Assessment of home visit

Assessment of Home Visit
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Assessment of Home Visit
As per the simulation video, the patient, Sallie Mae Fisher, is receiving care for congestive heart failure. However, her medical status continues to deteriorate. Rather than experiencing fluid overload, her body is experiencing a deficit in fluid volume. Mrs. Fisher has also lost about 14lbs in the past week which can be attributed to the fact that she does not take enough calories. This makes it necessary for the RN to provide her fluids and food including an effective nutritional plan for her body to gain strength.
According to the report from the RN, the patient exhibits bowel sounds which are hypoactive while her skin is both tented and less turgor. She is also dehydrated. This can be associated with the fact that she does not eat and drink as expected and is affected by the death of her husband. In such a situation, it is important to assess the patient’s mental status to ensure that it does not interfere with her recovery. It is also important to monitor any vital signs as patients who are dehydrated may experience low blood pressure and an elevated heart rate.
The patient is also not equipped with a home oxygen tank despite her respiratory rate being 24. Mrs. Fisher is at risk of experiencing falls because of her hypotension and polypharmacy. Her daughter, who is preoccupied with her job and family, finds it challenging having Sally’s medication refilled on time. This makes it necessary for the RN to consistently monitor her progress and ensure that her medications are refilled on time.

As per her medical report, the patient’s medical history shows that she has been affected by congestive heart failure, hypertension, and atrial fibrillation. According to Azad and Lemay (2014), most of the elderly patients who are admitted as a result of congestive heart failure, often exhibit various co-morbidities that require attention. The patients, mostly females, are affected by diastolic dysfunction. This makes it necessary for the RN to identify the conditions and the conditions that are highly likely to occur for the patient to receive proper care. As per the discharge orders, her medication list includes Vasotec, Nitroglycerin, and Digoxin; drugs which are quite useful in preventing the patient from falling and efficient in lowering her blood pressure.

Reference
Azad, N. & Lemay, G. (2014). Management of chronic heart failure in the older population. Journal of Geriatric Cardiology, 11(4): 329–337.