Health Assessment Case Scenario

Mrs. Jia Tien is a 78-year-old Chinese woman who has lived with her adult daughter (and family) for the past 18 years, when she moved to the United States. Past medical history and medications includes: • atrial fibrillation (digoxin; beta blocker; and coumadin) • type 2 diabetes mellitus (sulfonylurea) • osteoporosis (bisphosphonate) • dementia (cholinesterase inhibitor) • recurrent urinary tract infections (antibiotics prn) • increased frequency of falls She has been independent in activities of daily living until recently when increased episodes of wandering outdoors and falling have disrupted her functionality. During this past week, Mrs. Tien fell twice, hitting her head both times. Each time, she was transported via ambulance to the local Emergency Department for a CT scan and evaluation. After the second fall, she was admitted to the hospital for monitoring and evaluation. Mrs. Tien was found to have an aggressive urinary tract infection and worsening symptoms of dementia; the CT scan was negative. She spent three days in the hospital and two weeks in a rehabilitation center for strengthening and gait training. During a family meeting, an assisted living facility was recommended, as Mrs. Tien spends considerable time alone each day. The patient and daughter are not yet ready for this option, and Mrs. Tien is returning home. You are making the first visit as a home care nurse. Discussion Directions Compose a short paragraph discussing: • One functional assessment tool that you would find helpful to use in your assessment of Mrs. Tien. o The tool can be one which is reviewed in Chapter 31 of your Jarvis (2016) textbook or from another source. • Provide an overview of the tool.  • Discuss why you feel the tool you identified will be helpful for you as you plan Mrs. Tien’s care • In addition to your course textbooks, provide a minimum of one evidenced based, peer reviewed nursing journal reference to support the content of your post. • Follow all guidelines of the discussion rubric for this activity. • This activity will be graded using the discussion rubric. This activity is tied to: • Course Objective 1: Apply nursing concepts and theories to the practice of health assessment. • Course Objective 2: Incorporate a holistic and culturally competent approach to health assessment. • Course Objective 4: Analyze collected health assessment information to determine actual and potential risk factors and initiate an appropriate plan of care.

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