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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

    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.

    In 20+ years of nursing I've never used a nursing dx...this is homework..

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    If you pick a line of two of the case study and google it, you'll find that it's from some 1000 page publication called, "Handbook of Home Health Care Administration".

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    I am sure you are long gone, but, if not:

    Call 911.

    Communicate the address and the general nature of the call.

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    It is so funny how nurses are to include me. A couple of things

    1. This should go under student section not here

    2. Well you are on the right track but to prioritize think emergency situation it appears you are an EMT and I would assume you have been taught safety first then breathing. Since you can rule out safety at this time you are in the home and there is no emergent safety need although from the sound of it the house is a pig sty. Breathing would be number one to me followed by HR, tingling in all extremities and temp.

    I would want to transfer this patient to hospital and would call the provider using SBAR communication and ask for transfer to hospital to rule out sepsis. I would also place this patient on oxygen and start an IV NS. Because he does have a cath I wouldn't opt for lab draws because the hospital will more than likely do this.

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