Sallie Mae Fisher: Home Visit Analysis and Intervention Strategies

This report details a simulated home visit with Sallie Mae Fisher, an 82-year-old female with a history of chronic congestive heart failure (CHF), atrial fibrillation, and hypertension, who was recently widowed. The report analyzes the nurse's interaction with Sallie Mae, identifying key problems such as medication non-compliance, psychosocial distress related to her husband's death, and nutritional concerns. The report includes evidence-based nursing interventions to address these issues, such as the use of a pillbox for medication management, regular home visits to provide emotional support, and encouraging adequate food and fluid intake. The dialogue between the nurse and Sallie Mae is presented, highlighting the patient's needs and the nurse's approach to providing holistic care, encompassing physiological, psychosocial, educational, and spiritual needs. The report emphasizes the importance of drug compliance and addresses the patient's weight loss and dehydration, which are potential complications of her condition. The nurse's recommendations and the patient's response are discussed, emphasizing the significance of patient education and support in managing chronic conditions.

Nurse: Good morning Salle MAE, I am….and I will be your nurse for today. I understand that
you are having some difficulties dealing with the loss of your husband in addition to your
medical conditions? I am here to help you through it and to provide you with answers to all your
questions.
Sallie Mae: Yes, since the death of my husband I don’t care anymore.
Nurse: I understand. It is normal to feel lonely after being together for that long. How about we
discuss that?
Sallie Mae: Woody was my soul mate. His death really crushed me and I miss him so much. We
were married a long time. 59 years to be exact. I feel so lonely without him.
Nurse: It must be very hard for you all alone. I plan to make home visits here more often to ease
the loneliness if you would like that Sallie. I believe it helps to have someone to talk to
and I would like to be that person for you. How do you feel about that?
Salle Mae: Oh, that would be really wonderful. Thank you so much Nurse.
Nurse: I would also like to talk to you about drug compliance. With these many prescriptions it
can be hard to keep up with your medication, especially now that you are alone most of
the time.
Salle Mae: Ah, yes. The drugs are too many and I must admit, sometimes it slips my mind. I
forget what time is for what medication. My daughter also forgets to fill out my
prescriptions. She is very busy sometimes with her child and her full-time job.
Nurse: I understand Sallie. That is why I want to talk to you about the importance of drug
compliance and suggest a way of ensuring you take all your prescriptions at the right
time.
Sallie Mae: Alright. I think that should help.
Nurse: With the many drugs you are supposed to take, there is high risk for drug reactions and
side effects, especially at your age. It is important to ensure you take all the drugs that are
prescribed in order to treat your congestive heart failure and minimize the risk of
complications. I see that you have been admitted several times for deterioration of your
CHF?
Sallie Mae: Yes. I have been hospitalized four times. Recently I also stayed at the hospital for
three days because I couldn’t breath and my chest was in pain.
Nurse: Yes, these are some of the complications that can occur when you do not take all your
prescriptions as prescribed. I would recommend the use of a seven-day pill box as a
memory aid to help you remember when to take which medication. It very affordable and
easy to use. You can also call the hospital incase you have any questions about your
prescriptions and refills. Is this okay Sallie?

Sallie Mae: Yes nurse, the pill box would be very helpful especially since my daughter is rarely
around to remind me.
Nurse: Okay Sallie. I would also like you to ensure you take enough food. You have lost so
much weight which is a cause for concern. It is important to your health that you take
enough food and drink enough fluids. Your previous assessment shows that you are
dehydrated. This puts you at risk of electrolytes imbalance which is not good for your
health. Please ensure that you take fluids as much as you can. This will greatly improve
your health. Do you understand?
Sallie Mae: Yes, I understand. I admit, I have a bit lax in taking food and fluids.
Nurse: It is good that you understand Sallie. I am happy that we are in agreement. Do you have
any questions for me?
Sallie Mae: I feel much better after your visit. Where do I get the pill box for my drugs? I would
like to purchase it as soon as possible. I am very thankful for you taking your time to see
me nurse.
Nurse: That is okay Sallie. I am here for the betterment of your health. The pillbox can be
purchased on any pharmacy in the city. I want you to give me feedback after you use it. If
any problems ensure with its use you can always call me. Do not forget to eat
well and take your fluids Sallie. It is important.
Sallie Mae: I will nurse. Thank you