Mr. Mendez is a 67-year-old man who

Mr. Mendez is a 67-year-old man who is being seen in hospital for Thalamic infarction. He has right side weakness, had BM incontinent. Vital signs (VS) at this visit are 116/66, 95, 18, 97.5° F (36.4° C). He had a CBC and complete metabolic panel (CMP) completed 1 week before his visit, and the results are listed below. Laboratory Test Results : Sodium —————————————————— 140 mEq/L Potassium ————————————————– 4.2 mEq/L Chloride —————————————————– 100 mEq/L Bicarbonate ———————————————— 26 mEq/L BUN ———————————————————- 18 mg/dL Creatinine ————————————————— 0.8 mg/dL Glucose —————————————————— 94 mg/dL RBC ———————————————————– 5.2 million/mm3 WBC ———————————————————– 7400/mm3 Hgb ————————————————————- 15.2 Hct ————————————————————– 40.5 Platelets ——————————————————- 155 INR ————————- 1.3 Patient resting comfortably bed upon examination this AM. Denies any issues overnight. Patient reports eating/drinking without issueand states he had a BM in last 24hr. Patient intermittently tachycadic over last 48hr w/ stable BP- in NAD, denies symptoms. Will continue to moitor and reconsult cardiology PRN. medication scheduled atorvastatin (lipitor) table 80mg empagliflozin (jardiance) table 10 mg heparlin injection 5000 unit losartan (cozar) table 25 mg magnesium gluconate tabs 500mg netoprololl succinate er (toprol) xl 50 mg spironolactone (aldactone) table 25 mg PRN acetaminophen (tylenol) table 650 mg bisacodly (dylcolax) suppository 10 mg gadodiamide (omniscan) injetion 9.9 mmol 1. Make the concept map -Based on the clinical data you have collected, begin a concept map care plan by developing a basic skeleton diagram of the reasons your patient needs health care. -Write the patient’s reason for seeking health care or hospitalization (usually a medical diagnosis). -Around this central diagnosis, arrange general problems that represent your patient’s responses to this reason for seeking health care (usually the medical diagnosis). -Draw lines between nursing diagnoses to indicate relationships. 2. Formulate TWO nursing diagnosis with its complete components -Assessment- subjective and objective -Nursing Diagnosis- what related to what as evidenced by -Goal of care- use SMART FORMAT -Nursing interventions- independent, dependent, interdependent, -Patient response -Nursing evalution- goal met/ goal partial met/ goal unmet

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