Case NUR 3330 (NUR3330) (Solved)Jim Goodman community Case / Jim Goodman, A home health nurse is scheduled to see a new client, Jim Goodman, for weekly home health visits. Jim is a 77-year-old male with end- stage steroid-dependent COPD. 2021/2022

Jim Goodman, A home health nurse is scheduled to see a new client, Jim Goodman, for weekly home health visits. Jim is a 77-year-old male with endstage steroid-dependent COPD. He has had five hospitalizations over the past six months for COPD exacerbations. He is 69 inches tall and weighs 155 pounds. His comorbidities include hypertension, asthma, anxiety, and tobacco abuse. There is concern about the client’s adherence to the medication regime. The client is occasionally disoriented to place and time. Medications: NKDA. Oxygen nasal cannula 3 liters, Prednisone 5 mg daily Ipratropium Bromide/Albuterol Sulfate 3 mg/0.5 ml/cc solution four times daily via nebulizer Fluticasone one puff every 12 hours Amitriptyline 2.5 mg daily oral Metoprolol 200 mg daily oral Albuterol inhaler 2 puffs as needed. Surgical history: Jim’s surgical history is positive for a ruptured abdominal aortic aneurysm fifteen years ago and a subsequent abdominal hernia repair. Social history: Jim lives in a 55 and older low-income apartment building with his wife in a small rural community. He smokes 15 cigarettes per day, he does not drink alcohol, and he walks around the block four times per week. Community Assessment: small rural community with a main street with retail shops, restaurants, bank, a pharmacy, grocery store and a department store. The houses and buildings are well kept. The sidewalks near Jim’s apartment building are in moderate disrepair with some uneven surfaces and cracks. There are no open green spaces in the community or evidence of public transportation.