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QUESTION
Reply to discussion post
Post 1As the home health nurse, how would you approach Ms. C?
As the home health nurse, I would approach Ms. C with an open mind and compassion. Because her age, she may feel that people disregard her feelings towards her own health and treatment, I want her to know and feel like I am truly listening to her concerns and questions and that I am here to help her feel better. While speaking with Ms. C, I would emphasize the importance of complying with her doctors orders, that taking her medications as prescribed will improve her health and reduce admissions to the hospital. It's important that she understands that not following the regimen has dangerous outcomes. I would end our visit asking her if she had any questions or concerns and if there was anything I can do to help make this situation easier for her.
What risk factors might interfere with Ms. C’s plan of care?
Her son mentioned that he was concerned his mom would not take her medications and that she hasn't been compliant in the past, so the biggest risk factor, is her ability to adhere to the care plan and taking her medications as prescribed."Between 26% and 59% of older adult patients fail to take their medicines as prescribed. Some patients never fill their prescriptions, some fail to refill their prescriptions, and some don't follow the prescribed dosing schedule." (Burchum & Rosenthal, 2019). Her age and living alone is also a concern, is she mentally and physically able to care for herself and her health? Does she need assistance in remembering to take her prescriptions and is she physically capable of doing so? The last risk factor is the numerous conditions she is currently being treated for, does she understand what each medicine is for and why she needs to take it? Does she understand how much to take and when? Has she been educated and does she understand?
What must you evaluate to include in the plan of care?
First and foremost, due to her age and living alone, her mental status needs to be checked to determine if she can continue living alone or if other arrangements should be made. It is important to understand if she isn't compliant because she just doesn't want to- or is she struggling with remembering. Her physical capabilities, such as vision and strength to open bottles will need to be assessed to determine if she can take her medication by herself or if she'll need assistance (Sollitto, 2019). It is crucial that she is truly educated and can verbally explain her medication schedule to ensure she understands the regimen.
References:
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing care (10th ed.). St Louis, MO: Elsevier.
Sollitto, M. (2019, April 25). Top 6 Problems with Medication Adherence in Seniors. Retrieved October 21, 2020, from https://www.agingcare.com/articles/medication-problems-elderly-people-have-146111.htm
post 2Rheumatoid arthritis (RA) is an autoimmune, inflammatory disorder that
affects about 1% of the American population, each year disease results in more than 9 million physician visits, and over 250,000 hospitalizations, RA can develop at any age, even though initial symptoms usually appear during the third and fourth decades (Burchum & Rosenthal, 2019).
As the home health nurse, how would you approach Ms. C?
Medical adherence is by World Health Organization is the degree to which the person’s behavior corresponds with the agreed recommendations from a health care provider. Aged people are more likely to comorbidity and are at a greater risk of polypharmacy so present a higher risk of drug nonadherence than young people. I would use this technique to approach Ms. C by reminding her that the medications are very useful to help her feel better and that not abide by this instruction will likely to lead to overtreatment of her diseases or even further deteriorate her health. I would advise her to have a helpful attitude and abide by taking medications as doctor’s prescriptions because it will increase her health situations.
What risk factors might interfere with Ms. C's plan of care?
Some of the risk factors are patient factors, medication provider factors, and socio-economic factors. Iafolla (2013), found that there is a dramatic increase in atherosclerotic disease in patients with RA, risk factors, family history, and genetic predisposition appear to play roles, premature atherosclerotic changes might concurrently develop with subclinical inflammation for years before RA is clinically evident, Cardiovascular disease is hard to recognize in patients with RA therefore, it is wise to carefully assess all patients with RA shortly after the diagnosis of RA is made, reduce risk factors, and ensure proper control of RA symptoms.
Patient factors – an individual’s commitment and ability to follow to the medication schedule. These are further subcategorized into a mental state ( behavior and attitudes), demographics (old age, low education levels, culture)
Medication factors – they include drug (formulation, packaging), drug handling (difficulty in opening containers, need to cut tablets), drug regimen (complex dosing regimen).
Health care providers factors – it concerns issues such as poor communications, lack of patient involvement, low confidence in health care providers, failure to review medications.
What must you evaluate to include in the plan of care?
Mental status – this determines if the patient can handle medications on her own
Behavior habits and attitude – if the patient is willing to take medications or if she needs to follow-ups.
Physical status – if she can serve medications herself or needs a medical caregiver. If recently hospitalize it will indicate that more care needs to give to ensure medical complianceReferences
Burchum, J. R., & Rosenthal L. D. (2019). Lehne’s pharmacology for nursing care (10th ed.). St. Louis, MO: Elsevier.
Iafolla M. (2013). Rheumatoid arthritis and atypical cardiovascular disease: inflammation changing the clinical presentation. Canadian family physician Medecin de Famille Canadien, 59(5), 505–509.
grading rubric attachedProvides replies to two peers with simple comments and/or reference(s) not provided. A minimum of one (1) reference is required for each peer reply. *Each peer reply is less than minimum of 125 words.
Feedback:
No in text citation provided, which takes away from the validity of the content provided.Titles of books, web pages, and journals should be italicized in the reference list for all references. There should be in text citation within the body of all postings for each reference listed in the reference list. Credentials, such as PhD, should not be listed within the reference list. When 2 or more author or listed for a work, in text citation should include the first authors' last name, followed by et alFA2020 - RNSG 1301 Discussion Board Grading Rubric 20 Points
10 Points
5 Points
0 Points
Points Earned
Fully answers the prompt by Wednesday (11:59 p.m. CST) of the week assigned. Initial posting contains at least 2 references.
*Initial post must be aminimum of 150 words.
Fully answers the prompt by Wednesday (11:59 p.m. CST) of the week assigned. Initial posting contains less than 2 references.
*Initial post must be aminimum of 150 words.
Fully answers the prompt by Wednesday (11:59 p.m. CST) of the week assigned. No references included.
*Initial post must be aminimum of 150 words.
No initial posting by Wednesday (11:59 pm CST) or posting is less than the minimum of 150 words.
/20
Initial posting is rich in content full of thought, insight, and analysis.
Initial posting has substantial information. Thought, insight, and analysis have taken place.
Initial posting is generally competent. Information is thin and commonplace.
Initial posting is not relevant or no subject matter knowledge is evident.
/20
30 Points
20 Points
10 Point
0 Points
Points Earned
Provides a minimum of two substantive peer replies with reference by the end of the week (Sunday 11:59 pm). A minimum of one (1) reference is required per peer reply.
*Each peer reply must be aminimum of 125 words.
Provides replies to two peers with simple comments and/or reference(s) not provided. A minimum of one (1) reference is required for each peer reply. *Each peer reply must be a minimum of 125 words.
Provides only one peer reply by the end of the week (Sunday 11:59 pm). Appropriate references are not included on both peer responses.
*Each peer reply must be aminimum of 125 words.
No replies to peer postings or postings are less than the minimum of 125 words.
/30
15 Points
10 Points
5 Point
0 Points
Points Earned
Correct APA format of in-text citations (within the body of the posting) and references (in the list). Both are required to earn any points.
Less than 2 APA errors.
3-4 APA errors.
No use of APA format or 5+ errors.
/15
5 Points
3.5 Points
2 Points
0 Points
Points Earned
Spelling, grammar, punctuation, mechanics and word usage are correct and consistent with Standard American English.
Spelling, grammar, punctuation, mechanics, and word usage are adequate and consistent with Standard American English; errors do not interfere with meaning or understanding.
Spelling, grammar, punctuation, mechanics, and word usage are distracting and could interfere with meaning or understanding.
Spelling, grammar, punctuation, mechanics and/or word usage interfere with understanding and do not reflect scholarly writing.
/5
All references are relevant, scholarly, and less than 10 years old.
Some references are not relevant, scholarly, or less than 10 years old.
No use of references.
/5
5 Points
2.5 Points
0 Points
Points Earned
Posts indicate respect and consideration for peers and instructor and are written using scholarly language.
Posts indicate respect and consideration for peers and instructor but are not written using scholarly language.
No use of professionalism & netiquette.
/5
Total Points
/100
| Subject | Nuirsing | Pages | 5 | Style | APA |
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Answer
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Reply to Discussion Post
Post 1
Hello, thank you for sharing your thoughts on the discussion. Understanding the role of a home health nurse is essential in approaching Ms. C. Your description of how you would approach her situation shows a precise understanding of what entails home care. Considering the situation, it is easier for her to think that people disregard her feelings towards health and treatment, making it necessary to remain open-minded and compassionate during the care process (Burchum & Rosenthal, 2019). This has to be explicit in speech and action that are essential in developing rapport with the patient. Therefore, I agree with you about the need to ask questions to address particular concerns about the visit. Essentially, the visit only becomes fruitful when Ms. C understands the benefits of complying with the doctor’s orders and successfully takes her drugs as prescribed.
Moreover, I agree with you that age presents a significant risk factor in Ms. C’s compliance with the care plan. Staying alone at her age and condition is risky since she can easily fail to adhere to the medication plan, which her son already indicates is a significant concern. Since he had previously failed to take her medication, there is a high likelihood that she would repeat the same trend (Yap et al., 2016). Therefore, this makes it necessary to recommend an individual with a basic understanding of home-based care to assist her. She must have a company that would ensure she complies with the doctor’s prescriptions and refills her dosage.
References
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne's pharmacology for nursing care (10th ed.). St Louis, MO: Elsevier.
Yap, A. F., Thirumoorthy, T., & Kwan, Y. H. (2016). Medication adherence in the elderly. Journal of Clinical Gerontology and Geriatrics, 7(2), 64-67.
Post 2
Hello, thank you for such a detailed and well-thought-out post. Your analysis of the discussion is fascinating, especially with the details provided and the precision in addressing underlying concepts. Because of her age, Ms. C has a high likelihood of exhibiting drug nonadherence, creating a need to approach her with an open mind and adequate compassion (Burchum & Rosenthal, 2019). Essentially, the aim is to make her feel better and understand the essence of taking the drugs as prescribed by the doctor. The recovery will only be as good as her diligence in taking the medication, making a change of attitude toward the drugs very critical.
Therefore, I concur with you that a successful intervention would also incorporate identifying the risk factors and addressing them for a better response to the plan of care. Your analysis of the patient factors further explains the concerns raised by her son concerning her commitment and ability to follow the medication schedule. Primarily, age, education levels, and culture are all risk factors in such scenarios. Notwithstanding, the health care provider should recommend a home-based caregiver who would help the patient follow the medication plan (Kini & Ho, 2018). Such will further play a significant role in implementing the care plan's evaluation criteria, as illustrated in your post.
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References
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Burchum, J. R., & Rosenthal, L. D. (2019). Lehne’s pharmacology for nursing care (10th ed.). St. Louis, MO: Elsevier.
Kini, V., & Ho, P. M. (2018). Interventions to improve medication adherence: a review. Jama, 320(23), 2461-2473.
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