• March 19th, 2016

Home Visit with Sallie Mae Fisher

Paper, Order, or Assignment Requirements

As a group, observe the simulated “Home Visit With Sallie Mae Fisher” video (https://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php).
Refer to “Sallie Mae Fisher’s Health History and Discharge Orders” for specifics related to the case study used to inform the assignment.
Using “Home Visit With Sallie Mae Fisher” and “Sallie Mae Fisher’s Health History and Discharge Orders,” complete the following components of this assignment:
Essay Portion
After viewing the home visit, write an essay of 500-750-words in which you do the following:
1. Identify, prioritize, and describe at least four problems.
2. Provide substantiating evidence (assessment data) for each problem identified.
3. Identify and describe at least four medical and/or nursing interventions.
4. Discuss your rationale for the interventions identified.
Prepare this step of the assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
Scripted Dialogue Portion
Utilizing the information learned from the home visit, health histories, and discharge orders, write a scripted dialogue in which you provide Sallie Mae with education that describes her problems and the interventions identified to improve her condition. Consider Sallie Mae’s physiological, psychosocial, educational, and spiritual needs when developing your dialogue.
Your dialogue should resemble a script. The following is an example of a few sentences from a scripted dialogue:
Nurse: “Good morning, Salle Mae, my name is ______ and I will be your nurse today. I understand you are experiencing problems with ________.”
APA format is not required for this part of the assignment, but solid academic writing is expected.
Refer to “Home Visit With Sallie Mae Fisher Grading Criteria.”
Entire Assignment
identify and discuss at least 4 key medical and/or nursing interventions. Provide a rational for the four interventions and support with outside resources.

Sallie Mae Fisher’s Health History
and Discharge Orders

Sallie Mae Fisher Health History
Ms. Fisher is an 82-year-old female with a history of chronic congestive heart failure (CHF), atrial fibrillation, and hypertension. During the last 6 months, she has been hospitalized four times for exacerbation of her CHF. She was discharged home last Saturday from the hospital after a 3-day stay to treat increased dyspnea, an 8-pound weight gain, and chest pain.
Ms. Fisher is recently widowed and lives alone. She has a daughter, Thelma Jean, who lives in town but works full time and has family issues of her own. Therefore, family support is limited.
Hospital Discharge Instructions
• Mountain Top Home Health to evaluate cardio-pulmonary status, medication management, and home safety.
• Medical Equipment Company to deliver oxygen concentrator and instruct patient in use. O2 at 2 liters per nasal prongs PRN.
• Prescriptions given at discharge:
o Digoxin 0.25 mg once a day
o Lasix 80 mg twice a day
o Calan 240 mg once a day
• Order written to continue other home meds.

Sallie Mae’s Home Medication List
• Zocar 50 mg once a day
• Minipres 1 mg once a day
• Vasotec 10 mg twice a day
• Prilosec 20 mg once a day
• Furosemide 40 mg once a day
• Effexor 37.5 mg at bedtime
• Lanoxin 0.125 mg every other day
• Multivitamin once a day
• Potassium 40 mEq once a day
• Ibuprofen 400 mg q 4 hours as needed for pain
• Darvocet N 100 mg q 4 hours as needed for pain
• Nitroglycerin ointment, apply 1 inch every day

Typing Template for APA Papers: A Sample of Proper Formatting for the APA 6th Edition
This is an electronic template for papers written in APA style (American Psychological Association, 2010). The purpose of the template is to help the student set the margins and spacing. Margins are set at 1 inch for top, bottom, left, and right. The type is left-justified only—that means the left margin is straight, but the right margin is ragged. Each paragraph is indented five spaces. It is best to use the tab key to indent. The line spacing is double throughout the paper, even on the reference page. One space is used after punctuation at the end of sentences. The font style used in this template is Times New Roman and the font size is 12.
Nursing Diagnosis
The four key problems that Ms. Fisher have are the following: 1) fluid volume deficit related to several factors such [a) decreased motivation to drink fluids, b) related to the diet, and c) related to depression], 2) risk for fluid and electrolyte imbalance related to inadequate oral fluid intake and use of diuretics 3) risk for falls related to the illness, 4) risk for imbalance nutrition related to inadequate dietary intake less than body requirements.
Evidence to Support the Diagnosis
The assessment data that would support the first diagnosis of fluid volume deficit are as follows: 1) the fact that her blood pressure was only 90/56, 2) her skin turgor is coarse with the finding of tenting of the skin (normal skin when pinched for a few seconds should go immediately back to its original state), 3) her mucous membranes are dry. The second diagnosis is risk for fluid and electrolyte imbalance related to inadequate fluid intake and use of diuretics with the assessment showing hypoactive bowel sounds, low blood pressure, and her verbalization that her mind is cloudy. The third diagnosis of risk for falls related to her illness is that she almost tripped on the floor rug, her low blood pressure, and her verbalization that her mind is cloudy and she did not exhibit good balance as she was walking to the door. The fourth diagnosis is risk for imbalance nutrition related to inadequate dietary intake related to less than body requirement as evidenced by her fourteen pounds weight loss, walks slow, posture bent forward and her verbalization that she only had a can of soup for food .

The subheading above would be used if there are several sections within the topic labeled in a heading. The subheading is flush left and bolded, with each word of four letters or more capitalized.
Second Subheading
APA dictates that you should avoid having only one subsection heading and subsection within a section. In other words, use at least two subheadings under a main heading, or do not use any at all.
When you are ready to write, and after having read these instructions completely, you can delete these directions and start typing. The formatting should stay the same. However, one item that you will have to change is the page header, which is placed at the top of each page along with the page number. The words included in the page header should be reflective of the title of your paper, so that if the pages are intermixed with other papers they will be identifiable. When using Word 2003, double click on the words in the page header. This should enable you to edit the words. You should not have to edit the page numbers.
In addition to spacing, APA style includes a special way of citing resource articles. See the APA manual for specifics regarding in-text citations. The APA manual also discusses the desired tone of writing, grammar, punctuation, formatting for numbers, and a variety of other important topics. Although the APA style rules are used in this template, the purpose of the template is only to demonstrate spacing and the general parts of the paper. The student will need to refer to the APA manual for other format directions. GCU has prepared an APA Style Guide available in the Student Writing Center for additional help in correctly formatting according to APA style.
The reference list should appear at the end of a paper (see the next page). It provides the information necessary for a reader to locate and retrieve any source you cite in the body of the paper. Each source you cite in the paper must appear in your reference list; likewise, each entry in the reference list must be cited in your text. A sample reference page is included below; this page includes examples of how to format different reference types (e.g., books, journal articles, information from a website). The examples on the following page include examples taken directly from the APA manual.

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