According to Treas, et Al. (2019), the full-spectrum nursing model contains the steps of Assessment,
Diagnosis, Planning Outcomes, Planning Interventions, Implementation, and Evaluation. The situation warrants
further investigation, but my initial assessment is that Mrs. Pender is Mr. Pender’s caretaker and he’s suffering
some dementia-like cognitive decline. Mrs. Pender is likely in a hurry to get home so that she can care for her
husband, even though that may come at the risk of her own recovery. This is evidenced by the fact that Mr.
Pender quickly forgot who you were and that Mrs. Pender felt the need to feed him herself, even from her own
meal. This hypothesis explains why she’s in such a rush to get fully ambulatory again and is likely concerned if
she relies on pain medication it may slow her recovery, and thus, her discharge plan. Given this assessment,
my NANDA-I nursing diagnosis is Caregiver Role Strain (Ladwig, et Al., 2020).
As Mrs. Pender’s RN, she is my first priority. However, as a healthcare provider, I cannot ethically leave Mr.
Pender without the care he needs to be safe. I suspect the best way to care for Mrs. Pender is to ensure Mr.
Pender is also taken care of. My planned outcome would be for Mr. Pender to get the care he needs without
jeopardizing Mrs. Pender’s recovery. I would set a specific nursing goal related to the pain control and
ambulation trials of Mrs. Pender that involves appropriate levels of ambulation for her stage of recovery. The
fine details of these goals would depend on specifics not available to us in this exercise, such as what Mrs.
Pender’s injury is, her prognosis, and other health issues she may have.
Since some hospitals may allow family members to stay overnight, my initial intervention plan is to arrange for
Mr. Pender to stay in Mrs. Pender’s room if it is safe for all parties to do so. Food service staff could provide
meals for both of the Penders if Mr. Pender isn’t able to safely get food from the cafeteria himself. This would
allow Mrs. Pender to look after her husband without rushing her own recovery. If this isn’t an option at my
facility, looking for family or friends that could stay with Mr. Pender and watch over him should give Mrs.
Pender the peace of mind to turn her energy towards caring for herself, although she might still try to hurry
things more than her care team would see as ideal if she exhibits the ‘preoccupation with care routine’
characteristic (Ladwig, et Al., 2020). If neither option is feasible for this exact situation, or if I needed help with
the specifics of planning or implementation of my plan, I would involve a social worker or hospital administrator
to assist me in establishing appropriate care for both of the Penders.
I would closely evaluate the effectiveness of my interventions in their success towards my goals because it is
vitally important that an effective plan is made to make sure Mr. Pender is safe for his own sake, but also to
make sure that Mrs. Pender does not make a rash decision such as leaving against medical advice before it is
safe for her to do so. Doing so could be a serious risk to her health and would also indirectly risk Mr. Pender’s
safety as well. After evaluation of my interventions, I would assess the need for changes and continue the
cycle.
References:
Ladwig, G. B., Ackley, B. J., Flynn Makic, M. B., Martinez-Kratz, M., & Zanotti, M. (2020). Mosby’s Guide to
Nursing Diagnosis (6th ed.). Elsevier.
Treas, L. S., Wilkinson, J. M., Barnett, K. L., & Smith, M. H. (2019). Basic Nursing: Thinking, Doing, and
Caring. (2nd ed.). F. A. Davis.
LAURA MARIE MALDONADO
12:17amJul 16 at 12:17am
Manage Discussion Entry
Well, my first thought is Alzheimer's or dementia. You just introduced yourself to Mr. Pender and he already
does not recognize you and she is caring for him. I can see from that moment Mrs. Pender is ready to go home
and take care of her husband. She is an elderly woman who is in pain and trying to rush her healing process.
She will not take any pain medication at this point I think out of fear it will hinder her healing process. Mrs.
Pender is not worried about herself, she is trying to get home to take care of her sick husband who needs her.
She knows with his memory lapse he can not take proper care of himself. My next step would be counseling
Mrs. Pender regarding the pain medication and what her fear of the medication is. I want her to know she will
not be able to go home until she has properly healed and it is safe to do so. I would talk to her about family or
friends who can help take care of Mr. Pender while she is here. I think knowing someone is there helping him
will help her relax and focus on doing the right thing to heal the correct way . Mrs. Pender is an elderly lady she
should be spoken to with concern and love for the well being of her husband just as she does so she knows
you care and want to help. I would discuss what I have observed with the physician and social worker to try
and get Mrs. PEnder the best help we possibly could until she can be safely discharged home.
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