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Use appropriate theories and support your answer with clear reasoning.

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Original Question

HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH TEMPLATES NEED TO BE ANSWERED BASED ON CASE SCENARIO BELOW…. PATIENT: XX DNR, 85 YEARS OLD/ 223 LBS/ Allergies: penicillin, naproxen, trimethobenzamide, bananas/ BMI: 38.1 08/10 0600 Nursing Note: Client position is supine, in bed. 08/10 0700 Nursing Note: Report received from S. Richardson, RN. Client sleeping in room. 08/10 0715 Neuro/Cognitive: Alert, aphasic with garbled speech. Right arm and leg flaccid. Cardiovascular: Heart rate regular and even. +2 pedal pulses, +3 radial pulses. Respiratory: Breathing regular, even, unlabored. Lung sounds clear bilaterally. No cough. Integumentary: Redness to perineum without breakdown or drainage. Blanchable redness to sacrum. 08/10 0800 Nursing Note: Assessment completed. Barrier cream applied to perineum and sacrum. Client position is supine, in bed. 08/10 0900 Nursing Note: Medications administered, and client tolerated well, crushed in pudding. Protein shake at bedside for client to drink. 08/10 1000 Nursing Note: Client has large loose brown stool in bed. Perineal care completed along with complete bed bath and occupied bed change. Barrier cream applied to sacrum and perineum. Client position is on R side in bed. 08/10 1130 Nursing Note: Client transitioned to wheelchair using floor-based lift device. 08/10 1200 Nursing Note: Client transferred back to bed. Transfer sling in place. Small amount of blistering noted to sacrum. Client position is in wheelchair, with waffle pad to offload pressure. Date Temp HR RR BP SpO2 O2 08/10 0715 96.4 °F (35.8 °C) 82 18 128/64 97% RA Date ADL Notes 08/10 0800 Feeding 100% of breakfast with supervision. 08/10 1000 Hygiene Complete bed bath, shower cap, perineal care, and oral care with toothbrush. Date Result Notes 08/10 0800 132 mg/dL N/A Image transcription text 08/10 0900 PROVIDER PRESCRIPTIONS & NOTES Plan for Care Goal: Long term Stroke Care Plan: Reduction of risk for injury from stroke Inter… Show more 08/10 0900 Wound Nurse Consult Reason for consult: Concern for moisture associated skin damage. Assessment: Perineum is red with maceration present. Blanchable 5×4 cm sized area of redness to sacrum. No openings or drainage. Recommendations: Continue to apply barrier cream No briefs allow skin to air or disposable absorbent pad Frequent 2 hour turns High protein/high calorie shakes three times daily Scheduled toileting with bedpan with turns Will continue to follow client 08/10 1300 Speech Pathology Consult Reason for Consult: Chronic speech and swallowing impairment secondary to cerebrovascular accident. Assessment: Client continues to have significant, progressive aphasia with garbled, unintelligible speech. Client is alert and can answer yes/no questions appropriately, and is aware of surroundings. Continues to exhibit severe dysphagia. Recommendations: Continued use of honey-thickened liquids, puree diet Requires supervision with mealtimes Recommend rest prior to meals No liquid medications – crush pills and mix with thick liquid Image transcription text Nursing Flowsheets Provider Collaborative Care Other 08/10 Medical History: Stroke, Type 2 diabetes, right-sided deficits, severe 0700 aphasia, br… Show more Image transcription text Client Initials: Date of Care: Age/DOB: Admitting Diagnosis: Allergies Comorbidities: BSA/BMI: Code Status: Planned Treatments/Procedures: Nu… Show more

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