Nursing Care Plan For Mrs Green And Mr Grandin

Mrs Green’s Nursing Care Plan

Question 1 :In collaboration with the RN, following State/territory Nursing and Midwifery Regulatory Authority, Enrolled nurse standards for practice and acting within the Scope of Nursing Practice Framework, develop a nursing care plan for Mrs Green. Incorporating cultural and religious beliefs, provide two (2) actual and two (2) potential nursing diagnoses, including correct terminology, interventions and expected outcomes for each.

 Question 2: Mrs Green has confided that she has had trouble adjusting to her body image in middle age now that she is no longer fertile. How does her case relate to the sexual development stage experienced in middle age? 

Ans: Counseling is the most effective technique for her to overcome from the current circumstances she is in. It is indeed a technique which can really assist Mrs. Green in recovering from her devastated condition by empathy, kindness and guiding her back to a normal way of life. Counselling might provide her Mrs. Green with religious, spiritual, and mental health support in light of her current health situation so that she can allow herself to fully participate in her family.

Question 3: What could you do to contribute to Mrs Green’s health teaching, to reduce her embarrassment about performing ADL’s with a nurse assisting her? 

Ans: Mrs. Green would need  the services of a female-nurse who will assist her in regaining her confidence in her everyday duties. If a male nurse is assigned, she may feel uncomfortable or embarrassed as the male person would be assisting her in toilet, while taking shower, and getting dressed on a daily basis. Mrs. Green’s failure to shower on a daily basis or the incompleteness of her ADLS could be due to this. This may have caused her upset, and frustrated.

Question 4: Describe two (2) priority needs to be considered in planning for Mrs. green’s discharge.

Ans:

1. She needed immediate counselling, as well as any necessary medical therapy or physiotherapy, to help her overcome from the dilemma that she is in to as a
2. result of her menopausal state, which she refuses to recognise.
3. Green’s other aim is to have an abundance of personal support and care from her husband, as well as assistance from her children. Mrs. Green believes that she should be given time for emotional support because she is going through menopause, which may affect her sexual relationships.

Question 5: Identify one (1) community resource/support service that Mrs Green may need, when discharged.

Ans: Mrs. Green’s mobility must be assessed before she is released from hospital. Mrs. Green’s knee problem necessitates the nurse’s assessment as to whether she requires attending rehabilitation.

The discharge process will basically depends upon the assessment of the healthcare made during her stay in the hospital. It is important for her family members also to be present during the education sessions so that they can help her with the  medical need required. The nurse will need to check the patient’s mobility see if there are some hurdles that would block her movement in the staircase, using the toilet comfortably, and the accessibility of support for aiding her with her daily tasks. In addition to rehabilitation, she will need to see a physiotherapist to go over exercises and recover her mobility.

Question 6: Briefly explain the developmental stage, specifically as it relates to Mrs Green.

Ans: Mrs. Green is in the early menopause point of her life. It really is the point at when the hormone estrogen levels start to fall in an irregular way. It occurs shortly after 40 years of age. Mood changes and irritation occur during this phase, the other symptoms include vagina tends to dry up, hot-flashes making sexual inter-course a practise of agony, in addition to urinary difficulties.

Contributing to Mrs Green’s Health Teaching

Case Study 2: Mr George Grandin

On 12/6/14 at 1000hrs, you are assigned to admit a new client to your ward. Mr George Grandin is an 87 year old male of Spanish descent, who was admitted to your ward this morning, following a fall at home. On admission, his wife (Mary) and his daughter (Celeste) are in attendance.  He sustained significant bruising and swelling to his right hip and shoulder with a large skin tear to his right forearm. He did not sustain any fractures. He is admitted for pain relief and dressings to his forearm, as well as a physiotherapy review.  George’s daughter (Celeste) has requested an interview with the doctor, to determine if her father needs any extra care at home.
On assessment, George has bony prominences on his hips and pelvis and is at risk of developing pressure areas on these bony prominences. Cognitively, George is alert and orientated.  George tolerates a small, but nutritious diet at home that includes all aspects of nutrition.  He has no reported history of urinary issues and takes Metamucil daily to prevent chronic constipation.  George can shower and dress independently and had been ambulating independently prior to the fall, but is to be assessed by a physiotherapist for balance and gait and the need for a walking stick or frame. Medically, George is healthy for his age and other than Metamucil daily, he takes multivitamins and fish oil supplements, but no other medications.

Socially, he lives with his 82-year-old wife in an attached flat in their daughter’s home. George attends bowling and church weekly and states that his strong faith and his wife help him cope with his ageing process. George was born in Spain and immigrated to Australia in his late teens and identifies with strong Spanish ties in Australia.  George and his wife are practising Catholics, having a strong support network at home and at church. 
George’s observations on admission are Temp 36.1, BP 105/68, Respirations 18, Pulse 64, Height: 181cm and Weight: 65kg. George is very thin, with a BMI of 18.

Question 7: Following principles of best practice and risk assessment, identify one (1) stress management technique that you would recommend for Mr Grandin’s Nursing Care Plan

• It is important to identify the stress source that need to be noted and alternative to overcome the same should be  determined so that it may be easily  remembered.
• Grandin should read some inspirational books so that he can get enjoyment, satisfaction, or spiritual guidance from them.
• He needs to practice yoga. Deep breathing is being practised till he feels comfortable.
• Grandin can have pet at his home to play and spend time with it. 

Question 8: Identify one (1) appropriate method used to collect health related data, as a part of the admission process for Mr Grandin.

Ans: During the patient admission, it is important to measure the patient’s vital signs.  The above gives an approximate understanding of the patient’s current state and the emergency therapies he might need. The essential functions of a body, such as body temp, heart beat, breathing rates, and blood pressure, are all measured as the vital signs. It is also important to understand the any health condition in the family history is present or not; is the patient is allergic or not. In the present case vital sign assessment is important as it will help to quickly take the necessary action if needed for the patient in distress. 

Question 9: Considering Mr Grandin’s injuries and his low BMI, what regular nursing assessments/charts will George need?

Ans: The nurse must be cautious of a variety of elements, therefore she should keep a record that will serve as both a companion and a checklist. First and foremost, because the patient is elderly and has already experienced a serious fall, the nurse should do a fall risk  assessment in order to lower the patient’s future risk of falling. Furthermore, he has a lot of ailments that necessitate correct dressing. Wound dressing is a skillful interference that must be performed correctly in order for the wound to heal quickly. Poor wound dressing can cause a septic infection, putting the person’s health at risk. The patient is at risk of developing pressure ulcers, thus he must be placed on adequate air-filled beds such that the pressure is evenly distributed and no pressure ulcers develop. Additionally, his constipation can be treated with medicine, and fibre and roughage should be provided in his diet to help him overcome the problem.

Question 10: Chronic illness, coupled with the changes associated with ageing, must be considered when planning nursing care for an older client. Provide two (2) risk factors for older people in hospital.

Ans: In hospitals, treating senior patients can be difficult, as nurses generally report feeling more pressure while dealing with elderly patients than with young individuals. Patients who are older have less strength in their motions and are more likely to lose their balance. As a result, individuals will be at a greater risk of falling, that can result in fractures or perhaps even replacements. This causes excruciating pain and a lower quality of life. Additional concern that is directly linked to ageing is the development of mental diseases such as depression.

Question 11: Identify two (2) community resources or support services that George may need when discharged.

Ans: National Alliance on Mental Illness NAMI and Programs of All-Inclusive Care for the Elderly (PACE®)

Question 12: Access the relevant websites, to apply one (3) standard from each of the following code/guideline and relevant Act, that would be relevant to the case STUDY.

Ans: According to the case, the code of ethics that could be applicable to the situation is value statement 3, which states that nurses should value people’s variety. The nurse should not only respect the diversity of the patients, but also value their religion, language, and backgrounds, as well as her own sentiments, thoughts, and views about her own cultural similarities and differences. They should prepare themselves in such a way that they can build a wide range of cultural understanding and information in order to be more attentive to the language spoken.

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