Geriatric nursing review syllabus

clin" rel="nofollow">inical Flaherty, E., & Resnick, B. (Eds.). (2014). Geriatric nursin" rel="nofollow">ing review syllabus: A core curriculum in" rel="nofollow">in advanced practice geriatric nursin" rel="nofollow">ing (4th ed.). New York, NY: American Geriatrics Society. Case Study 1............................................ Mr. Wiggin" rel="nofollow">ins is a 78-year-old African American male with chronic kidney disease, which requires dialysis. The etiology of his renal disease was multifactorial?long-standin" rel="nofollow">ing uncontrolled HTN and DM nephropathy. He has been on hemodialysis for the past 10 years and has done relatively well. Four weeks ago, he had a major CVA and is min" rel="nofollow">inimally responsive. His condition is not expected to change, and the family is havin" rel="nofollow">ing a difficult time with his recent health changes. Advanced directives were discussed with them, and his wife is a durable power of attorney for his health care. The wife hates to see her husband this way and understands this is not how he would want to go on, but their children and many of the family members (his brothers and sisters) thin" rel="nofollow">ink the patient will return to himself. They want everythin" rel="nofollow">ing done in" rel="nofollow">in terms of life support measures?full code status. His family wanted a feedin" rel="nofollow">ing tube placed, and he is now receivin" rel="nofollow">ing 24-hour tube feedin" rel="nofollow">ings. You are the NP carin" rel="nofollow">ing for Mr. Wiggin" rel="nofollow">ins. You have known and cared for him and his wife for several years. The wife pulls you aside, shares her dilemma, and asks you to make the decision regardin" rel="nofollow">ing contin" rel="nofollow">inuin" rel="nofollow">ing medical care/support for her husband. How will you respond? Case Study 2....................................................... Mrs. Adams is a 96-year-old Caucasian female who has recently been diagnosed with colon cancer. She was admitted to the hospitalist service through the ED with dehydration and rectal bleedin" rel="nofollow">ing. The bleedin" rel="nofollow">ing resolved, and she received 2 units of PRBs and fluid/electrolyte replacement. She is stable and ready to be discharged home. Mrs. Adams is in" rel="nofollow">in remarkably good health, and other than arthritis and mild HTN, she has no significant medical or surgical history. She is able to carry out all of her essential daily livin" rel="nofollow">ing activities. She pays her own bills, is competent, and has good functional abilities. She was drivin" rel="nofollow">ing up until last year. Now, she has neighbor?s assist with weekly shoppin" rel="nofollow">ing and transportation to church. Her sensory, functional, and cogitative abilities were evaluated this admission and remain" rel="nofollow">in in" rel="nofollow">intact. She has been offered palliative surgical in" rel="nofollow">intervention, but deferred all treatment. Her only son is in" rel="nofollow">in agreement with his mother?s decision. Her parents and husband are deceased. You have been asked to obtain" rel="nofollow">in advanced directives. What will your discharge treatment plan be for Mrs. Adams? Case Study 3.................................................. Mr. Pierce is an 82-year-old East Indian male, recently widowed 6 months ago. He fractured his left hip 2 months ago attemptin" rel="nofollow">ing to climb his backyard fence to get his cat out of a tree. His children live in" rel="nofollow">internationally and have been takin" rel="nofollow">ing turns carin" rel="nofollow">ing for him. His eldest son brought him in" rel="nofollow">in through the ED last night because Mr. Pierce started havin" rel="nofollow">ing shortness of breath and his lips turned blue. In addition, his son noticed his left leg was very swollen compared to the right. The ED nurse practitioner ordered a thin" rel="nofollow">in cut cat scan (CT) with pulmonary embolism (PE) protocol and deep vein" rel="nofollow">in thrombosis (DVT) scan. Mr. Pierce has a large DVT that is obstructin" rel="nofollow">ing circulation and multiple pulmonary emboli. His condition is life threatenin" rel="nofollow">ing and he is only expected to live a few weeks. He has a livin" rel="nofollow">ing will and advanced directives and has requested to be able to die in" rel="nofollow">in the comfort of his home. ?I hate hospitals.? You have been consulted at the patient and family?s request because you are Mr. Pierce?s primary care provider. What additional services can be offered to ensure his care/comfort at home and to give him peace of min" rel="nofollow">ind regardin" rel="nofollow">ing his estate? To prepare: SELECT ONE of the three case studies. Reflect on the provided patient in" rel="nofollow">information. Thin" rel="nofollow">ink about potential outcomes for the patient in" rel="nofollow">in the case study you selected. Consider how care, treatment, and/or support might be facilitated for the patient. Reflect on how you might also address the needs of the family. Post an explanation of potential outcomes of the patient in" rel="nofollow">in the case study you selected. Then, explain" rel="nofollow">in how care, treatment, and/or support may be facilitated for the patient. Include how you might address the needs of the patient?s family as well.