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Discussion

Case study need help!

Hello everyone,

I am preparing for my 1st RN interview with home health. Could I possibly get some help with this case scenario? I am quite nervous and cannot really think through. Thanks in advance for your help.

Mr. Jones is a 27 year old patient with a diagnosis of human immunodeficiency virus,

Cytomegalovirus retinitis, dehydration, and dementia.

You are assigned to administer ganciclovir(DHPG) (300 mg in 100 ml 5% dextrose in water over 1 hour) via a Hickman-Broviac catheter. When you arrive at the house, Mr. Jones is upset. He cannot remember if he took his oral medications yesterday evening or this morning. The house is in total disarray. There are dishes in the sink, clutter on the floor, and cups half0filled with juice all over the bedroom. Mr. Jones is unshaven and complaining of tingling of the extremities. Your assessment reveals BP 100/60, HR 124 beats/min, RR 24, T 101.4 F (38.6C), and breath sounds clear. Mr. Jones has a reddened sacral area and dry skin. He does not remember if he ate breakfast. His roommate, Tom, is at work.

1. List 4 nursing diagnoses that pertain to this scenario

2. Identify 4 nursing issues that require immediate intervention

3. Prioritize Mr. Jones's care. What has to be done during this visit?

4. Determine what information you must communicate.

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    • Featured Replies

    Help, or someone to do the entire thing for you?

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    Help, or someone to do the entire thing for you?

    That's what I was thinking too.

    OP, if I answer your interview questions for you, can I have the job? I am currently unemployed.

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    If your critical thinking skills and education can not solve this for you...... avoid this scenario

    Consider another opportunity

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    His roommate, Tom, is at work.

    I don't think I'd be very good in home health because I just keep wondering about Tom.

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    • Author

    Right, I should try and ask for guidance.

    1. Nursing diagnosis: risk for infection(possibly sepsis?), decreased cardiac output, risk for injury, dehydration, impaired skin integrity, imbalanced nutrition...

    2. Issues: low BP, tachycardia, tachypnea, elevated temp, tingling of the extremities...

    Question 3& 4...what do i do in home setting?

    Can more experienced RNs, especially in Home health guide me?

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    Do other home health nurses really use "nursing diagnoses"? We learned about them in nursing school, I've been in home health for five years now and haven't used a single one since.

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    • Guides
    Right, I should try and ask for guidance.

    1. Nursing diagnosis: risk for infection(possibly sepsis?), decreased cardiac output, risk for injury, dehydration, impaired skin integrity, imbalanced nutrition...

    2. Issues: low BP, tachycardia, tachypnea, elevated temp, tingling of the extremities...

    Question 3& 4...what do i do in home setting?

    Can more experienced RNs, especially in Home health guide me?

    As a guide I want to give you a thoughtful reply but don't have time right now as I have to get the man cub to school and then myself to work - I will think on this write a reply this evening.

    Hppy

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    Definitely something along the lines of inability to perform adls.

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    You're joking right? The whole idea is to see how YOU use your critical thinking skills.

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    You need to take this patient to the hospital, he sounds septic to me or some other emergent issue going on. That's what I'd do if I were the home health nurse, take this guy to the ER. That would be the priority, I have no idea what nursing diagnosis go with this scenario, but those aren't important. Getting this guy the help he needs ASAP is the priority. The nursing diagnoses are Sepsis, Infection, Altered mental status...things along those lines.

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    This just reeks of homework- I cannot imagine an employer wanting this.

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