Specialized Home Health Care Nursing

Case Study One

I would assess Marie’s and Yvonne’s learning needs by finding what they already know about the drug and what they would like and need to know. The assessment will also include what they can learn and what methods would best suit their knowledge. (EuroMed Info, n.d) The best way to do the assessment is by asking both the patient and the caretaker relevant questions. I would ask the patient are; what her average day is like, her family, and her work to know more about her as an individual. Other questions include; what she is concerned more about her health and the best methods she enjoys learning through. Through questions, I will be able to assess Marie’s and Yvonne’s learning needs.

As reimbursed Medicare caters for extensive teaching, the teaching method is done through assessment for patients and their caretakers. It will include practical where Yvonne and Marie will practice taking the required amount of drugs, and any other thing that will need practice. Some of the strategies that will promote Marie’s self-care are; seeking support from professional counselors if mentally affected, having a healthy diet and regular exercises to promote physical care, associating with family and friends, and thinking positively. These strategies will help her regain physical, emotional, and mental health (Jane Brooke, 2013).  

It is imperative that treatment and safety balance for infusion therapy. Other than the environmental factors (Markkanen et al., 2017) in his journal on Infusion Nursing journalhighlights other elements after a research study. I assessed some of the factors in Marie’s home. One of them is uncontrolled home conditions that cause housekeeping unhygienic. Marie’s compound has many trees and flowers while her house door is close to them. The withering of these trees enters the house through the door and the windows causing dirt. It may affect her drugs if left open. Another safety requirement to assess is disruption from family members and pets. I will check whether Marie’s pets and relatives other than Yvonne who live around are disruptive or not. The last requirement I will assess is Marie’s access to assistive devices when infusing the drugs. Tools such as measuring bottles and thermometer should be available.

Other necessary assessments may include but are not limited to; Yvonne’s knowledge of infusion therapy and how she can help Marie in case of an emergency, eating habits of Marie to make sure it is healthy and does not affect the drugs. I will also assess Marie’s risky behaviors that may interfere with infusion therapy and worsen her health, such as cigarette smoking. In other words, Marie’s mental, physical, emotional, and spiritual health will need assessment for the infusion to perform the best.

Case Study 2

For Mary Beth’s case, the first assessment the nurse should do is to identify both medical and social history. It may be conducted through subjective and objective interviewing by asking her open-ended questions. Understanding the medical history of patients enables nurses to determine the baseline measurers related to patients’ health. Some of the problems the nurse should ask range within medical and social. One of them is the severity of the pains she experiences, the types of medications she has been taking, how often she takes her social life with friends and family, and other questions that describe medical and social history. Questions about social life will enable me as a nurse to know how to interact with her when executing my duties.

Comprehensive pain management is meant to ease patients’ pain with consistent pain (Middleton, 2004). However, some barriers make it difficult. One of them is patients having difficulties in expressing themselves. A patient may find it hard to talk about how they feel and how diseases affect their nerves. In the case study, Amy worries about her mother being unable to speak to the physician about pain control. Another barrier is the employment of wrong assessment tools. There is a wide variety of assessment tools used to collect information about a patient’s pain. Assessment tools also include knowledge and attitudes to pain management. Questions, verbal, and non-verbal communication, too, are assessment tools for pain management. If these tools are misinterpreted, then it might be challenging to manage pain. The third barrier is the inappropriate prescription of drugs and dosing intervals. If a clinician does not appropriately administer the right medications according to disease symptoms, then the pain might never cease.

Four factors determine Medicare hospice care eligibility for cancer, as (Compassus, 2020) explains. First, a patient’s palliative performance scale must be 70%—secondly, dependence for two or more daily life activities. Thirdly, the patient’s pathology report must show some evidence of metastases, and fourthly, the metastatic condition should result even after regular therapy. For Mary Beth’s case, she is eligible for Medicare hospice care because her bones and liver were diagnosed with metastasis after extensive chemotherapy, as the case study reveals.

For Mary Beth to stay comfortable, I would combine several interventions as a nurse. One of them is physiological interventions to make her physical body comfortable. Despite her pain, I would help her undertake simple body exercises to keep her body fir. Another intervention is on safety. For example, teaching her about the drugs, she is taking and keeping herself safe from stress, among other safety issues. Other interventions would be helping her change bed positions, ensure she takes oral drugs adequately, helping her ease pain, and paying attention to her when communicating.

Drug Card

Name- Immunosuppressive Drug

Use- the drug is used to treat autoimmune diseases such as Rheumatoid arthritis

Side Effects- increases the risk of infections (urination pain, fever, lower back pain).

Warnings- the drug should not be taken by people who have allergies to certain medications, history of chickenpox, and kidney and liver diseases.

References

Compassus. (2020, September 10). Hospice eligibility criteria for cancer. https://www.compassus.com/healthcare-professionals/determining-eligibility/hospice-eligibility-criteria-for-cancer

EuroMed Info. (n.d.). Assessing learning needs. https://www.euromedinfo.eu/assessing-learning-needs.html/

Jane Brooke, N. (2013). Palliative care has a place in residential aged care. Journal of Palliative Care & Medicine, 02(02). https://doi.org/10.4172/2165-7386.1000e114

Markkanen, P., Galligan, C., & Quinn, M. (2017). Safety risks among home infusion nurses and other home health care providers. Journal of Infusion Nursing, 40(4), 215-223. https://doi.org/10.1097/nan.0000000000000227

Middleton, C. (2004, January 20). Barriers to the provision of effective pain management. Nursing Times. https://www.nursingtimes.net/clinical-archive/pain-management/barriers-to-the-provision-of-effective-pain-management-20-01-2004/