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NUR132 Foundations of Nursing

Question

Answered

Question:

Violet is an 82-year-old female who lives alone since the death of her husband, Stan, 2 years ago.

Violet now lives in a one bed roomed centrally heated flat. She down-sized after Stan died, having previously lived in the same home together for 35 years.

Violet has difficulty managing the stairs to her flat from the entrance – 6 steps with handrail. There is a rear entrance without steps but the path to access her back door is not well-lit and she does not like to use that entrance.

Violet sometimes feels dizzy when standing up. She has had 2 recent falls - one accidental due to tripping over her cat, but she cannot recall the reason for the second fall. Violet has a telecare pendant.

Violet has diagnosed hypertension - sitting BP 136/84 and standing BP 114/62. After 2 minutes her standing BP recovers to 128/76. Pulse 79.

Once standing Violet uses her husbands stick to steady herself when walking.

Trip hazard – There is a rug in front of Violets chair.

Violet sometimes forgets to take her medications (or does not remember if she has taken them). She takes a prescribed statin and two prescribed anti-hypertensives.

Violet wears reading glasses. Sometimes she forgets to take them off when mobilising so her vision can be blurry.

Violets hearing is good and she does not use aids.

Violet enjoys conversation and company and has a good sense of humour.

Violet is aware of some deterioration in her memory. She can find it difficult to recall things and sometimes forgets medications /conversations which she finds frustrating.

Violet does not report any shortness of breath.

Violet is a non-smoker.

When last recorded Violet weighed 8 stone 11 lbs. She has lost 4kgs in last 3 months - 60kgs to 56kgs. Her BMI is 21

Violet says she has a lack of motivation to cook. Her daughter visits twice weekly and brings shopping.

Violet states she drinks 1-1.5 litres fluid (finds it difficult to drink more) and enjoys tea and squash (does not like water on its own). Violet enjoys a weekly Guinness.

Violet usually has cereal/toast breakfast and soup for lunch with main meal early evening - her favourite is steak & kidney pie.

She enjoys a chocolate biscuit and a slice of cake

Violet has top and bottom dentures and cleans these daily herself – they fit well and are not loose. Violets tongue is pink and moist and no signs of any furring or ulcers.

You will discuss this tool in your assessment session.

Violets bowels open every other day (type 4 Bristol stool chart) You will discuss this tool in your assessment session.

Violet experiences occasional stress incontinence and changes pads herself 1-2 times day (daughter purchases these from local supermarket).

Violet can mobilise to the toilet independently but sometimes struggles to get to the bathroom in time.

Violet does this independently but is finding this increasingly difficult (especially her legs and feet). She becomes tried and fatigued and the dexterity in her hands has deteriorated.

Violet uses a stool to sit on when she washes at the sink and a walk-in shower with perch stool. Violet uses E45 for dry skin but finds it difficult to get the lid off the pot.

You will discuss this tool in your assessment session.

Temp 36.8 centigrade. A routine urine sample has been tested – nothing abnormal detected. No other signs of clinical infection. Violet able to adjust clothing/ bed linen independently.

Violets flat is centrally heated and Violet likes to use fan in the summer months. 

Violet lives alone but has difficulty managing stairs to flat from entrance – 6 steps with handrail.

Violet finds it difficult to get up from her chair – sometimes takes up to 3 attempts to do this and sometimes Violet feels dizzy when standing up.

Violet uses her husbands stick to steady herself when walking and does worry about falling/losing her balance.

Violet misses gardening after moving to smaller property.

Daughter (Eve) visits twice weekly usually a Tuesday and Saturday but also manages work and looking after her children.

Violets husband Stan died 2 years ago and Violet feels his loss and misses him greatly. This has exacerbated her feelings of loneliness at times.

Violet has stopped going to church due to fear of falling and wide-open space. She also finds it difficult to stand up and sit down with the congregation during a service.

Violet has lost some of her identify since Stan died and social activity has reduced greatly, including not attending church and feeling part of her community. She feels lonely at times

Violet also is finding it difficult to meet all her personal hygiene needs including using the shower (sometimes she has a full wash using the basin), washing/drying her hair and apply her lipstick/makeup like she used to. Her daughter Eve does Violets hair when she visits and helps with the shower, although Violet feels embarrassed that her daughter has to do this.

Violet has an interrupted sleep pattern and may get up once or twice to go to the toilet and then reads to get back to sleep. Often her mind drifts to Stan and she feels upset and unable then to go back to sleep or wakes early if she does.

Violet talks about Stan dying and says ‘she is not frightened of dying as she will get to be with her Stan’ but would like to enjoy life more whilst she can.  Violet believes in spirituality and life after death and misses her church community - the faith leader has offered to visit Violet at home.

NUR132 Foundations of Nursing

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