85-year-old female presents with confusion and weakness. Per the…

85-year-old female presents with confusion and weakness. Per the patient’s family she has “not been acting right” for the last several days, occasionally saying things that “do not make sense”.  Today, initially when visiting, the family could not find their mother and then finally found her wondering around in her basement.  They found groceries sitting out on the counter. When questioned what she was doing, the patient was confused and did not know where she was. When obtaining the patient’s initial health history, she is unable to recall her PMH and is confused why she is being asked so many questions.  Patient oriented to self only and easily distracted during conversation and interactions with others. The patient’s daughter is at her bedside.  Per the daughter, she has noticed her mom lately becoming easily fatigued when performing simple house hold tasks and sleeping more. The daughter is able to provide a list of her mothers’ PMH and current medication list.  It is uncertain whether or not the patient has been taking her medications routinely or as ordered.  The patient’s skin is cool to touch. 

 

Past Medical History:

Hypertension

Osteoarthritis

Coronary Artery Disease

COPD

Diabetes

Overactive Bladder 

Urinary Incontinence 

Depression

 

Medication List

Aspirin 81mg Daily PO

Lisinopril 10mg Daily PO

Metoprolol 25mg ER Daily PO

Metformin 500mg bid PO

Tolterodine 2mg bid PO

Celecoxib 200mg Daily PO

Citalopram 20mg Daily PO

Atorvastatin 10mg Daily PO

 

Upon admission labs and a urine specimen were obtained. UA results are still pending. When sending the UA, you note the urine is concentrated, dark amber and cloudy. Patient only voiding 100ml at this time. Patient states “feeling dizzy” when walking back from the bathroom. You note the patient becomes easily fatigued with dyspnea on exertion when helping the patient back into bed.

 

Some of the patient’s lab results were as followed:

 

WBC 14

RBC 5.0

Hemoglobin 12

Hematocrit 49

Glucose 70

Sodium 150

Chloride 110

Potassium 3.8

BUN 30

Creatinine 1.1

Calcium 9.0

 

Vitals on Admission

 

BP: 100/50

Pulse: 112

RR: 24

SPO2: 92% on Room Air

Temp: 99.8 

Pain: 6/10 pain in lower back and legs

 

 

Based on previous patient information answer the following questions. 

 

 

1. After reviewing the previous clinical scenario, the patient’s past medical history, the patient’s presenting labs and vital signs, identify significant data which require immediate follow-up.   (Identify at least 5 and explain the significance of each for this patient) 

 

 

 

 

 

 

 

 

 

 

 

 

1. Upon recognizing these cues, what is your patient at risk for and why? (Provide supporting detail and evidence to back your response. Provide at least 3-5 sentences.)

 

 

 

 

 

 

 

 

 

1. For each finding what nursing interventions are necessary for the appropriate care of the patient?

 

Nursing Interventions

 

 

1. For each finding what would you need to assess to know if the outcome is effective?

 

 

 

 

 

 

 

1. What would you need to assess to know if the patient is improving or declining?

 

 

 

 

 

 

1. Review the patient’s medications and complete the chart below

 

Patient’s Medication	Indication for Medication Use	Priority Nursing Considerations	Education to Reinforce with your patient
Aspirin
Lisinopril
Metoprolol
Metformin
Tolterodine
Celecoxib
Citalopram
Atorvastatin

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. Review the following lab results and complete the table below.

 

Lab	Normal or Abnormal?	What may an abnormal result mean?  What may cause an abnormal result?
WBC 14		1.   2.
Hemoglobin 12		1.   2.
Hematocrit 49		1.   2.
Platelets 300		1.   2.
Sodium 150		1.   2.
Potassium 3.8		1.   2.
BUN 30		1.   2.
Creatinine 1.1		1.   2.

 

 

 

 

 

 

 

 

 

 

1. Review the following past medical history and complete the table below

 

 

Past medical history	Priority nursing assessment
Hypertension
COPD
Diabetes
Depression

 

 

 

1. You are preparing to speak with the provider regarding the priority findings.  What orders to you anticipate?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Explanation & Answer

Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Order Now and we will direct you to our Order Page at Litessays. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.