This is my first time doing anything like this. So lost, but this is what I got so far......
The scenario is:
1- What is your plan of care when you enter the room? Describe the first few actions you will complete immediately upon entering and the rationale for doing so.
2- Discuss communication techniques you will use in addressing this patient who is resistant to your care.
3- Define cultural awareness and what it means to you. How do you think it relates to this patient care scenario?
4- Summarize your proposed plan for this patient.
Sue is a 78 year old female client three days post op a right hip replacement. She is currently on your surgical inpatient floor. Sue is awaiting transfer to a short term rehab facility. In order to be transferred she must complete an evaluation by physical therapy. Sue is resisting an evaluation and any turning and repositioning until she speaks with her eldest son. Unfortunately, after several attempted calls to her son, he cannot be reached. As care is delayed, it is evident Sue's pain is increased and the risk of losing her bed at the rehab facility becomes more evident. Sue has also refused breakfast this morning and appears more withdrawn. Please care for the client in the role of the student nurse and help to communicate why mobility and nutrition are so important. Help to facilitate the plan of care for this client.
PMH: Allergy to Penicillin. Immunizations up to date (including pneumonia and flu). History of GERD and hypertension. On contact precautions for history of MRSA in urine. Patient is a widow and is Asian.
I would first take the patients blood pressure upon entering the room to ensure that it is under control(given hx of HXTN), and assess the client for pain (b/c she is post-op). Observe the clients expressions and actions, which may provide more information on whether she is experiencing pain. Enourage the client to eat some food or to drink at this time because she hasn't ate breakfast.
The student nurse would find out if there are any language barriers that would make it difficult for the client to express how she is feeling. Introduce his/herself and encourage the client to express her feelings and how she feels about the move to the Rehab; discussing some of her cultural beliefs. Ask the client if there is another familiar person in her family besides her son that she can speak to (or offer self).
Cultural awareness is being able to acknowledge, accept and even appreciate the differences of other cultures. Having cultural awareness will enable the nurse to provide culturally competent care. This is specifically important given this scenario with a client from an Asian background.A nurse that is culturally aware would understand that clients from such backgrounds tend to be more shy or withdrawn; also refraining from expressing pain.
The student would need to express to the older client the importance of mobility and nutrition given her medical conditions and the fact that she is post op, which makes her more susceptible to infection, falls and developing pressure sores. Explain to the client that good nutrition is important because poor nutrition willlead to a weakened immune system which may cause MRSA infection to reoccur.
pain management is needed following surgery to decrease the effects of pain and increase mobility in the older adult client.