E.J., 72 years old, was admitted to Community Hospital for a left below-knee amputation. E.J. was an

E.J., 72 years old, was admitted to Community Hospital for a
left below-knee amputation. E.J. was an insulin-dependent diabetic for 35
years. The amputation followed a long and unsuccessful period of treatment for
venous stasis ulcers. E.J. was transferred from the hospital to a
rehabilitation hospital on her fourth postoperative day. After 2 weeks at the
rehabilitation hospital, she was transferred to a skilled care facility near
her home for additional restorative care and regulation of the diabetes. She is
now ready to be discharged to her home. E.J. has a prosthesis and is able to
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E.J., 72 years old, was admitted to Community Hospital for a
left below-knee amputation. E.J. was an insulin-dependent diabetic for 35
years. The amputation followed a long and unsuccessful period of treatment for
venous stasis ulcers. E.J. was transferred from the hospital to a
rehabilitation hospital on her fourth postoperative day. After 2 weeks at the
rehabilitation hospital, she was transferred to a skilled care facility near
her home for additional restorative care and regulation of the diabetes. She is
now ready to be discharged to her home. E.J. has a prosthesis and is able to
ambulate with a walker. She performs her ADL with minimal assistance. She was
on a sliding scale and blood glucose monitoring 4 times a day while in the
long-term care facility. Her physician has now placed her on insulin twice a
day with daily blood glucose checks. Her vision is somewhat impaired due to the
diabetes. E.J. lives alone in a one-story home in a sage residential area. The
discharge planner at the skilled care facility has arranged continuing care for
E.J. through a local home health agency.

The following questions guide your development of a nursing
care plan for the case study.

1. Identify the assessment factors that are most important
in planning E.J.’s care.

2. List the nursing diagnoses that are applicable to E.J.’s
assessment.

3. Describe the complications for which E.J. is at risk.

4. Describe nursing interventions for preventing the
complications.

5. What specific actions would you take to prevent a
recurrence of venous stasis ulcers?

6. What additional community services does E.J. need?

7. What nursing services (frequency of nurse visits,
services from a nursing assistant, other home health services) would you plan
to meet her needs? What services would each person provide?

8. Describe the outcomes you expect for E.J.?

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