i have two diagnosis that i am having trouble making a short term/ long term goal can i please get some help.
#1. Risk for falls r/t elevated blood glucose level as evidenced by patient fainting and being found on the floor of their home with no recollection of the incidence.
#2. Ineffective coping r/t death of spouse as evidenced by patient crying, appearing withdrawn, poor appetite, high blood pressure, and patient stating she would like to "be left alone".
Here is the case study scenario:
Mrs. D. is a 73-year-old recently widowed female with a history of CAD, MI- 5 years ago, NIDDM- 7 years, and fairly good health. She was brought into the ER by her daughter, who because she could not reach the patient by phone went to the patient's apartment and found the patient on the floor with no recollection of how she got there. The patient has been admitted with a diagnosis of syncope. Vitals signs: 148/94, 93- irregular, 24, 97.8 F, blood sugar 317.
The physical assessment shows no signs of injury or bruises and the patient is able to move all extremities without any pain. At present Mrs. D. is quiet, answers questions appropriately with short replies, is withdrawn, states that she wants to "be left alone", and has been see crying. Her appetite is poor, color is pale, and she cannot remember the last time she had "a decent" meal and "could care less".