Nursing Care PlanCLIENT CLINICAL PICTUREMr. GB is a 78 year old white male admitted to the Bay Pines VAMC on 06/18/96. for "atypical chest pain and hemoptysis". V/S BP 114/51, P 84, R 24, T 97.4. He appears alert, oriented x 3 and cheerful. Bowel sounds present x 4. Pt. has a red area on tailbone. Treatment with Silvadene was started. Pt. Has a fungal lung infection with a pleural suction drainage tube inserted into the chest. The patient is extremely thin with poor skin firmness with a diagnosis of cachexia (wasting) secondary to malnutrition and infection. The patient has no known drug allergies but is allergic to disinfectant sprays and dust. Advanced folder directives. DNR code status. Primary Physician Dr. R, Thoracic Surgeon Dr. L. Psychology Dr.W. When necessary, PT, OT dietary and infectious disease consultations are carried out. He lives with his wife of 56 years. His son and daughter come to visit him. He doesn't smoke. He wears dentures but didn't wear them. Does not use a hearing aid but has hearing impairment.Pt. is able to perform all of his ADLs with limited assistance. He wants to get better and leave the HSP. Pt. Said 90 days is too long to be here." Pt. Says he's worried about taking care of the tube area when he gets home and doesn't believe his wife can do it for him. Diet: Puree, high in protein , low fat, anti-dumping with calorie counting (all meals) and drink supplements between meals at 79 cc/hour 12 hours a day through the PICC line MEDICAL DIAGNOSTICS: empyema, hemoptysis, necrotizing pneumonia, aspergillosis (Aspergillus fumigatus) cachexia secondary to malnutrition/infection, hypothyroidism, type II diabetes melitium and... half of the document... control The home health aide/nurse must understand this after discharge. OUTCOME/OBJECTIVE STATEMENT: Short term: Patient will verbalize feelings of concern regarding maintaining self with SO at home prior to discharge. Long-term: (After discharge) Patient will work with home health care provider to relieve frustration and avoid further depression. Bibliography: REFERENCES: Brunner, LS & Suddarth, D. S Textbook. of medical-surgical nursing, 1988 6th ed. JB Lippincott Company, PhiladelphiaDoenges, ME & Moorhouse, MF Nursing Care Plans 3rd ed. 1993 FA Davis Company, Philadelphia Fischbach, Frances, A Manual of Laboratory & Diagnostic Tests, 4th ed., JB Lippincott Company, PhiladelphiaLewis, SM & Collier, IC Medical Surgical Nursing, 4th ed. Mosby Company, St. Louis.Mosby Company. Hardcover Folio Drug Views 1994 St. Louis