Student hi..... Difficulty Swallowing The Client: # 4362-12 Mary Smith is a 29 year old divorced mother of 2 young children aged 4 and 6. She has no family living in On Multiple Sclerosis about 5 years ago and the disease has progressed quite rapidly. She now depends on a wall experienced episodes of dysphagia recently. She had colon surgery 1 year ago due to bowel adhesions from ileostomy that has been producing large amounts of foul smelling, watery effluent. She tells you that she's e leakage around her appliance and the odour. When you ask her about her diet she tells you that she's on a f whatever she can afford. Most of her money goes towards food and clothing for her children. She has been relies on Welfare and child support to get by. Mary tells you that she has lost about 10 kg. since her surger cachectic. She has a productive cough and tells you that it hurts to take a deep breath. Her children are cu friend. The Diagnosis The client's admitting diagnosis is: ?Pneumonia, generalized weakness, dehydration, malnourishment and History: Ms. Smith moved to Ontario from Nova Scotia about 8 years ago after she got married to her former husba MS, her husband filed for divorce. He's been making regular child support payments and sees the kids a c cordial relationship with him but he has remarried and is not providing much help to her. In addition to g experiencing vision loss and bladder control issues as her MS has progressed. Mary used to be very active women's soccer for a number of years. She loves to read but is having difficulty with this as her vision lo religious person but states "only God can help me get out of this mess". She's quite worried that she wil "family" again. Mary had no health issues until she was diagnosed with MS. She lives in an accessible ap- and friends who are "there for her" but she really hates to ask others for help. Admission Findings: On admission you find a frail, young lady who is very quiet in her demeanour and does not want to bothe somewhat depressed. Her ostomy appliance has been leaking stool and appears to be badly in need of c periostomal edges are red and inflamed and she has a 3 cm ulceration on the posterior aspect of her sta wash badly and has a very unpleasant body odour. Her clothing are soiled with stool leaking from her -92 BP-146/80 R-24 She wears glasses to read and has excellent hearing.
Student hi..... Difficulty Swallowing The Client: # 4362-12 Mary Smith is a 29 year old divorced mother of 2 young children aged 4 and 6. She has no family living in On Multiple Sclerosis about 5 years ago and the disease has progressed quite rapidly. She now depends on a wall experienced episodes of dysphagia recently. She had colon surgery 1 year ago due to bowel adhesions from ileostomy that has been producing large amounts of foul smelling, watery effluent. She tells you that she's e leakage around her appliance and the odour. When you ask her about her diet she tells you that she's on a f whatever she can afford. Most of her money goes towards food and clothing for her children. She has been relies on Welfare and child support to get by. Mary tells you that she has lost about 10 kg. since her surger cachectic. She has a productive cough and tells you that it hurts to take a deep breath. Her children are cu friend. The Diagnosis The client's admitting diagnosis is: ?Pneumonia, generalized weakness, dehydration, malnourishment and History: Ms. Smith moved to Ontario from Nova Scotia about 8 years ago after she got married to her former husba MS, her husband filed for divorce. He's been making regular child support payments and sees the kids a c cordial relationship with him but he has remarried and is not providing much help to her. In addition to g experiencing vision loss and bladder control issues as her MS has progressed. Mary used to be very active women's soccer for a number of years. She loves to read but is having difficulty with this as her vision lo religious person but states "only God can help me get out of this mess". She's quite worried that she wil "family" again. Mary had no health issues until she was diagnosed with MS. She lives in an accessible ap- and friends who are "there for her" but she really hates to ask others for help. Admission Findings: On admission you find a frail, young lady who is very quiet in her demeanour and does not want to bothe somewhat depressed. Her ostomy appliance has been leaking stool and appears to be badly in need of c periostomal edges are red and inflamed and she has a 3 cm ulceration on the posterior aspect of her sta wash badly and has a very unpleasant body odour. Her clothing are soiled with stool leaking from her -92 BP-146/80 R-24 She wears glasses to read and has excellent hearing.
Chapter14: Cpt Surgery Iv
Section: Chapter Questions
Problem 17MC
Related questions
Question
Potential nursing diagnosis
Transcribed Image Text:Student N
The Client: # 4362-12
•Difficulty Swallowing
Mary Smith is a 29 year old divorced mother of 2 young children aged 4 and 6. She has no family living in Ontario. She was diagnosed with
Multiple Sclerosis about 5 years ago and the disease has progressed quite rapidly. She now depends on a walker for ambulation and has
experienced episodes of dysphagia recently. She had colon surgery 1 year ago due to bowel adhesions from her 2 C-Sections. She now has a
ileostomy that has been producing large amounts of foul smelling, watery effluent. She tells you that she's embarrassed to go out due to
leakage around her appliance and the odour. When you ask her about her diet she tells you that she's on a fixed income and basically eats
whatever she can afford. Most of her money goes towards food and clothing for her children. She has been off work since her surgery and
relies on Welfare and child support to get by. Mary tells you that she has lost about 10 kg. since her surgery and she appears weak and
cachectic. She has productive cough and tells you that it hurts to take a deep breath. Her children are currently being cared for by a close
friend.
The Diagnosis
The client's admitting diagnosis is: ?Pneumonia, generalized weakness, dehydration, malnourishment and dysphagia.
History:
Ms. Smith moved to Ontario from Nova Scotia about 8 years ago after she got married to her former husband. After she was diagnosed with
MS, her husband filed for divorce. He's been making regular child support payments and sees the kids a couple of times a week. Mary has a
cordial relationship with him but he has remarried and is not providing much help to her. In addition to generalized weakness, Mary has beel
experiencing vision loss and bladder control issues as her MS has progressed. Mary used to be very active in the community and coached
women's soccer for a number of years. She loves to read but is having difficulty with this as her vision loss progresses. She has never been :
religious person but states "only God can help me get out of this mess". She's quite worried that she will never be able to go home and be a
"family" again. Mary had no health issues until she was diagnosed with MS. She lives in an accessible apartment and has great neighbours
and friends who are "there for her" but she really hates to ask others for help.
Admission Findings:
On admission you find a frail, young lady who is very quiet in her demeanour and does not want to bother anyone. She appears sad and
somewhat depressed. Her ostomy appliance has been leaking stool and appears to be badly in need of changing. Upon inspection, the
periostomal edges are red and inflamed and she has a 3 cm ulceration on the posterior aspect of her stoma. She needs a shower and hair
wash badly and has a very unpleasant body odour. Her clothing are soiled with stool leaking from her stoma. Her vital signs are: T - 38.5 1
-92 BP-146/80 R-24 She wears glasses to read and has excellent hearing.
Doctor's Orders:
bed rest with bathroom privileges - A1
Stomahesive powder and skin prep to edges of stoma
contact precautions
Stool for C&S ASAP
Urine for Culture and sensitivity
Enterostomal therapist to see
dietician to see
DAT-push fluids
Vital signs q8h
Opthalmologist to see
Chest x-ray today
intake and output q8h
Oxygen at 2L/min via NP PRN
Deep breathing and coughing exercises q4h
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Student Name
Date
Nursing Diagnosis
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Assessment data that supports the nursing
diagnosis
Care Plan
Plan/Goal(s)
Interventions
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