1.What nursing interventions might the nurse
implement for this patient?2.What would be a successful outcome for
Mr. Cobbs?3.What intellectual, technical, interpersonal,
and/or ethical/legal competencies are most
likely to bring about the desired outcome?4.What resources might be helpful for
Mr. Cobbs?PATIENT CARE STUDY
Read the following patient care study and use
your nursing process skills to answer the
questions below.
Scenario:Ms. Elgaresta, age 54, a single
Hispanic woman, is being followed by a cardi-
ologist who monitors her arrhythmia. Last
month, she started taking a new heart medica-
tion. At this visit, she says to the nurse practi-
tioner who works with the cardiologist: “Right
after I started taking that medication, I got
terribly constipated, and nothing seems to
help. I’m desperate and about ready to try
dynamite unless you can think of something
else!” She reports a change in her bowel move-
ments from one soft stool daily to one or two
hard stools weekly, stools that cause much
straining. The nurse practitioner realizes thatregulating Ms. Elgaresta’s heart is difficult and
that her best cardiac response to date has been
with the medication that is now causing con-
stipation. Reluctant to suggest substituting
another medication too quickly, she asks more
questions and Ms. Elgaresta responds, “I’ve
never been much of a drinker, 2 cups of coffee
in the morning and maybe a glass of wine at
night. Water? Almost never. And I don’t drink
juices or soft drinks.” Analysis of her diet
reveals a diet low in fiber: “I never was one
much for vegetables, and they can just keep all
this bran stuff that’s out on the market! Coffee
and a cigarette. That’s for me!” Ms. Elgaresta
is a workaholic computer programmer and
spends what little spare time she has watching
TV. She reports tiring after walking one flight
of stairs and says she avoids all forms of vigor-
ous exercise.
1.Identify pertinent patient data by placing a
single underline beneath the objective data in
the case study and a double underline beneath
the subjective data.
2.Complete the Nursing Process Worksheet on
page 261 to develop a three-part diagnostic
statement and related plan of care for this
patient.
3.Write down the patient and personal nursing
strengths you hope to draw upon as you assist
this patient to better health.
Patient strengths:Personal strengths:4.Pretend that you are performing a nursing
assessment of this patient after the plan of
care is implemented. Document your findings.260 UNIT VII PROMOTING HEALTHY PHYSIOLOGIC RESPONSES
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