PN2 Clinical
The nurse is caring for Zilla Carrera, a 72-year-old who suffered a stroke and has developed a deep vein thrombosis (DVT) and is being treated with an anticoagulant. The client walks short distances (20 feet) with the assistance of a walker and one person. Zilla has generalized weakness with the right leg and arm being somewhat weaker than the left side. Since suffering the stroke, Zilla has had difficulty with constipation, having hard irregular stools, and a decreased appetite but is able to swallow effectively, using a soft diet. The client demonstrates leakage of urine and is wearing a disposable brief. The client needs assistance to bathe and perform other personal hygiene. Zilla’s family has been present and supportive throughout the hospital stay and sometimes assists with personal hygiene needs. Zilla is sometimes forgetful and attempts to get up without assistance; a bed alarm has been used to assist with fall prevention as well as the family calling for help when they are present.
- Recognize cues (identify relevant subjective and objective assessment related to patient’s condition) 2. Analyze cues/ Prioritize hypothesis (Based on the assessment information, identify and prioritize the top 3 client problems, write down the relevant assessment information that supports the problem) 3 O S 1A, 61 :s Take Action/Implementation (Identify important nursing interventions that should be taken to address each client problem e-v
Answer preview for PN2 Clinical
APA
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