Susan Frank is a nurse in a home care agency, and she is making her initial visit to a new patient. The patient’s name, Jay Gold, looks familiar, and when she enters his home, she finds she knew him in her former job. Susan had first met Mr. Gold more than a decade ago when she was working on a medical unit at the local community hospital. At that time, Mr. Gold had been admitted to the hospital for diabetes with ketoacidosis. It was at this time that he discovered he had insulin-dependent diabetes. During his initial hospitalization, he was started on insulin and had to learn to care for his diabetes. In the weeks that followed his hospitalization, Mr. Gold returned to the medical unit to see the nurses who cared for him each time he had a visit with his dietitian and diabetes educator. As his diabetes came under control, Mr. Gold returned to his outgoing, energetic baseline. He talked to the nurses about his sales job, his wife, and his two daughters and told them how much he had learned in caring for his disorder.Susan was shocked to see Mr. Gold’s appearance now. He was lying in his bed with his back to her and did not look up when she entered the room. As she spoke to him, she noted that his color was ashen. His voice was soft as he spoke, and he appeared depressed and lethargic. He had had a right above-the-knee amputation (AKA), and Susan noted a large scar on his chest. She reviewed his record and found that Mr. Gold’s diabetes had progressed rapidly and that he had multiple complications. He had had a coronary artery bypass graft (CABG) 2 years ago and was also being monitored for decreased renal function. He had vascular problems and neuropathy, which led to the AKA. The reason for the home visit was that Mr. Gold was found to have osteomyelitis, requiring 6 weeks of intravenous antibiotics.
Mr. Gold is married. He and his wife live in a pleasant, 2-story condo in an upscale community in a quiet retirement area. His two grown daughters are married but visit often. Susan learns that Mr. Gold has not been able to work for a number of years and is relying on Social Security disability and his wife’s part-time job.
1. Select one of the nursing models/theories interactive processes and unitary process, choose one of these that will help Ms. Frank in assessing Mr. Gold and planning for his care. Why did your group select that model?
-Imogene King: King’s Conceptual System and Theory of Goal
Attainment and Transactional Process
-Martha Rogers: The Science of Unitary and Irreducible Human Beings
2. Based on the model selected, what additional information would Susan want to collect/assess?
3. Based on the model selected, how would Ms. Frank initiate a plan of care for Mr. Gold?
4. Do you think that Susan would assess and plan differently for Mr. Gold’s care if she used the theory you did not select for Mr. Gold? Why or why not?
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