J.D. is a 77-year-old female and was admitted to the Emergency

Question Answered step-by-step       J.D. is a 77-year-old female and was admitted to the EmergencyDepartment for reports of low urine output, poor appetite, fatigue, inability to sleep through the night, and moderate swelling in her feet and ankles. The nurse notes that J.D. appears unkempt and disheveled.  When asked about her health history J.D. reports, “I’ve never had any problems before, and I haven’t been to a doctor in years.” Upon further assessment the nurse notes that J.D. has +2 edema to bilateral ankles and feet, slightly rapid and labored breathing, crackles in her lung bases, and generalized weakness in all her extremities. J.D. is asked for a urine specimen and is only able to produce a small amount of about 50 ml and the urine is very dark and concentrated.1)   Based on the nurse’s assessment what is J.D.’s main medical issue/possible medical diagnosis? What about her assessment leads you to that conclusion? What labs do you anticipate the physician to order? 2)   J.D. is diagnosed with a UTI and stage 4 kidney failure and is told that, while she does not require dialysis at this point, the disease will most likely progress and the doctor recommends that she receive some education about the process prior to discharge from the hospital. She is admitted the a medical-surgical floor for observation. The staff nurse on the unit enters J.D.’s room to complete her admission assessment. During the assessment J.D. says to the nurse, “I can’t believe this is happening to me. I thought I was healthy, and I only recently started to feel bad. What am I going to do?” What is the best response by the nurse?a.    “It’s going to be all right. You know now and we are going to help you.”b.    “At least you don’t need dialysis yet.”c.    “You sound like you are feeling very overwhelmed right now.”d.    “My mother was diagnosed with kidney disease and she has been living with it for 10 years now and she’s fine.”  3)   The nurse continues to assess J.D. At one point during the assessment J.D. states. “I don’t know if life’s worth living now that I have an incurable disease. I’m probably better off if I do not wake up tomorrow. Maybe I should go home and die.” After hearing this, what interventions should the nurse perform? (Select all that apply)a.    Obtain an order from the doctor for restraints as J.D. is a danger to herself.b.    Request the physician order a psychiatric consult.c.    Request an order for a 1:1 sitter to stay with J.D.d.    Remove all sharp objects from the room and anything else J.D. may harm herself with including belts or scarves.e.    Ignore it, J.D. is just overwhelmed she did not mean her statement. 4)   Given J.D.’s scenario which type of crisis is she experiencing?a.    Maturational/developmentalb.    Traumatic stressc.    Psychiatric emergencyd.    Situational/dispositional 5)   While J.D. is on the medical unit what interventions do you anticipate the nurse to perform related to her medical diagnosis/initial physical assessment?  6)   Besides the nurse who else on the healthcare team do you anticipate involving in J.D.’s plan of care? 7)   J.D. was stabilized medically and admitted to the mental health unit for suicidal ideation and depression. The nurse admitting J.D. is creating her care plan. Which nursing diagnosis is the priority for J.D.?a.    Ineffective copingb.    Risk for suicidec.    Impaired social interactiond.    Self-care deficit 8)   What is the second most important nursing diagnosis for J.D.?a.    Ineffective copingb.    Risk for suicidec.    Impaired social interactiond.    Self-care deficit 9)   J.D. has been on the mental health unit for 5 days. The nurse evaluates J.D.’s plan of care and knows that J.D. has met her goals when:a.    J.D. can state that she no longer feels suicidal but does continue to have some depressive symptoms.b.    J.D. reports no depression on day 5 after stating depression was high on day 3.c.    J.D. states, “I no longer want to kill myself, but I still don’t know what I’m going to do about this diagnosis when I get home.”d.    J.D. reports that she no longer needs antidepressant medication. 10)  J.D.’s mood has improved, and she denies suicidal ideation and is going to be discharged from the unit. What resources should the nurse provide for J.D.?    Health Science Science Nursing MENTAL NR 326 Share QuestionEmailCopy link Comments (0)