Part 1: Binita Wadhwa is a 72–year old female who presents to the emergency department with left wrist pain after falling at home. She was diagnosed with mild cognitive impairment and diabetes mellitus type II in her 60s.
She has a history of hypertension, transient ischemic attack, vision loss, renal insufficiency, and peripheral neuropathy. She has had many previous hospitalizations related to diabetic complications and cardiovascular complications. She sometimes forgets to take her medications and does not adhere to diet or fluid restrictions.
She states “There are few things left I can enjoy so I eat what I want when I want. I just want to be left alone”.
She smoked for much of her adult life, but quit in her 50s.
She is essentially wheelchair bound and on supplemental oxygen via nasal cannula. Her primary caregivers are her daughter and son–in–law. Further interviewing reveals that she is left at home alone for long periods of time while they work; and she injured her wrist in the kitchen after falling while trying to get something to eat. Upon inspection; she appears slightly unwashed, smells faintly of urine, and has multiple ecchymoses and skin tears visible on both arms in various stages of healing. She is thin and gets short of breath easily with excessive talking and movement. She is a follower of Hinduism. For Ms. Wadwha,
1. Describe 2 ethical–legal dimensions and the nurse’s responsibilities related to the client (10 points)
2. Explain 2 modifications based on client limitations that the nurse should make in order to complete a safe, effective, and comfortable physical exam (10 points)
3. Discuss 2 potential healthcare referrals for the client and the need/benefit to the client (10 points)
4. Explain 2 potential cultural and/or spiritual considerations related to care for this client (10 points)
Part 2: Find an adult volunteer with sibling(s) who is aware of his/her biological family’s health and complete a family history. Use essay format or place information in a table. A blank table is available to copy/paste. For the volunteer,
5. Complete a history of 3 generations. For each family member, identify initials, gender,alive/deceased, current age/age at death, major illnesses, and cause of death. If unknown, state what is unknown (20 points)
6. Describe patterns of illnesses and genetic health risks based on the family history
