Sallie Mae Fisher’s Health History and Discharge Orders – Case Study Questions And Answers

Assignment Instructions

Refer to “Sallie Mae Fisher’s Health History and Discharge Orders” for specifics related to the case study used to inform the assignment. Using “Home Visit With Sallie Mae Fisher” and “Sallie Mae Fisher’s Health History and Discharge Orders,” complete the following components of this assignment:

Essay Portion

After viewing the home visit, write an essay of 500-750-words in which you do the following:

  • Identify, prioritize, and describe at least four problems.
  • Provide substantiating evidence (assessment data) for each problem identified.
  • Identify and describe at least four medical and/or nursing interventions.
  • Discuss your rationale for the interventions identified.

Prepare this step of the assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.


Sample Solution

Visit with Sallie Mae

From the information provided in the case study, Ms. Fisher has four problems, which are listed in order of priority with the first problem having the highest priority and the last problem the least priority. She has a chronic congestive heart failure. Within the last six months, she has been hospitalized several times due to chronic congestive heart failure. Ms. Fisher also has hypertension. This is portrayed by her blood pressure, which is 90/56. Ms. Fisher also has atrial fibrillation, which is characterized by the fact that she claims to have a cloudy mind. Last but not the least, Ms. Fisher has dyspnea for which she was admitted for three days prior to her discharge on the previous Saturday.

Intervention for CHF

Ms. Fisher should engage in activities that reduce the workload of the heart. The nurse may also provide Ms. Fisher with oxygen to relieve ischemia at a flow rate that is based on the healthcare provider’s policy or Ms. Fisher’s condition. Ms. Fisher should also engage in minimal activities to reduce her activity tolerance to myocardial oxygen demands (Ahmed, 2009).

Intervention for Hypertension

Ms. Fisher should restrict her physical activities. She should rest on the bed or chair. She should also ensure that her environment is quiet. Provision of dietary sodium as required would also help in controlling the condition (Carter, Bosworth & Green, 2012).

Intervention for Atrial Fibrillation

Sallie Mae should analyze the medication that Ms. Fisher is currently taking. From the information provided, it is evident that Ms. Fisher is taking anticoagulants. Therefore, Sallie Mae should analyze the lab values for heparin and prothrombin time.Sallie Mae should also analyze Ms. Fisher’s stability. From the information provided, Ms. Fisher is exhibiting altered mental status. Therefore, Sallie Mae should order for synchronized cardioversion (Stewart et al., 2015).

Intervention for Dyspnea

Intervention for dyspnea would involve the provision of psychological care. This would help in reducing Ms. Fisher’s anxiety. Sally Mae should also ensure that Ms. Fisher’s positioning maximizes her respiratory function while simultaneously reducing her effort. Sally Mae should also ensure that Ms. Fisher engages in breathing exercises. This would enable them know how to control their breathing and reduce discomfort due to dyspnea. Oxygen therapy is also one of the primary interventions for dyspnea. It not only helps in relieving the shortness of breath but also provides psychological benefit to patients (Gordon, 2014).

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