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Mrs. L is a 80 year-old female who lives alone in a two-story house. 

Mrs. L was doing very well on her own until she fell in her kitchen. After being brought to the emergency department, it was unclear if she had a mechanical fall or if she had a syncopal episode. She was found to have a non-displaced right clavicle fracture and an arm sling was placed. She was also found to be hypotensive and dehydrated. Additionally, an EKG revealed atrial fibrillation, which has been treated in the past with cardioversion at age 60 and managed with Metoprolol 25 mg ER since. Additional testing revealed stage 4 heart failure with less than a 36% ejection fraction. The physician determined her life expectancy to be no more than 6 months.  After consultation with the family, the physician ordered hospice care. Mrs. L will be transitioned to SAR for 2 weeks and then to home, where hospice will provide care. 

PMH – osteoarthritis, CHF, depression, anxiety

Social History – non-smoker, moderate alcohol use, widowed x 7 years, Catholic and attends mass weekly

Medications – Tylenol 650 mg every 4 hours PRN pain, daily multivitamin, Prozac 60 mg/day, Oxycodone 5mg PO every 4 hours PRN pain (prescribed in the hospital), Metoprolol 25mg ER/day

 

Assignment 

discuss three or more important aspects the nurse practitioner should consider about Mrs. L and her transition from the acute care hospital to SAR and then to home with hospice care. 

 

How will the nurse practitioner coordinate care for her in the home? 

SCIENCE
HEALTH SCIENCE
NURSING

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