Reference no: EM133551575

Assignment:

An 83-year-old male was admitted with Acute metabolic encephalopathy, acute sepsis, atrial fibrillation, hypertension, and leukocytosis. His previous medical history includes hypertension, dyslipidemia, and type 2 diabetes. A-fib on Pradaxa, OSA, dementia, Nash cirrhosis, history of hepatic encephalopathy with lymphedema, and history of colon cancer status post partial colectomy who presents from a skilled nursing facility with altered mental status coded as a stroke. Neurology was consulted, and the patient's CT and MRI results indicate no CVA - Neurology signed off. At admission, the patient was 103.8 degrees Fahrenheit.

Likely Aspiration that leads to sepsis. He also failed the swallow evaluation. The patient was treated for aspiration pneumonia and acute hypoxic respiratory failure, both of which have resolved. The patient has also completed the prescribed course of antibiotics. As the patient continued to fail swallow evaluation, the recommendation was to place a G-tube via IR; however, during the procedure, the colon perforated. The patient was taken to the operating room, where the colon was repaired. A new G-tube was placed, and a nasogastric tube for suction. He was placed on TPN until the colon and stomach were healed. He had some Gl bleeding, possibly post-procedure.

The hospital course was three mos ago. He is still placed on a PEG tube, strict NPO. He is a resident at a skilled nursing facility and is bedbound for 2 years now. He is A&Ox1.

QUESTIONS:

1. What is the primary nursing priority (provide the rationale).

2. List 3 educational priorities that should be included in this client's plan of care. Explain what you would teach and why.

3. What disciplines would you collaborate with to improve or stabilize the client's current condition? What disciplines would you collaborate with to prepare the client for discharge? Include the rationale regarding why these disciplines would be helpful for your client.