Home Visit with Sally Mae

Based on the discharge instructions , Sally Mae’s physical assessment and home assessment , the following are the problems identified:

• Dehydration resulting in   hypotension
• Polypharmacy
• Depression 
• Constipation
• Unsafe home environment: Risk for fall
• Financial concerns.

Medical / Surgical interventions

1. For Rehydration. 

Sally Mae can still drink though she complains of loss of appetite and nausea, so fluids should be encouraged. She is not too ill to think of IV fluids yet. For nausea, ginger ale should be provided for Sally Mae. This will provide fluid and also help with nausea. Mrs May should be encouraged to drink lots of plain water.  It is to be noted that there is a bottle of diet coke  beside Sally May, if Sally Mae likes to drink this she should be encouraged  too. Gatorade is also an option. Encourage her to continue to take soup for meals  until appetite is better and also to eat fruits like banana and watermelon.

2. Polypharmacy 

Sally Mae is taking multiple drugs to treat the same conditions of Hypertension and heart failure :Digoxin, Calan(Verapamil), Vasotec (enalapril) and minipres (prazocin) . A medication reconciliation should be done and Sally educated  so that only one of digoxin and Lanoxin should be taken. Also educate Sally Mae  on the need to for Sally to take only one of the furosemide that has been duplicated in her medication lists. 

3. Constipation

Provide fruit lax, encourage consumption of fruits and encourage to drink copious fluids. 

4. Depression

Encourage Sally  to join a senior’s day care program  to relieve her loneliness.

5. Provide oxygen. Apply for government- sponsored  home Oxygen service for Sally and explain to her she does not have to pay. 

References

Grand Canyon University (2013). Sally Mae Fisher ‘s Health history and discharge orders.[Course Material]. (2018). In Pathophysiology and Nursing Care of Client’s Health. Retrieved from NRS410V.R.SallieMaeFishersHealthHistoryandDischargeOrders_Student_02-11-13.docx….

Grand Canyon University (GCU). (Producer). (2013). Home visit with Sally Mae. Retrieved from(http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php)