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Instructions : observe the simulated “Home Visit With Sallie Mae Fisher” video (http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php).

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.

Scripted Dialogue Portion

Utilizing the information learned from the home visit, health histories, and discharge orders, write a scripted dialogue in which you provide Sallie Mae with education that describes her problems and the interventions identified to improve her condition. Consider Sallie Mae’s physiological, psychosocial, educational, and spiritual needs when developing your dialogue.

Your dialogue should resemble a script. The following is an example of a few sentences from a scripted dialogue:

Nurse: “Good morning, Salle Mae, my name is ______ and I will be your nurse today. I understand you are experiencing problems with ________.”

APA format is not required for this part of the assignment, but solid academic writing is expected.

Refer to “Home Visit With Sallie Mae Fisher Grading Criteria.”

Sallie Mae Fisher’s Health History  and Discharge Orders

Sallie Mae Fisher Health History

Ms. Fisher is an 82-year-old female with a history of chronic congestive heart failure (CHF), atrial fibrillation, and hypertension. During the last 6 months, she has been hospitalized four times for exacerbation of her CHF. She was discharged home last Saturday from the hospital after a 3-day stay to treat increased dyspnea, an 8-pound weight gain, and chest pain.

Ms. Fisher is recently widowed and lives alone. She has a daughter, Thelma Jean, who lives in town but works full time and has family issues of her own. Therefore, family support is limited.

Hospital Discharge Instructions

• Mountain Top Home Health to evaluate cardio-pulmonary status, medication management, and home safety.
• Medical Equipment Company to deliver oxygen concentrator and instruct patient in use. O₂ at 2 liters per nasal prongs PRN.
• Prescriptions given at discharge:
  • Digoxin 0.25 mg once a day
  • Lasix 80 mg twice a day
  • Calan 240 mg once a day
• Order written to continue other home meds.

Sallie Mae’s Home Medication List

• Zocar 50 mg once a day
• Minipres 1 mg once a day
• Vasotec 10 mg twice a day
• Prilosec 20 mg once a day
• Furosemide 40 mg once a day
• Effexor 37.5 mg at bedtime
• Lanoxin 0.125 mg every other day
• Multivitamin once a day
• Potassium 40 mEq once a day
• Ibuprofen 400 mg q 4 hours as needed for pain
• Darvocet N 100 mg q 4 hours as needed for pain
• Nitroglycerin ointment, apply 1 inch every day