Nursing Case Study: Sallie Mae Fisher

Sallie Mae Fisher is a recently widowed, depressed, 82-year-old-female with congestive heart failure (CHF), atrial fibrillation, and hypertension. She has been hospitalized four times for CHF exacerbation. With limited family support, and a long list of medications, she is having difficulty managing her CHF. During a home health visit, the nurse and nursing student assess Sallie Mae and identify several concerns. This essay will define and prioritize those concerns, and list four interventions with rationales for each. A brief description of subjective and objective findings will precede the identified nursing problems and suggested interventions.
Subjective Information
Subjectively, Sallie states, “My mind just feels so cloudy” and “I’m just
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One would be having her enroll in an outpatient cardiac rehabilitation program. This type of program has many different parts that include: nutrition counseling, exercise that is closely monitored, emotional support, and education that is focused on lifestyles changes that affect the heart health (Mayo Clinic, 2016).
CHF and A-fib can cause pre-load and decrease cardiac output. Due to Sallie’s minimum knowledge of her condition, she would benefit from cardiac rehabilitation. Cardiac rehab will provide physical therapy, nutrition counseling, education, and emotional support and counseling. Cardiac Rehab classes also offers educational classes and activities where cardiologists and physicians from other departments will talk with patients about their risk factors, diets, exercises, and the importance of being compliant with medication and treatment regiments.
Intervention Two: Medication
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Oxygen therapy can reduce the heart 's workload and makes easy to breathe and decrease shortness of breath ("Web MD," 2016.)
Intervention Five: Fall prevention
During home visit nurse noticed many hazards in her house, which can cause falls. Her home environment is not safe. Mrs. Fisher needs more education about the importance of a clutter free environment, adequate lighting, supportive shoes, and non-skid socks. She needs to be educated about what to do if she falls and cannot get up. She also needs to make sure she has easy access to an emergency response system. In addition, she is taking medication, which can cause orthostatic hypotension, which might cause syncope in elderly.
Rationale for Fall Prevention
Syncope puts the elderly high risk for fall. Risk of injury is 5.9% higher with fall from syncope (Ungar et al., 2013). Clutter, poor lighting, inadequate footwear, and medications that can cause hypotension are all risk factors that increase the risk of falls. Falls constitute the most common mechanism of injury in geriatric patients (Sterling, O’Connor, & Bonadies, 2000). It is important for Sallie to live in a safe home and take precautions to prevent her from

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