Question Ms. Vitatony arrives at the primary care clinic via a Medicaid appro

Question Ms. Vitatony arrives at the primary care clinic via a Medicaid approvedtransporter van. The private clinic markets itself as a clinic for seniors, an increasingly popular marketing concept. You are newly employed at the  clinic as a nurse practitioner. Ms. Vitatony checks in at the front desk as a new patient, saying she lives close by and Medicaid approved transportation to this clinic. In the exam room she tells you that she is 71 years old, is a retired housekeeper, can make ends meet only because she lives in the house willed to her by her grandfather many years ago. Grandparents and parents all died of old age. She has no siblilngs. Her income is a small Social Security check and she does not have to work, However, she is on her “second round” of baby-sitting for her grandchildren. Two, she cared for as babies are in school, but she now has two more babies, 3 months and 10 months old, children of her grandchildren. She feels weak and tired all the time. For two days she has been coughing and sneezing. She has been having headaches over her eyes and last night she had a chill. She tells you she is worried and cannot sleep at night. This is her family and she wants to help them. Both sets of parents have had COVID, they think, as they were sick but not tested. Ms. Vitatony worries about the person who came to fix her door last week after someone attempted to break in. She tells you she learned today that he is in the ICU on a ventilator with COVID. He had told her he was not going to be vaccinated. Ms. Vitatony has had two COVID vaccinations from the senior center on her block but she has not the booster. She has not had a flu shot. She tells you she is aware that she is high risk at her age with her condition of high blood pressure and asthma.  She saw this on the local TV news. Her family members tell her that COVID is over-rated, that they had it and are fine. They just want her to take some vitamins, stop worrying, and focus on the children. None of the four parents would drive her today as they have no time off from work. She came in the Medicaid van while a neighborhood teen is watching the babies. She tells you the teen has been vaccinated. She hands you her medications and asks what she should do in case she has COVID. She asks to be treated as quickly as possible as she has little time.  MedicationsHCTZ 25 mg daily, Losartan 50mg daily, Lexapro 10 mg daily, MVI daily, Calcium 18 mg daily, Melatonin 6 mg nightly, Tylenol 10 mg every 6 hours as needed for pain. She also has an oxygen concentrator for shortness of breath that she does not use, and an inhaler which she uses at night but left behind today.   Complete a SOAP Note.Include social determinants of health in the history and the plan. Would you need to know more about her social determinants of health? What are the priorities as you review the information you have? What exam(s) would you do? What tests? Consider who, if anyone, you might consult, interdisciplinary professionals or others.  What/when/how should she be seen for/if follow up? What is your reflection upon completing this case? Reflect upon your thinking after you completed this visit.    Health Science Science Nursing NURS 6565 Share QuestionEmailCopy link Comments (0)

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