Course Project Case Study: Mrs. Davis is a 78-year-old Caucasian resident of a long-term care facility. She shares a private room with her husband of 50 years who also resides at the facility. Her husband is receiving hospice care and has a medical diagnosis of advanced dementia and type 1 diabetes. She has a past medical history of vascular dementia, dysphagia, CVA, asthma, and acute viral bronchitis. She is considered obese and has a current stage III pressure ulcer to her sacrum. She has right sided weakness following the stroke. She transfers using a Hoyer lift. Lately, she has a poor appetite and is refusing to get out of bed.Orders include:Do not resuscitateUp to chair as toleratedEnsure high protein shake BIDMechanical soft, nectar thick liquidsAFO to RLE on in AM, off at HSOT consult for R arm brace/splintPerform AROM and PROM q shiftNegative Pressure Wound Therapy to sacral wound at 125mmHg continuousChange dressing three times weekly and PRNNotify physician for wound drainage >100 mL in one hourMedications Include:Hydrocodone 5/325 q 6 hours for moderate to severe painDocusate sodium 100 mg daily PRNClonidine 0.1 mg PO TIDMetoprolol 25 mg PO dailyAspirin 81mg PO dailyAlbuterol inhaler: 180 mcg (2 puffs) every 6 hours PRN
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