Please add links to the references provided and also answer the questions based on the rubrics and the instructions uploadeClient Profile
Ronald Sherbino is a 73 year old male. Recently widowed fromhis wife of 52 years. He has one son who lives close by and a daughter wholives in Vancouver. He was diagnosed 3 years ago with diabetes which prior tohis wifes passing was well controlled. He also suffers from chronic pain aftera knee replacement in 2017. He lives alone in the family home and does not havevisitors often due to the social distancing advisement and his sons workschedule. He visits the Emergency Department on the urging of his son who isworried about his welfare after stopping in to check on him and finding himconfused and disheveled. The son reports that his dad had not been acting likehimself on the phone and has discovered he has not filled his prescriptions inover a month. Ronald is admitted to the general medicine department to get hisblood sugars under control.
Case Study
Ronalds initial presentation to the ED revealed a bloodglucose level of 26 mmol/L and he was positive for ketones. Confused to dateand place. After a 5 day admission Ronalds blood sugars have stabilized anddischarge planning has begun. During ahealth teaching session about a new insulin that has been added to his regimeRonald discloses I dont see the point in learning this. Im going to stopchecking my blood sugars when I get home. I just want to die. Later on in theday Ronald asks the RPN administering his evening insulin how much insulinwould it take to put me in a coma? The nurse asks if he has thoughts ofharming himself. Ronald replies that he doesnt want to manage his life aloneand states next time he wont answer the phone when his son calls. He alsoexpresses anger towards his son for taking him to the hospital. Chris, Mr.Sherbinos son, is extremely upset when talking with the nurses expressing guiltthat he didnt realize his dad wasnt doing well sooner and that he should havemade him move into his home when his mother passed.
Additional Information
Patient Data: 73years old, height 179 cm, weight 75 kg
Signs and Symptoms: Concerning statements about potential self-harm,suicidal ideation
Allergies: NKDA
Medication: Humalog 10 u subcutaneous AC TID, Lantus 12 u subcutaneousQHS, ASA 81 mg PO OD, Ramipril 5 mg PO OD, Tylenol ES 500 mg PO BID PRN forpain
Past medical history: HTN, DM, Left knee replacement
Diet restrictions: Diabetic diet with reduced sodium
Events Preceding: Recent death of spouse, Diagnosis ofdiabetes1.
Discuss 4 factorsthat place Ronald at risk for developing a mental illness.
2. List 3 prioritynursing assessments. Why are each ofthese important?
3. List 3 prioritynursing interventions. Why are each ofthese important?
4. Discuss howtherapeutic communication will help the nurse care for Ronald and his family?
5. Provide 3 examplesof how the nurse will employ therapeutic communication skills when caring forRonald and his family.
*Please note examplerequires the discussion of a concrete application rather than simply listing a technique.
6. Does Ronaldsbehavior warrant involuntary admission to the hospital? Why or why not?
7. Discuss threelegal/ethical considerations related to this case.
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