The patient is noteworthy for high level of health seeking behavior and a high degree of medicalization. The patient reports that depression is a significant factor in her life related to prior physical, emotional and sexual abuse and to her general state of disability. She does not leave her home very much except to attend medical appointments and is highly dependent upon her family for her needs and care. The patient’s life appears to revolve around her illnesses and conditions she describes herself as a multiply disabled person. When I first met her, she was reviewing information provided to her by the transitional care unit pertaining to difficulties in emerging from anesthesia and about her medications. The patient is very focused on understanding and accessing information about her conditions/diagnoses and treatments. The patient does not cook for herself and is maintained during the day with tea until her son comes to make her dinner. One son comes to her home everyday to cook her dinner. She has four children who live locally and whom she indicates are very supportive. The patient is widowed and lives alone in Natick. In addition, her past medical history is noteworthy for obstructive sleep apnea patient uses a CPAP. She associates the onset of fibromyalgia subsequent to being involved in a physically and emotionally abusive intimate adult relationship and to self-described post traumatic stress disorder relative to childhood sexual abuse. Her past medical history is noteworthy for fibromyalgia from which the patient experiences considerable disability. She is obese and indicates that she struggles with this and is aware of the relationship of her obesity to her osteoarthritis and current procedure as well as to other current and potential diagnoses. The patient is a former smoker with COPD she quit smoking just prior to the current surgery and seems to be managing this well. Her incision was healing well with no local swelling, warmth, or exudates and the wound erythema was receding from the marking drawn around the incision. She continues to experience edema of the left operative extremity no thromboembolus was identified and her physician ordered an additional diuretic. The patient has otherwise experienced good recovery with physical therapy 1-2 hours per day/5 days per week. The consultation suggested that her lethargy might be attributable to oxycodone (patient is allergic to milnapricine and several other drugs) which the patient takes for ongoing pain and fibromyalgia. A neurological consult was ordered to assess the patient’s difficulty emerging from anesthesia no source of this difficulty was identified during examination. She subsequently emerged from anesthesia and the urinary retention resolved. She had difficulty emerging from anesthesia and experienced urinary retention. The patient was transferred to Braintree Rehabilitation Center on 5/24/12. The total knee replacement (TKR) was conducted at Metrowest/Leonard Morse Hospital on 5/21/12. ![]() Registered nurses perform interventions based on the following actions: (MEATA)If you need assistance with writing your nursing essay, our professional nursing essay writing service is here to help! Find out more Nursing Diagnosis: Impaired physical mobility related to ventilation-perfusion mismatch as evidenced by shortness of breath on ambulation and inability to ambulate more than 10 feet independently. Write one short term and one long term goal for the following nursing diagnosis. Long term goals are usually achieved by discharge. Short term goals can usually be achieved by the end of your shift. Provide rationale for each intervention being performed by an RN. ![]() Provide 2 RN interventions for each goal that you developed in #1. Registered nurses perform interventions based on the following actions: (MEATA). ![]()
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