1. ) medication – family does not seem to understand the need of Mr. Trosack taking the medication, think that diet alone will solve the problem. Needs to understand the reasoning behind both BP and diabetic medication. 2. ) Diet – BP and diabetic diet. Expired food needs to be assessed 3. ) ADL’s – pt just had surgery, stairs in house, how will pt get food, utilize restroom with small room, need bathroom assistance/safety features such as raised toilet seat, handrails in shower, handrails in hallway, etc
A. ) medication – if do not take meds, will return to hospital. Elderly people often forget, may overdose, someone should administer medications or put them in a M-S pill container for him. Be sure to teach about postural hypotension due to BP med. (check this) Diet – must learn to adapt to low sodium diet to manage BP and diabetic ADA diet to manage diabetes ADL’s – need to ensure basic needs are met, will be following surgery so will be more difficult to pt to get around that he is used to.
If someone can help shop for him and get basic needs (bathroom, kitchen supplies, etc) that will ensure pt has adequate supplies necessary for living. 2. 1. Social worker/case manager – set up home care help, set physical therapy to be started, get medical supplies ready for the household (walker, wheelchair, shower seat) 2. physical therapist – help with rehab of hip, assist with ADL’s as well 2A. RN with nurse aid – oversees care of pt and teaches disease processes, dispenses meds, nurse aid – assist with ADL’s/cooking, getting supplies . Stairs at home – difficult for post-op patient, and if pt does not want any assistance, if refuses – unable to move around, complete ADL’s, will not be able to eat – will need to consider placement if continues to refuse assistance, no elevator Possibility of non-compliance with meds – unhappy with having to take the “darn” medications, so pt may refuse to take meds Apt is small – will be difficult to get around using a walker, also cluttered, many rugs will need to be removed from apt No safety features in bathroom, small
Trash and groceries has to be taken by stairs Food expired in refrigerator – concerned if pt is eating expired food or if he is not eating enough at all B. ) 1A. ) 1. Explain to family disease process of diabetes and high blood pressure and importance of diet, blood sugar monitoring, and medications. Need for a nurse aid/assistant to help with groceries, cooking, medication, blood sugar checks, ADL’s, getting items needed for living Need for apt to be re-organized – carpets removed, de-cluttered, safety features installed in bathroom and hallway 1B. With elderly pts, even if they are sick, it is beneficial to participate in social activities or else the feel they are losing their life, losing independence, so pt should participate in social events for elderly people, (daycare), will boost self esteem, help in recovering process, decrease depression 1C. ) Psychologically, if the patient is depressed, they won’t want to get up and move around, slowing down the recovery process. Won’t want to eat, slowing down the recovery process.
Diabetes will worsen with poor diet/not eating appropriate food, causes poor health. 2. ) This man needs to be placed in a rehabilitation center where they have activities for patients. If pt is able to participate, it will help mentally and physically. Pt is getting the help that he needs with a safe environment (no stairs, no clutter) food will be prepared and provided for patient catered to his specific diet needs. A physician will be there overlooking pt’s care process. Nurses will take pt’s vital signs daily and be able to monitor that and blood sugar.