Case Study 16—Mr. G. – Stroke and Rehabilitation With Answers Problem-Based Learning/Critical Thinking Ackley and Ladwig’s Nursing Diagnosis Handbook, 13th Edition Makic (2024)

Makic: Ackley and Ladwig’s Nursing Diagnosis Handbook, 13th Edition Case Studies (2024) Problem -Based Learning/Critical Thinking Case Study 16—Mr. G. – Stroke and Rehabilitation Case Scenario Mr. González is a 70 -year-old man who suffered a stroke 6 weeks earlier and is now being prepared for d ischarge to his home from the rehabilitation hospital. He has mild dysphasia and hemiparesis of his right side but has physically responded well to rehabilitation. He has also been diagnosed with hypertension, hypercholesterolemia, and type 2 diabetes. He has numerous new prescribed medications and will need his blood pressure and glucose frequently monitored. His wife, Mrs. González, will be his primary caregiver. The nurse has been teaching both Mr. and Mrs. González about such topics as safety, fall prev ention, stroke prevention, and medication and treatment management over the course of the rehabilitation stay. The nurse has noted that stressors have been interfering with the teaching sessions. Mr. González’s mood has become increasingly anxious, and he becomes easily frustrated. On the day of discharge, Mrs. González asks to speak to the nurse privately and confides that she is afraid of “making a mistake.” She states she does not feel confident about what she has learned. The nurse spends time carefully reviewing the discharge instructions and reassures her that a home health nurse will be visiting for the first few weeks to follow up on Mr. González’s care. The nurse calls the home health nurse and provides an update of Mr. González’s status and informs the home health nurse of Mrs. González’s concerns. Nursing Assessment Mr. and Mrs. González are both 70 years old and of Hispanic origin. The preferred language in the home is Spanish, although both Mr. and Mrs. González are comfortable speaking English . According to Mrs. González, the extended family believes in treating those who are “ill” with special foods and spices. The rehabilitation nurse conducts a more detailed assessment of home remedies with Mrs. González and discusses the potential for harm from drug interactions. Mrs. González is relieved when the nurse lets her know she will pass this information to the home health nurse for further teaching and follow -up. A. ASSESS 1. Identify the significant symptoms by underlining them in the assessmen t. 2. List those symptoms (those you have underlined) that indicate the client has a health problem. 3. Group the symptoms that are similar. Case Study 16-2 B. DIAGNOSE 1. Select possible nursing diagnoses for this client. Do this by looking at the list of nursing di agnoses in the book, Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence -Based Guide to Planning Care . Possible nursing diagnoses: 2. Validate the possible nursing diagnoses. Compare the signs and symptoms (i.e., defining characteristics) that you have identified from your client assessment with the defining characteristics for the nursing diagnosis that you have selected. Also, read the definition and determine if this diagnos is fits this client. Validated nursing diagnoses include: 3. Write/select a nursing diagnostic statement for one of the nursing diagnoses by combining the nursing diagnosis label with the related to (r/t) factors. a. The label is the title of the nursin g diagnosis as defined by NANDA -I. Include the Domain and Class. b. A related to (r/t) statement describes factors that may be contributing to or causing the problem that resulted in the nursing diagnosis. NANDA -I label: Related Factors (r/t) The complete nursing diagnostic statement is: C. PLAN 1. Select appropriate NOC outcome from the Ackley/Ladwig text. NOC outcome: Fill out the grid with NOC indicators and the appropriate Likert scale. Select the appropriate point on the Likert scale to measure the client’s current status. INDICATOR