You are the nurse caring for an 81-year-old female client in an assisted living facility with a history of dementia, falling, hypertension, dysphagia, anxiety, insomnia, and depression. The client is regularly feeding with thin liquids. The client has a history of smoking and no other health problems.
Vital signs:
- Temperature: 99.2° F
- Heart rate: 91 beats/min
- Respirations: 20 breaths/minute
- O2 saturation: 93% on 2L oxygen via nasal cannula
- Blood pressure: 110/68 mm Hg
- Pain: "6/10"
- Focused assessment findings:
- Alert and oriented to person and forgetful
- He moves all four extremities, and refuses to ambulate, on a wheelchair
- The apical pulse is regular at 91 beats/minute
- Lungs clear to auscultation, diminished bilaterally
- Bowel sounds hypoactive, abdomen soft, tender in all four quadrants
- medications
- amlodipine 2.5mg-once a day
- furosemide 20mg-once aday
- atorvastatin 5mg-once a day at bedtime
- melatonin 5mg-once a day at bedtime
- memantine 10mg-twice a day
Using the information from the scenario, create a care plan using the attached template.
NUR2349 Professional Nursing I
Module 05 Written Assignment – Care Plan
Student Name: __________________________
Date: ______________________
Client Gender: ____________ Client Age: ________
Client Diagnosis: __________________________________________________________________________________________________
|
Assessment data for Nursing Diagnosis |
Nursing Diagnosis (3) |
Expected Outcomes with Indicators (1 per Nursing Diagnosis) |
Nursing Interventions (2 per Expected Outcome) |
Evidence-based Rationale for each Nursing Intervention (Cited/referenced) |
Evaluation (How do you know it worked?) |
Respond to this critical thinking question:
Describe evidence-based precautions to prevent this client from obtaining a nosocomial infection. Provide supporting rationales.
Support your response with evidence from credible sources.