Barack Obama

Patient Profile Male African American, Irish, and English 56 years old 70 inches tall 84.1 Kilograms Married President of the United States

Patient Summary Admitting diagnosis: C/O pain in lower back and when the patient urinates. Surgical interventions: Perform and ultrasound, blood draw, and extracorporeal shock therapy.

Patient Summary (cont.) History of Present Health Concern: Smoker, and poor nutritional diet Past Health History: Allergic reaction to Pen. G causing hives

Diagnosis/Orders Kidney Stones (Renal Calculi) Encourage fluids Reduce sodium and animal protein from diet Collect and strain urine Send to lab www.niddk.nih.gov/health-information/health-topics/urologic-disease/kidney-stones-in-adults/Pages/facts.

Nursing Diagnosis Activity Intolerance related to pain AEB reported a pain level of 7/10 on numeric pain scale. Dressing self-care deficit related to pain AEB inability to bend and move comfortably. Impaired physical mobility related to pain AEB the limited range of movement comfortably.

Patient Outcome/Goal Allow the patient to bathe himself while avoiding abdominal pain or further injury and to intervene if the patient needs assistance or does not do a sufficient job alone.

Nursing Interventions Administer pain medication before activity(bath). Gather all appropriate equipment before beginning (including hygienic products). Prepare appropriate equipment if patient becomes unstable/unbalanced.

Rationales Provide pain relief measures, such as ice packs, heat, and analgesics for sore joints 45 minutes before bathing; move extremities slowly and carefully; and inform the client before movements associated with pain occur (Ackley, 678). To minimize pain before bath. Consider environmental and human factors that may limit bathing ability, such as bending to get into the tub, reaching for bathing items, grasping faucets, and lifting oneself. Adapt environment by placing items within easy reach, installing grab bars, lowering faucets, and using a handheld shower (Ackley, 678). To minimize risk of fall/injury and maintain comfort. Ackley, Betty J., Gail Ladwig. Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care, 10th Edition. Mosby, 2014. VitalBook file.

Evaluation Goal was met! The patient was properly bathed and experienced tolerable pain.

Day 2 Today you are assigned to Mr. Obama again and he is having difficulty with urination. He feels like hi bladder is full, but only dribbles when voiding. What is your priority nursing diagnosis? Write a care plan based on your diagnosis?

References Ackley, Betty J., Gail Ladwig. Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care, 10th Edition. Mosby, 2014. VitalBook file. Rodgers, G. P. (2013). What i need to know about kidney stones. National institute of diabetes and digestive and kidney diease. Retrieved from www.niddk.nih.gov/health-information/health-topics/urologic-disease/kidney-stones-in-adults/Pages/facts.