Type 2 diabetes mellitus

 

Mrs. Jia Tien is a 78-year-old Chinese woman who has lived with her adult daughter (and family) for the past 18 years when she moved to the United States. Past medical history and medications include:

atrial fibrillation (digoxin; beta-blocker; and coumadin)

type 2 diabetes mellitus (sulfonylurea)

osteoporosis (biphosphonate)

dementia (cholinesterase inhibitor)

recurrent urinary tract infections (antibiotics prn)

increased frequency of falls

She has been independent in activities of daily living until recently when increased episodes of wandering outdoors andfalling have disrupted her functionality. During this past week, Mrs. Tien fell twice, hitting her head both times. Each time, she was transported via ambulance to the local Emergency Department for a CT scan and evaluation. After the second fall, she was admitted to the hospital for monitoring and evaluation. Mrs. Tien was found to have an aggressive urinary tract infection and worsening symptoms of dementia; the CT scan was negative. She spent three days in the hospital and two weeks in a rehabilitation center for strengthening and gait training.

During a family meeting, anassisted livingfacility was recommended, as Mrs. Tien spends considerable time alone each day. The patient and daughter are not yet ready for this option, and Mrs. Tien is returning home. You are making the first visit as a home care nurse.

Discussion Directions

Compose a short paragraph discussing:

One functional assessment tool that you would find helpful to use in your assessment of Mrs. Tien.

The tool can be one that is reviewed in Chapter 32 of your Jarvis (2016) textbook or from another source.

Provide an overview of the tool.

Discuss why you feel the tool you identified will be helpful for you as you plan Mrs. Tien’s care.

In addition to your course textbooks, provide a minimum of one evidenced-based, peer-reviewed nursing journal reference to support the content of your post.

 

Sample Solution

During my initial home care visit with Mrs. Jia Tien, I would find the Functional Activities Questionnaire (FAQ) particularly helpful. This tool is a standardized assessment designed to evaluate an individual’s ability to perform instrumental activities of daily living (IADLs), which are crucial for independent living. The FAQ consists of ten items, each assessing a different IADL, such as managing finances, preparing meals, and using transportation. Each item is scored on a four-point scale, ranging from “normal” to “unable to do.” The FAQ’s strength lies in its ability to provide a comprehensive overview of a patient’s functional abilities beyond basic self-care. It’s helpful in Mrs. Tien’s case because it will allow me to objectively assess her current level of independence in essential tasks that have likely been impacted by her recent falls, worsening dementia, and aggressive UTI. By identifying specific areas of functional decline, such as managing her medications or navigating her environment, I can tailor her care plan to address her individual needs and prioritize interventions that promote safety and independence within her home. This tool will help me to create a baseline, and also to monitor the effect of interventions over time.

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