Reference no: EM133219861

Assignment:

• Mr. Joseph Lawrence (J.L.) is a 74-year-old Caucasian English-speaking male. He currently resides in a small rural community where he has lived with his family for over 50 years. Client's date of birth is February 2, 1947. He was born just outside the rural community in southern Illinois that he currently lives, and his ethnic roots go back "a few" generations to family that emigrated to the U.S. from Ireland.  
• J.L has been married to the "love of his life" for 52 years, Mrs. Mary Ellen Lawrence. Together they had two children, Justin, who is 48; and Colleen, who is 46; and four grandchildren, Rebecca (24), Thomas (22), Carleen (12) and Andrew (25). Although they consider themselves a "tight knit" family, Justin lives in California, and Colleen resides in Arizona along with their spouses and children. They can visit approximately twice per year. Mrs. Lawrence was diagnosed with Alzheimer Disease approximately 2 years ago, and Joseph has now become her primary caregiver as her health is declining. 
• J.L. has a high school diploma and worked as a local business owner in a sporting goods store until his retirement 9 years ago. He currently has Medicare with a supplemental policy. He is a reliable source. He describes his general health as "not bad for a man my age with arthritis, diabetes and heart disease, I keep up with the best of them." 
• J.L.'s past medical history includes a history of osteoarthritis, diabetes mellitus type II, coronary artery disease, and coronary artery bypass surgery 9 years ago (his only previous hospitalization). He is up to date on his immunizations (Influenza, pneumococcal, shingles, and T-dap). He is allergic to penicillin: he stated he had it as a child and developed a severe rash. His current medications are Ibuprofen two tabs every 4 hours as needed for joint pain, Metformin 500 mg two tabs daily for diabetes, Metoprolol succinate extended-release tablet 200 mg daily for heart disease/hypertension, and one multivitamin daily. He states that currently he is 5"11" and weighs 190 lbs. 
• J.L. has no "regularly scheduled" exercise, however during a typical day he walks up and down the stairs about 3 times daily and takes short walks in the driveway while caring for his wife, who currently cannot be left alone. He feels he sleeps approximately 4-5 hours per night, as he is up frequently caring for his wife. 
• The 24-hour diet recall includes the following: A piece of toast and bran cereal for breakfast, a turkey and salami sandwich with American cheese for lunch, and a Stouffer's frozen meatloaf with mashed potatoes and carrots for dinner, with 2 chocolate chip cookies for dessert. He reports moving his bowels daily, with occasional difficulty in starting a stream and frequent urination. He drinks 2-3 cups of caffeinated coffee during the day with generally one more cup with dinner. The only alcohol he reports consuming is one glass of wine daily prior to bed. He denies taking any street drugs or un-prescribed medications, smoked 1 pack of cigarettes per day for 35 years, which he was successful at quitting approximately 10 years ago. 
• J.L. reports feeling safe in the neighborhood he has lived in for many years, and reports adequate heat, electricity, and water in the home. He currently drives, with the nearest store 6 miles away, which he generally visits twice per month to "store up on frozen and canned goods." He reports his wife was a great cook, and they enjoyed making traditional "Irish meals of meat, potatoes, bacon and vegetables such as cabbage, carrots and celery" for many years prior to her diagnosis. 
• He is in Erik Erikson's state of "Ego Integrity vs. Despair." His collaborative resources include friends in the community, family (by phone or FaceTime), connections with the local parish with home visitations from the priest of the parish and a close relationship with his primary healthcare provider and nursing staff.

From this scenario:

question 1:Identify assessment data related to J.L.'s assessment that may indicate dehydration.

Question 2:Is Mr. J.L. at risk for impaired urinary elimination? Why or why not?