TASK 42 You are a registered nurse working at Newtown Community Hospital. Your patient, Ms. Mary Bell, is being discharged today. Patient: Mary Bell (Ms.) Age : 66 Years
Marital status : Single Family : Nil
First admitted : 24 June 2017, Newtown Community Hospital Discharge : 15 July 2017
Diagnosis : Unstable diabetes mellitus.
Small infected (left) foot ulcer
Medical history : Non-insulin-dependent diabetes mellitus -15 years.
Medications : Glibenclamide (Glimel) 5mg daily.
Metformin (Diabex) 850mg t.d.s. Amoxycillin/clavulanate (Augmentin Duo Forte) 875/125mg orally, b.d.
Social/family background: Retired at 65 from managerial position 2016.
Lives alone in own four bedroom home.
Income: small pension – much lower than pre-retirement income.
Reports no relatives or close friends. Reports no outside interests.
Since retirement alcohol intake has increased and dietary quality has decreased.
Periodic problems with self-administration of hypoglycaemic medication.
Nursing management and progress: Medical hypoglycaemic agent (glibenclamide) to continue Antibiotic therapy (Augmentin Duo Forte) for review at completion of current course. Ulcer daily saline dressing, monitor wound margins, observe for signs of complications, review healing progress, etc.
Discharge plan: Monitor medication compliance, blood sugar levels, alcohol intake, diet. Encourage moderate exercise programme. Suggest establishment of income-producing activity Encourage establishment of social activities. Prepare a letter to the community nurse, emphasising the need for an overall life- style plan, and suggesting involvement of community social worker service.
Writing Task: Using the information given in the case notes, write a letter of discharge to Ms. Jane Rudik, the community nurse at Newtown, Community Health Centre, informing her about the patient’s condition and her medical and social needs, Address your letter to Ms. Jane Rudik, Community Nurse, Newtown Community Health Centre, Newtown
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