Identify and describe at least four medical and four nursing interventions to meet client needs.

Health history

Ms. Davis is an 82-year old female with a history of chronic congestive heart failure (CHF), atrial fibrillation, and hypertension.  During the last 6 months, she has been hospitalized four times for exacerbation of her CHF.  She was discharged home last Saturday from the hospital after a 3 day stay to treat increased dyspnea, an 8-pound weight gain, and chest pain.

Ms Davis is recently widowed and lives alone.  She has a daughter, Tammy Faye, who lives in town but works full time and has family issues of her own.  Therefore, family support is limited.

HOSPITAL DISCHARGE INSTRUCTIONS

• Mountain Top Home Health to evaluate cardio-pulmonary status, medication management, and home safety.
• Medical Equipment Company to deliver oxygen concentrator and instruct patient in use.  O2 at 2 liters per nasal prongs PRN.
• Prescriptions given at discharge:
• Digoxin 0.25 mg once a day
• Lasix 89 mg twice a day
• Calan 240 mg once a day
• Order written to continue other home meds.

Home Medication List

Zocar 50 mg once a day

Minipress 1 mg once a day

Vasotec 10 mg twice a day

Prilosec 20 mg once a day

Furosemide 40 mg once a day

Effexor 37.5 mg at bedtime

Lanoxin 0.125 mg every other day

Multivitamin once a day

Potassium 40 mEq once a day

Ibuprofen 400 mg every 4 hours as needed for pain

Darvocet N 100 mg every 4 hours as needed for pain

Nitroglycerin ointment, apply 1 inch every day