Ase Study

Course Project Case Study: Mrs. Davis is a 78-year-old Caucasian resident of a long-term care facility.  She shares a private room with her husband of 50 years who also resides at the facility.  Her husband is receiving hospice care and has a medical diagnosis of advanced dementia and type 1 diabetes.  She has a past medical history of vascular dementia, dysphagia, CVA, asthma, and acute viral bronchitis.  She is considered obese and has a current stage III pressure ulcer to her sacrum.  She has right sided weakness following the stroke.  She transfers using a Hoyer lift.  Lately, she has a poor appetite and is refusing to get out of bed.

Orders include:

  • Do not resuscitate
  • Up to chair as tolerated
  • Ensure high protein shake BID
  • Mechanical soft, nectar thick liquids
  • AFO to RLE on in AM, off at HS
  • OT consult for R arm brace/splint
  • Perform AROM and PROM q shift
  • Negative Pressure Wound Therapy to sacral wound at 125mmHg continuous
  • Change dressing three times weekly and PRN
  • Notify physician for wound drainage >100 mL in one hour

Medications Include:

  • Hydrocodone 5/325 q 6 hours for moderate to severe pain
  • Docusate sodium 100 mg daily PRN
  • Clonidine 0.1 mg PO TID
  • Metoprolol 25 mg PO daily
  • Aspirin 81mg PO daily
  • Albuterol inhaler: 180 mcg (2 puffs) every 6 hours PRN

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