Elder Abuse/Vulnerable Adult
Clinical Dilemma Activity
John Peterson, 82 years old
Primary Concept
Interpersonal Violence
Interrelated Concepts (In order of emphasis)
Stress
Coping
Anxiety
Ethics
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
Management of Care 17-23%
Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12%
Psychosocial Integrity 6-12%
Physiological Integrity
Basic Care and Comfort 6-12%
Pharmacological and Parenteral Therapies 12-18%
Reduction of Risk Potential 9-15%
Physiological Adaptation 11-17%
© 2020 KeithRN LLC. All rights reserved.
No part of this case study may be reproduced, stored in retrieval system or transmitted in any form or by any means,
electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN
This study source was downloaded by 100000840725322 from CourseHero.com on 01-28-2022 15:08:05 GMT -06:00
https://www.coursehero.com/file/74983205/STUDENT-Elder-Abuse-Clinical-Dilemmadocx/
, I. History of Present Problem:
John Peterson is an 82-year old male who is brought to the emergency department (ED) by his son because of concerns of
caregiver neglect. John lives in his apartment and requires help with ADLs during the day. When the son visited his dad,
he found him soaked in urine, surrounded by spoiled food, with dried vomit on his clothing. The trash cans outside the
home were overflowing, and inside, there was debris and old food left on the bedroom and kitchen floors. John is
complaining of pain in his feet, which he attributes to his diabetes. The son reports that his current caregiver is a family
friend who has a history of drug addiction and may have relapsed.
The patient is alert and oriented and admits to feeling sickly. He does not remember when he last had a glass of
water. There is a distinct smell of feces and urine. Upon closer assessment, there are dried feces in his perirectal area with
a large red swollen scrotum and redness in his groin folds. There is also evidence of skin tears/bleeding on the left lateral
thigh that appeared to be of a friction/shear type mechanism. Mr. Peterson states that he has not had a bath in three
weeks. He also reports being unable to get up from the chair by his bed without assistance for the last three days because
of increasing weakness and fatigue.
Personal/Social History:
Mr. Peterson’s son, Frank, reports that the patient was relatively healthy and self-sufficient up until the age of about 77.
His first wife, Frank’s mother, died 20 years ago. He remarried two years after his first wife died. Frank and his father’s
second wife, Janet, did not get along well, which resulted in a more distant relationship between father and son. Frank
lives about four hours away, is an only child, and visits 2-3 times a year.
When Janet died a year ago, it first became apparent that John needed help with day to day functioning. John was
resistive to leaving his home or having “strangers” come into his house but finally agreed to let a family friend help out.
During a previous visit, Frank noticed that his father had a frailer appearance and was more forgetful. It has been about
three months since his last visit. Frank reports that his father does not have many visitors or close friends that are still
alive.
What data from the histories is important & RELEVANT; therefore, it has clinical significance to the nurse?
(Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
1.Patient was found soaked in urine, there 1.This general assessment indicates that the patient is not capable of
was dried vomit all over his clothes, and performing ADL’s independently, the caregiver is neglecting this patient
surrounded by spoiled food. and not helping out as expected, the dried vomit could indicate a possible
infection and dehydration.
2.Patient has Diabetes
2. This condition coupled with the neglect could complicate the patient’s
health since it requires close monitoring.
3.Complaining of pain in his feet, which the
attributes it to his diabetes.
3.This could indicate that the diabetes has not been managed well and
therefore poor circulation to his feet that lead to tissue death in feet and
4.Patient reports feeling sickly, doesn’t possible amputation.
remember when he last had water, the
patient is weak and feels fatigued.
4.This could mean the patient is dehydrated and has been starved.
5.There is a distinct smell of feces and urine.
5.This is a sign of neglect. The continuous moisture can lead to further
6.Dried feces in perirectal area, the skin breakdown, and if feces get into the bloodstream via tears in the skin,
scrotum is large, red and swollen with it could lead to a systemic infection.
redness in the groinfolds.
6.The lack of hygiene could lead to further skin breakdown and possible
7.The patient has skin tears that are insentience.
bleeding.
This study source was downloaded by 100000840725322 from CourseHero.com on 01-28-2022 15:08:05 GMT -06:00
https://www.coursehero.com/file/74983205/STUDENT-Elder-Abuse-Clinical-Dilemmadocx/
Clinical Dilemma Activity
John Peterson, 82 years old
Primary Concept
Interpersonal Violence
Interrelated Concepts (In order of emphasis)
Stress
Coping
Anxiety
Ethics
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
Management of Care 17-23%
Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12%
Psychosocial Integrity 6-12%
Physiological Integrity
Basic Care and Comfort 6-12%
Pharmacological and Parenteral Therapies 12-18%
Reduction of Risk Potential 9-15%
Physiological Adaptation 11-17%
© 2020 KeithRN LLC. All rights reserved.
No part of this case study may be reproduced, stored in retrieval system or transmitted in any form or by any means,
electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN
This study source was downloaded by 100000840725322 from CourseHero.com on 01-28-2022 15:08:05 GMT -06:00
https://www.coursehero.com/file/74983205/STUDENT-Elder-Abuse-Clinical-Dilemmadocx/
, I. History of Present Problem:
John Peterson is an 82-year old male who is brought to the emergency department (ED) by his son because of concerns of
caregiver neglect. John lives in his apartment and requires help with ADLs during the day. When the son visited his dad,
he found him soaked in urine, surrounded by spoiled food, with dried vomit on his clothing. The trash cans outside the
home were overflowing, and inside, there was debris and old food left on the bedroom and kitchen floors. John is
complaining of pain in his feet, which he attributes to his diabetes. The son reports that his current caregiver is a family
friend who has a history of drug addiction and may have relapsed.
The patient is alert and oriented and admits to feeling sickly. He does not remember when he last had a glass of
water. There is a distinct smell of feces and urine. Upon closer assessment, there are dried feces in his perirectal area with
a large red swollen scrotum and redness in his groin folds. There is also evidence of skin tears/bleeding on the left lateral
thigh that appeared to be of a friction/shear type mechanism. Mr. Peterson states that he has not had a bath in three
weeks. He also reports being unable to get up from the chair by his bed without assistance for the last three days because
of increasing weakness and fatigue.
Personal/Social History:
Mr. Peterson’s son, Frank, reports that the patient was relatively healthy and self-sufficient up until the age of about 77.
His first wife, Frank’s mother, died 20 years ago. He remarried two years after his first wife died. Frank and his father’s
second wife, Janet, did not get along well, which resulted in a more distant relationship between father and son. Frank
lives about four hours away, is an only child, and visits 2-3 times a year.
When Janet died a year ago, it first became apparent that John needed help with day to day functioning. John was
resistive to leaving his home or having “strangers” come into his house but finally agreed to let a family friend help out.
During a previous visit, Frank noticed that his father had a frailer appearance and was more forgetful. It has been about
three months since his last visit. Frank reports that his father does not have many visitors or close friends that are still
alive.
What data from the histories is important & RELEVANT; therefore, it has clinical significance to the nurse?
(Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
1.Patient was found soaked in urine, there 1.This general assessment indicates that the patient is not capable of
was dried vomit all over his clothes, and performing ADL’s independently, the caregiver is neglecting this patient
surrounded by spoiled food. and not helping out as expected, the dried vomit could indicate a possible
infection and dehydration.
2.Patient has Diabetes
2. This condition coupled with the neglect could complicate the patient’s
health since it requires close monitoring.
3.Complaining of pain in his feet, which the
attributes it to his diabetes.
3.This could indicate that the diabetes has not been managed well and
therefore poor circulation to his feet that lead to tissue death in feet and
4.Patient reports feeling sickly, doesn’t possible amputation.
remember when he last had water, the
patient is weak and feels fatigued.
4.This could mean the patient is dehydrated and has been starved.
5.There is a distinct smell of feces and urine.
5.This is a sign of neglect. The continuous moisture can lead to further
6.Dried feces in perirectal area, the skin breakdown, and if feces get into the bloodstream via tears in the skin,
scrotum is large, red and swollen with it could lead to a systemic infection.
redness in the groinfolds.
6.The lack of hygiene could lead to further skin breakdown and possible
7.The patient has skin tears that are insentience.
bleeding.
This study source was downloaded by 100000840725322 from CourseHero.com on 01-28-2022 15:08:05 GMT -06:00
https://www.coursehero.com/file/74983205/STUDENT-Elder-Abuse-Clinical-Dilemmadocx/
