Community Health

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Submitted By jcarry
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Community Health Nursing Case Study


Mr. Evans is a new patient to this nurse. This is the first home visit and upon presentation the patient has tachycardia and presumably newly diagnosed Atrial fibrillation, for which he takes Digoxin. According to records last Digoxin level was two months ago. Respiration are increased and adventitious breath sounds are noted. Patient states that this is his baseline. Patient has COPD and takes Proventil PRN and Theo-Dur twice a day. Patient reports he had a hospitalization for “congestion in his heart” and is currently on Lasix 40 BID. Patent denies any acute distress, home health aid reports recent weight loss, loose stools and complaint of nausea.
This nurse in the field would interview the patient and his wife after the clinical assessment. I would ask about any anorexia, loose stools, nausea and or vomiting. Patient does take a stool softener daily. After assessing attend skin turgor and sign if dehydration, this nurse would investigate when the patient takes his medication, and if he has been missing any doses of meds. This nurse would ask when his next cardiology follow up is and when he is due for any labs including a BMP since 40 mg of Lasix twice a day is a higher dose, and for a current digoxin level. This nurse would ask how the patient is sleeping and how often he is using his rescue inhaler for shortness of breath and wheezing. This nurse would ask when his next follow up with oncology is and how long he has had the port, when the last time it was accessed. “he unique features of CVADs require specific strategies for reducing CVADRI rates: the devices are designed for long-term use, are manipulated at various healthcare facilities (in some cases, they must be serviced, even if there are signs of infection, and it is difficult to visualize the devices during manipulation), and are mechanically…...

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