Nurse: Good morning, Sallie Mae, my name is Rachel, and I will be your Nurse today. I understand you are not feeling well despite being recently discharged from the hospital, and you are experiencing symptoms such as fatigue, loss of appetite, and generally feeling ill?
Sallie Mae: Good morning, Rachel. Yes, it seems I can't feel better. I don’t feel like eating or doing much for that matter.
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Nurse: It is understandable; the recent months have been pretty tough on you. I was hoping we could spend some time together this morning to talk about your health and the medications you prescribed upon discharge and you know, see how we can best improve your overall health and make you feel better.
Sallie Mae: Sure, we can spend time together. I am starved for company anyway (lightly smiling). I have been rather lonely since Woody passed, while my daughter visits from time to time, she is busy with her own family, and I don't want to bother her with my issues.
Nurse: (Smiling) I am not in a hurry Sallie Mae. I am particularly concerned with your adherence to medication. Some prescribed drugs such as Lasix (furosemide) is supposed to be taken twice a day, and if you are only taking your medicines at night you see you are not adhering to the doctor's instructions?
Sallie Mae: oooh I didn't realize. I often wake up pretty tired, and most times, I only remember to take my medicine when I am about to get in bed at night.
Nurse: It is crucial for you to take your medications per the doctors’ instructions if you want to feel better (Accetta, 2016) . I also believe you are currently taking an overdose of some medicines. You see, the new medication Lasix 80mg twice a day imply that you should not take your old drugs the Lasix 40mg once a day. The same case with the Digoxin which in the new discharge order should be taken 0.25mg once a day as such not necessary for you to take the Lanoxin 0.125mg daily. These overdosages could explain why you have been experiencing a lower heart rate than average (Accetta, 2016) .
Sallie Mae: Nurse, I didn't realize I was repeating medication. I make a point of finishing my dosage as prescribed.
Nurse: That is good. Finishing the dosage is vital for good health. However, you should discontinue taking the previous Laxin 40mg once a day and the Lanoxin 0.125mg, and in fact, the medicine should be disposed of (Accetta, 2016) . I will help you with the organization of the medical cabinet to help you keep track of your medication.
Sallie Mae: Thank you. You are very kind Nurse.
Nurse: You are very welcome. I also highly recommend you make an effort to acquire the 2 litres of oxygen since the lack of enough could be the reason you are exhausted and hasn't had much energy.
Sallie Mae: It just that I did not want to be charged extra, but I guess it is essential.
Nurse: Yes, very important the supplement oxygen will facilitate the reduction in restlessness, fatigue and shortness of breath. I am also concerned about your poor nutritional status. In a mere week, you have lost 14 pounds (Arslantas, Adana, Ergin, Kayar, & Acar, 2015) .
Sallie Mae: It is just that I don't have an appetite, and most days, I don't feel like cooking. Cooking for one is not motivating at all. (Smiling lightly)
Nurse: (Chuckling) I know. But you have to try. Failure to eat is the reason for the weight loss, poor skin turgor and tenting in addition to the bowel problems you are experiencing including lack of bowel movement and the sounds (Lewis, Dirksen, Heitkemper, & Bucher, 2014) . Do you have any friends in the town?
Sallie Mae: I do have a widowed friend.
Nurse: Maybe you should arrange for weekly meals with your friend, and I could also arrange for a home health agency in addition to signing you up for a meal delivery service so that you do not have to cook every time you need a meal.
Sallie Mae: Okay, that is great; the lack of desire to cook is the reason I don't eat. Woody used to motivate me to cook, you know.
Nurse: Okay. I have to leave now. I have another appointment. Don't forget, medications according to the doctor's instructions, try to eat and drink more water and acquire the recommended oxygen.
Sallie Mae: Okay, Thank you, Nurse.
References
Accetta, R. C., (2016). Polypharmacy: Strategies for reducing the consequences of multiple medications. Today's Geriatric Medicine, 9 (3), 24.
Arslantas, H., Adana, F., Ergin, F. A., Kayar, D., & Acar, G. (2015). Loneliness in elderly people, associated factors and its correlation with the quality of life: A field study from western Turkey. Iran Journal of Public Health, 44 (1), 43-50.
Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., & Bucher, L. (2014). Medical-surgical nursing: Assessment and management of clinical problems, 9th edition. St.Louis: MO: Elsevier/Mosby.
