University of Phoenix College of Nursing NUR/403-Theories and Models of Nursing Practice Week Two

Case Study Grid

Nursing diagnoses may relate to physical, emotional, psychosocial, and cultural needs. Name: Kim Orta List five factors of patient history that demonstrates nursing needs: 1) Physical: Prenatal care-has only been to 3 prenatal visits 2) Psychosocial: Little support from family and friends, little to no support from boyfriend, no friends in the US, no church home r/t difficulty with transportation, stays home to care for her 3 daughters, ages 5, 7, and 9 years old 3) Social: 9th grade education, speaks no English 4) Emotional: States she feels alone and depressed 5) Cultural: Non-English speaking Hispanic female 1) Inability to identify, manage, and/or seek help to maintain health related to lack of support systems and resources as evidenced by difficulty with transportation to prescribed prenatal visits and little to no support from patients boyfriend and family, and not having friends in the U.S. 2) Social Isolation related to inability to engage in satisfying personal relationships as evidenced by having little or no support by her significant other, expressed feelings of aloneness demonstrated by the patient stating she feels alone and depressed. 3) Spiritual Distress related to sociocultural deprivation as evidenced by inability to participate in usual religious practices, inability to establish a church home, and difficulty with transportation.

State three nursing diagnoses using taxonomy of NANDA:

For each nursing diagnosis, state two desired outcomes:

1) The patient will deliver her baby +/- 2 weeks from EDC and have a healthy birth outcome.

2) The patient will attend scheduled prenatal visits monthly, bi-monthly, then weekly until delivery as pregnancy progresses.

University of Phoenix College of Nursing NUR/403-Theories and Models of Nursing Practice Week Two 3) The patient will have reliable transportation to and from her scheduled prenatal and mental health appointments, and church. 4) The patient will engage in social involvement by establishing a support network through her church that will help foster friendships as well as address spiritual concerns, to decrease feelings of being alone and depressed within 2 weeks. 5) The patients depression and sense of feeling alone will diminish with increased interaction and assistance in the caregiving role in regard to the intimate relationship between the patient and her boyfriend and involved parenting role of the boyfriend.

For each outcome, state two nursing interventions:

6) The patient will establish a church home within 2 weeks. 1) Use therapeutic communication; actively listen to and acknowledge the patients feelings and concerns in a friendly, caring manner while maintaining good eye contact sitting at the patients level and displaying open body language. 2) Ask the patient about her physical and mental health, feelings, and what she considers priorities during her care and if she feels safe at home. 3) Ask the patient about her roles and responsibilities, family dynamics, and address concerns. 4) Conduct a meeting with the patient and boyfriend to discuss their living situation and care of the patient and their children. 5) Ask the patients boyfriend what he feels are priorities for himself and their family and inquire about his feelings and concerns using therapeutic communication. 6) Provide a list of resources and referrals to the patient containing telephone numbers and addresses of hospitals, clinics, churches, mental health resources. 7) Develop a plan of action to meet the needs of the patient and provide the patient with a copy .

University of Phoenix College of Nursing NUR/403-Theories and Models of Nursing Practice Week Two 8) Arrange for free transportation to and from prenatal visits via La Clinica Madre Medical Van and contact a church of the patients choice for possible home visits and/or transportation to church. 9) Follow up with the patient bi-weekly to evaluate needs and concerns. 10) Provide written information in Spanish and utilize an official Spanish translator to convey information and confirm understanding. 11) Set up an initial mental health consultation appointment and provide the patient with a free roundtrip transportation voucher. 12) End prenatal visits and follow-up telephone conversations by asking the patient if she has any questions and ask if there is anything else you can do for her.

For each outcome, state one evaluation method:

1) The patient attended each prenatal visit as scheduled. 2) The patient delivered her baby on the EDC and both patient and newborn are healthy. 3) The patient utilizes/utilized the free transportation vouchers for prenatal and mental health visits. 4) The patient attended her mental health evaluation appointments monthly. 5) The patient is attending church and has formed a network of friends whom she visits and/or she receives visits from which has elevated her mood and she states she no longer feels alone and depressed. 6) The patients boyfriend has been helping with chores and caring for their 3 children, thus decreasing stress for the entire family and strengthening family bond.