NURS 3234 Fundamentals case study - week 3.|Fundamentals The Health Care Delivery System

Fundamentals case study - week 3. Ch. 3 Health, Illness, and Disparities 1. You are a nurse caring for a 42-year-old mechanic who is hospitalized for a gangrenous wound on his foot. His history includes unmanaged diabetes, smoking (20 pack-years), and hypertension. He denies alcohol use. He supports himself with full-time work. Socially, he belongs to a motorcycle club and enjoys riding whenever his work schedule allows. When asked how he would rate his overall health, he reports, “I may not have much money, but I’ve got my health!” (Learning Objectives #2 & #5) a. What pertinent data can you gather based on available patient information? b. How would you categorize the patient’s illnesses? c. What questions should you ask yourself when caring for this patient? d. Which stage-of-illness behavior avoidance does this patient seem to display? Give the rationale for your choice. e. What strategies could you propose to the patient to promote health and prevent illness? f. What factors can be useful in predicting a patient’s use of health-related behaviors? 2. A 23-year-old woman was admitted to your institution with abdominal pain with nausea and vomiting for the past 2 weeks. She immigrated to the United States one year ago from a Latin American country, has limited English skills, and has not been able to work. As her nurse, you attempt to engage her in conversation. She rarely makes eye contact and has a flat affect. You note that she is holding onto a rosary. (Objective #3) a. What factors should the nurse consider to be related to this patient’s access to health care? b. How might the human dimensions guide the nurse for this patient’s plan of care? Ch. 8 Health Care Delivery System 1. You are a home health care nurse scheduled for a home visit to your patient, a retired accounts payable clerk who is 7 days postsurgical with a new colostomy. Your patient lives with her husband who is involved in her care; they compile a list of questions between visits to ask upon your arrival at their home. During this visit, the patient has questions regarding her colostomy equipment and stoma care; her husband has questions regarding his current medication regimen. Both of them express concerns over recent changes in their health care coverage. (Learning Objectives #5 and #8) a. What data in the scenario are pertinent? b. Outline your nursing care responsibilities, as the home health care nurse, in this scenario. Compare and contrast these responsibilities with those found in the acute care setting. c. What would be your recommendation for the husband’s medication questions? d. What is the home health care nurse’s role and responsibilities related to the challenges of health care reform? 1. You are a nursing student attending clinical at a large, urban university hospital where you engage in direct patient care with clinical instructor supervision. At the nurses’ station, you overhear various nurses addressing patient care needs, including an RN requesting consults with a physical therapist, a respiratory therapist, a dietitian, and a social worker. Another nurse discusses the potential need for palliative or hospice care consults for a patient. You observe a physician assistant approach the nurse with a list of written orders. (Learning Objectives #5 and #6) a. Outline the roles of the various licensed health care workers mentioned in this scenario. b. Compare and contrast palliative and hospice care. What is the major difference between the two? c. As a nurse, what is your responsibility regarding physician assistant (PA) orders