Nursing Plan of Care: MM is a 27-year-old single mother of a…

Nursing Plan of Care: MM is a 27-year-old single mother of a… Nursing Plan of Care:MM is a 27-year-old single mother of a year-old child, and a junior-level nursing student. She works every other weekend as a nursing assistant. She has just received a letter from the Dean informing her that she is in academic jeopardy and will fail out of the program unless her grades improve. She presents this to her faculty adviser.After talking with MM, who calls herself a failure and cries as she describes her situation at home, her faculty adviser suspects a serious self-esteem problem and helps her to list factors contributing to her current sense of failure and low self-esteem. The following list is generated:Significance:Receives little understanding, affection, approval from the father of her child and mother-in-lawHer mother is very supportive but get impatient when she has to study even at night and can’t spend time with her childFeels a failure in all roles that are important to her – daughter, wife and mother”They do love me at work, though, which makes me feel like nursing is what I should be doing”VirtueI’ve always believed that hard work pays off and that if you were faithful to your duty you’d be rewarded by the good life – I’m beginning to doubt that. Maybe I’m fool for trying so hardI do still try to live according to my beliefs and feel okay about this. I treat others as I’d like to be treatedI know God is there to support me.PowerI always believed I could do anything I put my heart and soul into. But I can’t seem to change my present situation, and if I fail out of school, that will be the end of all my dreamsOther Information:Overeat (15-lb weight gain during the past year), difficulty sleeping, fatigue, now sensitive to criticism, and expressions of feeling unloved, alone, and no longer able to managePersonal strengths include history of “can work” mentality, high motivation to succeed and past history of success as mother and nurse’s aide.Complete the nursing care plan with nursing diagnosis, goal, nursing interventions and rationales, and evaluation. 2.  Case Scenario: An 87-year-old client was admitted to your ward yesterday. During shift report you are told that the client has visual and hearing impairments.What actions should you take to help with the client’s visual impairment? What actions should you take to help with the client’s hearing impairments? How can environmental stimuli be adjusted for this client?3. Aura is a 80-year-old female who is admitted to an inpatient acute care center for scheduled hip-replacement surgery. On admission for the surgical procedure, Aura is functionally independent and living at home but reports having some “mild forgetfulness”. The surgery and post-anesthesia recovery period are uneventful, but on postoperative Day 2, she develops severe confusion and agitation.Questions:What additional assessment data should the nurse collect?Compare/ contrast the symptoms of dementia, delirium, and depression. What condition is the patient is exhibiting? What are the possible triggers?What are priority nursing interventions for the client at this time?4. You are a school nurse, and two junior high school students drop by the health office to have you settle an argument that they have been having. One student thinks that you cannot get pregnant if you have sex during your period; the other student thinks that it might be possible. How can you answer this question in a way that allows the opening for further discussion about sex?    A 25 year old man is in the out patient department to secure medical certificate for employment purpose. After you provide health teachings regarding human sexuality, STIs and testicular cancer, the client makes a sexual advance toward you. What are nursing strategies to deal with the client’s inappropriate sexual behavior. 5. You are a nursing student about to take second fundamentals of nursing test of the quarter. You received a poor grade on the first exam, so you stayed up all night studying hard to do better on this test. You left the house in a hurry this morning without eating breakfast because your stomach felt upset. Now as you sit down to take the exam, your heart is racing, your hands are sweaty and cold, and you are having trouble concentrating. What do you think is the physiologic cause of your symptoms? In what positive ways could you cope with the stress of the situation? 6. The Enriquez have been married for 19 years and have two children, Jorge, who is 16, and Marie, who is 13. It has been 2 years since Mrs. Enriquez was diagnosed with ovarian cancer, and this period has been difficult for the entire family. At present, she is extremely cachexic (thin) and in the end stage of her illness. She initially tried aggressive treatment, and several chemotherapy regimens failed. During her last hospitalization 2 months ago, a decision was made not to continue treatment, and Mrs. Enriquez told her family she wanted to die at home.The nurse who has been visiting Mrs. Enriquez at home asked for assistance from her colleagues in devising a plan of care for Mrs. Enriquez. Until now, Mrs. Enriquez wanted nothing to do with the local hospice because of a reported “bad experience” a neighbor had. Her insurance will not provide for all the home nursing care she needs, and her husband and children have been trying to meet her needs for nursing as well as run the house and meet their own needs. A demanding woman, Mrs. Enriquez never seems satisfied with anything anyone does, and the family is looking utterly frustrated, angry, and fatigued. Mr. Enriquez is coping by “opting out”; he frequently spends the night with friends and doesn’t even call home to report on his whereabouts. Marie’s grades have fallen, and she has dropped out of cheerleading and other school activities so that she can take of her mother. Mr. Enriquez who has been silent until now, recently confided that he doesn’t know how much longer he can go on this way, and seemed horrified to hear himself say, “I just wish she would die already and get this all over with!” He is very concerned about the change what is happening. For her part, Mrs. Enriquez seems oblivious to her family’s needs and, even in her weakened state, multiplies pleas for assistance. She seems to be afraid of dying and never wants to be left alone.From the scenario, identify a nursing diagnosis, nursing goal and at 3 nursing interventions with rationale to achieve your identified goal. Health Science Science NursingNUR 103Share QuestionEmailCopy link Comments (0)

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