Patient Medical History Assessment

Question DescriptionOlder Adult Simulation Scenarios. In order to get the most out of the experience, please make sure to read all of the scenarios so that you are familiar with the patients that you will be caring for.Please write out your responses and submit to the simulation faculty at the start of the simulation experience:What considerations from the patient’s history could have an impact in the plan of care for these patients?Consider the assessment tools that you learned about in the classroom; which would be applicable in the scenarios and explain why? Review SPICES, PAIN AD and the Confusion Assessment Method (CAM) tools.Background for Scenario 1:Lucy is an 80 year old female admitted three days ago after sustaining a left femoral neck hip fracture from a fall at home. She lives alone and reported that she was going outside to grab the mail when her legs gave out. Neighbors witnessed the fall and called 911. Upon arrival to the Emergency Department she was in a lot of pain and unable to bear weight on the left side. During the fall she also sustained an abrasion to the left elbow and forearm. She was admitted under Dr. Spencer from Orthopaedic surgery who repaired the hip with a total hip arthroplasty two days ago. Lucy has a medical history of HTN, CAD, HF, Osteoarthritis and early onset dementia. She is 5’3’’ and weighed 145 pounds on admission. She has an allergy to Penicillin and MorphineBackground for Scenario 2Harold is a 73 year old male admitted two days ago with hyperglycemia; his blood sugar was 480mg/dl on arrival. He lives alone, but was complaining to a family member over the phone that he felt lightheaded and weak, so they called 911. Paramedics brought him to the closest ED, but since his primary care provider is not associated with our hospital, his admitting physician is Dr. Shah. He was initially admitted to the ICU and put on an insulin drip, but has been transitioned to subcutaneous insulin and transferred to our medical surgical floor yesterday afternoon. Harold has a medical history of Type II DM, retinopathy, peripheral neuropathy, HTN, osteoarthritis and an appendectomy when he was 23. He is 5’9’’ and weighed 215 pounds yesterday. He has no allergies to medication..Background for Scenario 3Emily is an 80-year-old female being admitted thru the emergency department with a diagnosis of rule out urinary tract infection.She lives at home with her son who called 911 because the patient had become more lethargic and confused over the past 2 days.Emily has a history of a left –sided mastectomy with left axillary node dissection 10 years ago and lymphedema to her left arm.She also has a history of dementia with episodes of delirium during past hospitalizations.Emily is 5’6” tall and weighs 102 pounds.She is alert to person but is disoriented to place and time.Her lungs sounds were clear and she cannot remember the last time she had a bowel movement.

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