Critical Thinking Case Study NS is a 72-year-old woman who immigrated to the Uni

Question

Critical Thinking Case Study

NS is a 72-year-old woman who immigrated to the United States from Egypt 5 years ago. She is a widow, has five grown children, and follows Islamic doctrine. She lives with her oldest daughter, and a younger daughter and three sons live near her home. NS is currently hospitalized due to a recent cerebral vascular accident. She has left-sided paralysis. The attending physician tells the patient she should go to a rehabilitation unit for 3 weeks for physical therapy. The oldest daughter is present for the physician’s visit. Both the patient and her daughter appear anxious but do not ask the physician any questions.

Medications Prescribed Warfarin 3mg DQ, check INR every week, Aspirin 81mg, Metoprolol 25mg DQ, Hydrochlorothiazide 12.5mg. , Celexa 10mg QD, The RN develops a discharge teaching plan to address anxiety, medications, safety & depression.

List the goal for this teaching/coaching plan Anxiety,Medications,Safety & Depression

Describe three teaching resources what resources can she use to complete teaching?

Identify the teaching strategies that can be used

List the specific instructions that may be needed regarding her medication and what adverse reactions to be aware of/and what to do

Identify two factors that may negatively influence adherence to the medication and how they can be overcome

Describe how to include the family

Provide information on how and when she should seek support and help

Explanation / Answer

1. List the goal of this teaching/coaching plan Anxiety, Medications, Safety & Depression

To reduce or relieve from anxiety

To adhere with the medications as ordered

To ensure patient safety

To get relieved from depression

2. Describe three teaching resources what resources can she use to complete teaching?

Flash cards to provide clear instructions on medications

Pamphlets for depression information and how to get rid of it

Plackards for anxiety management

3. Identify the teaching strategies that can be used:

Clear goals

Questioning to know their understanding level

Reinforcing the points for clear understanding

Summarizing to make it easier for learning

Allowing time for asking questions

4. List the specific instructions that may be needed regarding her medication and what adverse reactions to be aware of/and what to do

When warfarin is taken along with aspirin, risk of bleeding is higher. Hence it is prudent to keep the patients INR in low ranges. Frequent testing of INR every 1-2 weeks is manadatory

Change in patients health may be asked to monitor

Educate about warfarin therapy and INR management

Ask the patient to be vigilant for the symptom and sign of blood loss

Dietary intake of vitamin-K

Advise to avoid drinking alcoholism, binge drinking

Advised for activity reduction which are prone for injury

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