Nurse Home Visit Assessment and Education for Sallie Mae Fisher
Sallie Mae Fisher, a recently widowed 82-year-old female, was discharged from the hospital last Saturday after a three day stay related symptoms of congestive heart failure (CHF) exacerbation, including dyspnea, chest pain, and a weight gain of 8 pounds. This was Sallie’s fourth hospitalized in the past six months for the same diagnosis. Her other history includes hypertension and atrial fibrillation (AF). This paper will explore problems related to her CHF, physical assessment, and psychological and spiritual well-being identified during a recent home visit. Intervention to assist Sallie to better manage her health and reduce her hospitalizations will be discussed.
Identified Problems
Ms. Fisher’s health history and frequent exacerbation of CHF have caused her to be on multiple medications. Despite these medications she has been …show more content…
Fisher, commonly occurs in heart failure because of reduced cardiac output, which reduces perfusion to the lungs and other organs of the body (Klabunde, 2015). Pulmonary edema, also frequently associated with heart failure can cause dyspnea (Klabunde, 2015). Sallie Mae’s discharge orders included home oxygen use at 2 liters nasal cannula as needed and Lasix can assist with reducing her dyspnea. She shows a knowledge deficit related to her refusal to allow the delivery and set up of the oxygen concentrator and using oxygen at home.
Recurrent chest pain is another problem identified by her recent hospitalization and nitroglycerin ointment prescription. According to Stewart and Blue (2004) chest pain is a result narrowing of the coronary arteries, which decreases blood supply to the myocardium, causing pain in the chest as a result of poor oxygenation. In addition to the nitroglycerin she has also been prescribed ibuprofen and Darvocet N for pain. Oxygen may also help alleviate her chest discomfort related to dyspnea (Healthwise Staff,
Sallie Mae Fisher, a recently widowed 82-year-old female, was discharged from the hospital last Saturday after a three day stay related symptoms of congestive heart failure (CHF) exacerbation, including dyspnea, chest pain, and a weight gain of 8 pounds. This was Sallie’s fourth hospitalized in the past six months for the same diagnosis. Her other history includes hypertension and atrial fibrillation (AF). This paper will explore problems related to her CHF, physical assessment, and psychological and spiritual well-being identified during a recent home visit. Intervention to assist Sallie to better manage her health and reduce her hospitalizations will be discussed.
Identified Problems
Ms. Fisher’s health history and frequent exacerbation of CHF have caused her to be on multiple medications. Despite these medications she has been …show more content…
Fisher, commonly occurs in heart failure because of reduced cardiac output, which reduces perfusion to the lungs and other organs of the body (Klabunde, 2015). Pulmonary edema, also frequently associated with heart failure can cause dyspnea (Klabunde, 2015). Sallie Mae’s discharge orders included home oxygen use at 2 liters nasal cannula as needed and Lasix can assist with reducing her dyspnea. She shows a knowledge deficit related to her refusal to allow the delivery and set up of the oxygen concentrator and using oxygen at home.
Recurrent chest pain is another problem identified by her recent hospitalization and nitroglycerin ointment prescription. According to Stewart and Blue (2004) chest pain is a result narrowing of the coronary arteries, which decreases blood supply to the myocardium, causing pain in the chest as a result of poor oxygenation. In addition to the nitroglycerin she has also been prescribed ibuprofen and Darvocet N for pain. Oxygen may also help alleviate her chest discomfort related to dyspnea (Healthwise Staff,