

5. Does the client's sexual orientation impact the care he will receive?

6. Are there any common aging changes that may be of a concern with the client's prognosis or recovery period? Are there any complications that may be of concern with this client and why?