Theresa Samuels, a 72-year-old-retired African American woman,…
Question Answered step-by-step Theresa Samuels, a 72-year-old-retired African American woman,… Theresa Samuels, a 72-year-old-retired African American woman, arrives to the community health center for her three-month follow-up appointment. T.S., has a medical history of diabetes, type 2, osteoporosis, secondary hypertension, and dyslipidemia. Due to the death of her only daughter from COVID-19, 4 months ago, T.S., has become the sole caregiver of her three teenage grandchildren. Troubled with unexpected finances, T.S., conveys to the nurse the immense pressure and stress she has been experiencing since the death of her daughter. The patient had her bloodwork completed at LabCorp prior to her appointment. The nurse conducts a comprehensive assessment and notes the following objective and subjective data: Objective data:Blood pressure = 140/90Heart rate = 92Respiratory rate = 22Pulse oximetry = 94% on room air Present weight and height= 210 lb. (95.2 kg) / 5’5 Physical AssessmentHEENT=Pupils equal, reactive, responsive to light and accommodation.Cards = Regular rate and rhythm; S1S2; Grade 1/6 systolic murmur; 2+ pitting edema bilateral lower extremities; +2 pedal pulses bilaterally; +2 radial pulse bilaterally; no carotid bruit auscultated.Resp = Respiratory rate 22 bpm; mild wheeze noted in bases bilaterally; all other lung fields clear to auscultationGI = Bowels normal; present in all 4 quadrantsSkin = Skin is dry and intact; not rashes or skin lesion notedGU = Voids frequently; urine output is <30mL/hr; tea-color urineNeuro = Intact; oriented to person/place/time/situation (X4); motor and sensory function within normal limits Labs Hemoglobin A1C = 7.5%Cortisol level = 35 mcg/dLFasting blood glucose = 132mg/dLErythrocyte sedimentation rate (ESR) = 45 mm/hr Subjective data:Complains of muscle aches and pains with movement, and some tingling in the lower extremitiesShe states that her vision is blurry at timesMost of the time she is compliant with her medications but will sometimes avoid taking Hydrodiuril to keep from having to go to the bathroom so oftenSleeping 3 - 4 hours a nightEats a candy bar if her blood glucose is less than 120 mg/dL Medication Reconciliation Crestor 40 mg DailyDiltiazem 180 mg PO DailyLotensin 10 mg PO DailyMetformin ER 500 PO DailyCholecalciferol 25 mcg PO DailyCalcium 1000 mg PO DailyHydrodiuril 12.5 mg PO DailyNPH 10 units BID During the health assessment, the nurse offers T.S., the yearly influenza vaccine; but T.S., declines, stating, "The flu shot will cause me to get the flu and I just don't have the time to be sick." Using the case scenario attached, make a concept care map using Mindmeister, Lucid Chart, or Padlet (all free accounts) to illustrate the relationship between obesity, stress adaptation, and sleep disorder to the previously learned concepts.Recognize Cues - identify the assessment findings that are essential to reporting to the healthcare provider for each disorder as it relates to obesity.Analyze/Hypothesize Cues - explain the assessment findings, highlighting why the client is experiencing the health conditions.Generate Solutions - identify the appropriate nursing interventions/patient teachings that incorporate her health history to promote health for this client. Health Science Science Nursing NURS 314 Share QuestionEmailCopy link Comments (0)
