541➤ CLINICAL EXAMPLE
Martha Smith, a 79-year-old widow with Alzheimer’s disease, was admitted to
a nursing home. The disease has progressed over the past 4 years to the point
that she can no longer live alone in her own house. Martha has poor judgment
and no short-term memory. She had stopped paying bills, preparing meals, and
cleaning her home. She had become increasingly suspicious of her visiting nurse
and home health aide, finally refusing to allow them in the house.
Following her arrival at the facility, Martha has been sleeping poorly and fre-
quently wanders from her room in the middle of the night. She seems agitated
and afraid in the dining room at mealtimes, is eating very little, and has lost
weight. If left alone, Martha would wear the same clothing day and night and
would not attend to her personal hygiene.
- What additional assessments would the nurse want to make to plan care
for this client? - What nursing diagnoses would the nurse identify for this client?