Mrs Bee, a 74 year old woman, was admitted to the ward at 2030 Wednesday evening. She was brought to the hospital by patient transport.
She lives at an assisted living facility with her husband Terry who is non-ambulant, but is her next of kin. She has a mental health history of depression, especially since the death of her daughter 10 years ago. She also has a diagnosis of dementia, which she currently suffers from some forgetfulness at times. Her physical
history includes a left hip replacement 9 months ago, low blood pressure which she is taking medication for, she has recently been diagnosed with reflux and has a top set of dentures.
The staff at the assisted living facility have noted a decline in her mental state over the last 3 days. She has been more irritable, confused, apathetic with periods of agitation and thoughts of the female nursing staff trying to steal her husband.
It is now 1030 Thursday morning and the nurse is about to touch base with Mrs Bee.
Conversation with Mrs Bee:
Setting the scene: Mrs Bee is sitting in the chair of her room in the Hospital. Staring at her hands, hands are fidgeting.
Nurse Sandra: Walks into the room “Good morning, Mrs Bee, how are you today? (Mrs Bee: mumbles) My name is Sandra; I will be your nurse for today. Do you mind if we have a quick chat?”
Mrs Bee: “I suppose that will be okay”
Nurse Sandra: Tell me what has been happening for you Mrs Bee, what has brought you into hospital? Mrs Bee: Well Mary brought me in last night…
Nurse Sandra: Who is Mary?
Mrs Bee: My daughter (Mrs Bee’s daughter has been dead for 10 years) Nurse Sandra: I see, and why did Mary bring you in?
Mrs Bee: She just wanted to get rid of me… the tree outside isn’t nice to me anymore. But you know that! (Mrs Bee throws her hands up in the air)
Nurse Sandra: That doesn’t sound good. Mrs Bee can you tell me what day it is? Mrs Bee: (long pause) Its Monday. (It’s actually Thursday)
Nurse Sandra: Do you know where you are Mrs Bee?
Mrs Bee: At the hospital! (Looks sharply to the left at the wall) Nurse Sandra: How have you been feeling lately Mrs Bee?
Mrs Bee: hmmm, a bit tired… What time is breakfast? Nurse Sandra: Breakfast was at 0830 Mrs Bee. It’s now 1030
Mrs Bee: Oh… (Looks squinty at the Nurse Sandra) Who are you? Nurse Sandra: I’m Sandra, Mrs Bee, I’m your nurse for today…
Mrs Bee: Mary is that you? What happened to you love, you look terrible!
Nurse Sandra: I am Sandra, your nurse for today. Are you feeling yourself today, Mrs Bee?
Mrs Bee: I am quite fine, there is nothing wrong with me! (she stated this quite loudly and firmly)
Nurse Sandra: That’s good Mrs Bee. Can I ask you some questions about your health? (Mrs Bee nods). Thank you. The night nurse has told me that you have been up to the toilet during the night, are you finding that you need to pass urine a lot?
Mrs Bee: I don’t remember getting up, I slept all night (Mrs Bee pressed her call button 8 times overnight wanting to go to the toilet, but was not able to pass much urine. There was an offensive smell when she did pass urine and she did not open her bowels. When the night staff tried to put a pad on her, she became very agitated and distressed)
Nurse Sandra: Ok Mrs Bee. Have you had much to drink today? Mrs Bee: I am not thirsty (Mrs Bee lips look very dry)
Nurse Sandra: Have you used your bowels recently?
Mrs Bee: I must have yes (Mrs Bee doesn’t seem so sure about this) Nurse Sandra: Are you in any pain?
Mrs Bee: since my hip operation a few years back I am always in pain (Mrs Bee has a hip operation 9 months ago and has been using Endone for pain management) I don’t feel right there (gesticulates at abdominal area) It feels so sore… Maybe after breakfast I will feel better … Where is Terry gone, he was right here, God knows where he ends up half the time.
Nurse Sandra: Do you want me to call Terry for you?
Mrs Bee: What business is it of yours where my husband is, he is my husband, you can just get lost (Mrs Bee was quite animated when stating this)
Nurse Sandra: Alright MRs Bee I will go and speak to the Doctors.
Presentation:
After reading the conversation that Nurse Sandra has had with Mrs Bee, please include in a PowerPoint presentation:
- A MSE for Mrs Bee.
- Outline what assessments, (mental health and physical) you would need to complete on Mrs Bee.
- Outline what interventions are needed for Mrs Bee.
- What could Mrs Bee current diagnosis be?
- What interventions would be implemented to resolve this diagnosis?
- What are the goals of care for Mrs Bee?
- Who is going to be involved in the care of Mrs Bee?
Your presentation should be 1500 words (+/- 10%) and will include writing within the PowerPoint and associated notes (submitted as one, in PowerPoint format not pdf). This is to be submitted via email to the examiners.
Your presentation should be 35 minutes duration with an additional 10 minutes allowed for discussion and feedback.
This assignment must be referenced as per APA 6th
