Initial post (minimum 350 words): Please discuss the prompt associated with the first letter of your last name, using the module readings to support the content of the initial post:
S-U: View the NIH video Know Stroke. Know the Signs. Act in Time (http://stroke.nih.gov/materials/knowstrokevideo.htm). Assignment help – Discuss ways to use this information to teach older adults about strokes.
Touhy: Ebersole & Hess’ Toward Healthy Aging, 10th Edition
Chapter 25: Respiratory Health and Illness
Answers to Nursing Study Critical Thinking Questions (Text)
Has Mrs. Chu Been Undiagnosed?
One of your assigned patients in the acute care hospital where you are working is being prepared for an elective hip replacement due to long-standing arthritis. In your assessment, you find that Mrs. Chu seems to become slightly short of breath when she is speaking. This had been attributed to her advanced age and heart disease, even though her heart disease is well controlled at the time. As you gently proceed in your assessment she admits that she has a cough that seems to “come and go a lot” and that she is no longer doing many of the things she used to do because she is easily fatigued. When you inquire she tells you that she was a heavy smoker but that was “many years ago.”
1. What is your nursing priority in caring for Mrs. Chu at this time?
a. Make sure that the medical staff who are caring for her are aware of your assessment prior to her surgery.
2. Assignment help – Discuss with another student two nursing diagnoses that can be drawn from this case.
a. Activity: examples of potential diagnoses.
Patient’s lack of awareness of signs and symptoms of potential COPD (e.g., long-term cough affecting her function) or heart disease that is not under optimal control.
Chronic fatigue likely associated with untreated or undertreated illness.
3. Develop a nursing intervention for the diagnoses and then compare them with another student’s interventions.
a. Activity: examples on interventions associated with the above.
Provide both oral and written materials regarding COPD/heart disease (in language patient can understand) once a diagnosis has been made.
Work with patient to develop strategies to best incorporate periods of fatigue and periods of more energy into her life to maximize function for as long as possible.
CRITICAL THINKING QUESTIONS AND ACTIVITIES
1. Are end-of-life topics appropriate when caring for someone with COPD?
a. Yes, they are appropriate and specific topics will vary based on the type of COPD, the prognosis, the concurrent chronic conditions, and cultural and religious beliefs.
2. Think about the last place you either worked as a nurse or were assigned to as part of your nursing studies. Assignment help – Discuss any strategies that were used in the facility to minimize the development of respiratory illnesses among patients.
a. Student activity or assignment, response varies.
3. What additional strategies would you recommend?
a. Student discussion or assignment based on Question 2.
Touhy: Ebersole & Hess’ Toward Healthy Aging, 10th Edition
Chapter 26: Common Musculoskeletal Concerns
Answers to Nursing Study Critical Thinking Questions (Text)
Does Mrs. Svӧld Need a Calcium Supplement?
Mrs. Svӧld is an 80-year-old woman of Scandinavian descent. She is a very petite woman who moved to a nursing home several years ago. She is dependent on others for her mobility. She is only able to get outside at the rare times her sister visits. As you review her medication list you notice that she is not taking any supplements, including calcium and vitamin D. She does, however, take Fosamax.
1. Is your patient at risk for osteoporosis?
a. She most likely already has osteoporosis, even if this is not on her “problem list” as noted in her medical record. Although it is possible, it is highly unlikely that she is taking Fosamax preventively.
2. Since she already takes Fosamax, does she need to take supplements?
a. It is recommended that all persons who do not have regular and adequate sunlight exposure take calcium supplements; some sources say everyone should. Vitamin D supplementation is recommended for everyone. This recommendation is even more important in someone who is being treated for osteoporosis.
3. What can you do, if anything, to foster bone growth in Mrs. Svӧld, and is it necessary since she lives in a nursing home and is immobile?
a. Work with dietary staff to maximize the availability of calcium-rich foods available to her.
b. Work with the activities staff to develop a means for her to participate in weight-bearing exercise of any kind.
c. Modify the plan of care to include light exposure (not through glass) for short periods of time on a daily basis.
4. Is Mrs. Svӧld at any more risk for osteoporosis than some of your other patients? Why or why not?
a. Yes, she has all of the risk factors.
CRITICAL THINKING QUESTIONS AND ACTIVITIES
1. Analyze your own diet and activities and determine your relative risk for osteoporosis.
a. Answers will vary. Search risk factors or see http://www.osteoporosis.org.za/downloads/FRAX-report-09.pdf for good starting places.
