C4000 Case Study 5 - course point modules PDF

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Hailey Lawson Professor Kinzie Lee NURS4000 21 February 2019 Community Case: Case Management Case Part 1 Florence Brown, a 67-year-old woman, recently spent 3 days in the hospital following a myocardial infarction (MI). Florence waited over an hour in the emergency room before it was determined that she had had an MI. She had two stents inserted while in the hospital. Florence has had hypertension for 20 years. Florence, who lives alone, will receive home health visits after discharge. The home health nurse, Judy Prescott, will provide the case management assessment for Florence and develop a comprehensive post-discharge plan to meet Florence’s physical, mental, and social needs. Questions for students: 1. Why is continuum of care so important in the older population? a. Continuum care is imperative in the recovery and maintenance of the elderly population’s health. Hospitals are not equipped for long term treatments anymore, which is why community nurses have such a vital role in ensuring there is a safe environment to go home to. 2. What are three key case management priorities that are evident from this brief description? a. The RN needs to assess her fatigue, weakness, and dizziness to make sure this does not continue. Florence has a house with no bedrooms or showers on the first floor, so if she is too weak to climb stairs then she will not be able to participate in proper hygiene. If she is too fatigued, then she will likely neglect her cooking and household chores. She could therefore lack proper nutrition. Thirdly, she has a son who has tried to assist Florence, but he lives thirty minutes away and she feels guilty for burdening him. Therefore, she could be more likely to fall without his assistance, and she could even become socially isolated without support. 3. How do the signs and symptoms of MI differ between females and males? a. Men have classic signs of as MI such as chest pain or discomfort in one or both arms, back, neck, jaw, or stomach. Women present with different signs of as MI such as: shortness of breath, nausea, vomiting, back pain, or jaw pain. 4. Are women treated differently from men in regard to access to care? If so, what is the evidence? a. According to Healthy People 2020, the determinants of health consist of personal, social, economic, and environmental factors that influence health From Lippincott CoursePoint for Community and Public Health Nursing. © Wolters Kluwer.

Hailey Lawson Professor Kinzie Lee NURS4000 21 February 2019 status, which is something to consider when assessing access to healthcare. These determinants could affect women treated differently, especially if they are from a lower socioeconomic class with less education. Specifically, women are disregarded more frequently when having an MI because their symptoms present differently than the classic chest pain. This can lead to devastating health outcomes. 5. What other information would be important to know regarding Florence’s hospital stay and discharge instructions to provide effective case management? a. Discovering if there were any barriers to accessing health services would be important to assess, because this could lead to revealing unmet health needs. Health service barriers could lead to delays in receiving appropriate care, and an inability to get preventive services. This chain of events could lead to rehospitalization that could be prevented if the home health nurse does not find her physical and emotional support viable to be living alone.

From Lippincott CoursePoint for Community and Public Health Nursing. © Wolters Kluwer....