Reference no: EM133654037

Assignment:

William Janvier is a 62-year-old male who was born on August 22, 1961, in Meadow Lake, Saskatchewan and is now currently residing in a long-term care facility in Fort McMurray, Alberta. He was admitted to the long-term care facility 9 months ago after being hospitalized following a 2-week binge drinking bender which then resulted in a drug overdose. Once in hospital he was diagnosed with Korsakoff's Syndrome and was deemed incompetent to care for himself at home. Aside from alcohol and the use of cocaine, William is also a heavy smoker and has hypertension. Due to urinary retention from an enlarged prostate, he also has a catheter to help monitor his output.

Mr. Janvier grew up in a home with strong cultural beliefs and went to school on the reserve in Beauval, Saskatchewan. However, his older siblings attended the residential schools, which vastly impacted Harry and his family. William lost his father when he was 5 years old, and his mother remarried when he was 10. William's stepfather was verbally and physically abusive to himself and his siblings as they grew up, which led his mother to divorce his father when William was 15. At 16 years old, William quit school and went to work in the oil field industry to help support his family and mother. William was known to be a soft spoken, shy, kind, and respectful kid growing up and he always ensured his mother was taken care of. He has 3 sisters and 3 brothers in his family, and he was the third youngest of them all. 1 of his brothers, Norman, lives 2 hours away from Fort McMurray and is listed as his next of kin and his sister Linda who lives in British Columbia is noted as his second next of kin. William's other siblings are spread out across Saskatchewan, British Columbia, and Manitoba.

As a child and into his young adult years, William enjoyed playing hockey, whether it was on an outdoor rink or an inside arena. He also had a love for the outdoors, nature, and traditional cultural practices. After losing his job working in the oilfield 10 years ago due to the recession and layoffs, he became depressed and turned to alcohol and drugs to cope. When he lost his job, he also had to sell his beautiful house, new truck, and quad to be able to afford to live, which led to him renting places when he could and couch surfing with family and friends to have a roof over his head.

William can feed himself and he is on a regular diet, normally he eats very well. He needs assistance with his ADLs and needs multiple reminders for his personal care. With the catheter William tends to pull on it as it irritates him or he will sometimes forget about it as he gets up to move, which has resulted in the catheter being pulled out numerous times. He is continent of stool, but wears pull ups as he occasionally fails to wipe himself properly after using the washroom. Being in the long-term care facility William is going on 6 weeks of being sober from drugs and alcohol, but he continues too heavily smoke. Most days he stays in his room and his brother will come visit with his 2 nieces and 1 nephew to keep him company and bring him cigarettes.

Today William is oriented to person only, complains of "burning" from his catheter that had been inserted 2 days prior after he pulled out the previous one. His urine is amber colored and smells quite foul and concentrated when the nurse empties the foley bag. When William is handed a washcloth and is instructed to wash his face, he drops the cloth onto the floor and has a confused look on his face. The nurse washes him up and while dressing he tries to put his whole body through the neck hole of his shirt and struggles to follow any directions with his personal care.

1. What is the client's strength as determined by nurse and client?

2. Health priorities as determined by the nurse and the client.

3. What is your first nursing diagnosis/first highest priority with the planning of client goal with reference and expected outcome with reference? list at least 3 interventions with rationale per intervention with references.

4.What is your second nursing diagnosis/second highest priority with the planning of client goal with reference and expected outcome with reference? list at least 3 interventions with rationale per intervention with reference.