Community Health - Swift River Cases Scenarios; all answered and graded.

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Community Health - Swift River Cases Scenarios; all answered and graded. Judith Hanks Room Judith Hanks, 64-year-old woman discharged about one year ago from the hospital following discectomy to re... pair a herniated disc. During that hospitalization, Judith’s husband of 9 years, Elton, visited her and found her behavior very different from her usual behavior. As his with her visit progressed, Judith began having tactile hallucinations and was very restless. Finally, Judith’s husband called the hospital nurse into the room and the nurse found Judith hypertensive and tachycardic and Judith was very diaphoretic. Judith and her husband both revealed that they were drinking 8- 10 alcoholic beverages per day. As part of that hospitalization Judith went through alcohol withdrawal and was diagnosed with alcohol-related cirrhosis and began care for condition. Judith also has a history of heart failure which was stabilized during the hospitalization. Current medications include: carvedilol (Coreg) 3.125 mg twice daily, spironolactone (Aldactone) 200 mg/day, Vitamin B Complex (1/day), MVI (1/day) Allergies: Shellfish, adhesive tape. As part of the management and discharge processes, both members of the couple pledged to become sober and were generally successful over the past year with ongoing support group participation at the Alcoholics Anonymous at a local church. They have both had one or two serious relapses of using alcohol when life stressors were more than they can handle. One night, Elton went to a local bar, after an argument with his wife, and drank all evening. When driving home, he was the cause of a motor vehicle accident which caused no injuries but damaged his car beyond repair. Their children decided to take both Judith and Elton’s licenses away and do errands for them every few weeks. This caused Judith and Elton to not be able to attend their Alcoholics Anonymous meetings or see their primary care healthcare provider whose practice is 55 miles from the Hank’s home. Since her hospitalization, Judith has become deconditioned and she has gained 30 pounds. Her activity is limited to her bed, her bathroom, and her living room with the television and some comfortable chairs. Because of the Hank’s rural location, lack of transportation, and Judith’s immobility, the healthcare provider recommends telehealth management until the Hanks’ circumstances change. The Telehealth Nurse Care Coordinator receives the referral for Judith’s care. The Telehealth Nurse reviews Judith’s electronic health record and emails the primary care healthcare provider with questions. The Telehealth Nurse plans a virtual conference with Judith and Elton. The Hanks do have a smartphone and a computer but are somewhat reticent to use a technology-based intervention. They state they are “willing to give it a try. [Show More]

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