Scripted Dialogue Portion Utilizes information learned from the home visit, health history, and discharge orders presented in the simulation to develop a patient dialog. Out of 10 points. Dialog addresses physiological, psychosocial, educational, and spiritual needs of the client. Out of 20 points. Sallie Mae Fisher’s Health History and Discharge Orders Sallie Mae Fisher Health History Ms. Fisher is an 82-year-old female with a history of chronic congestive heart failure (CHF), atrial fibrillation, and hypertension. During the last 6 months, she has been hospitalized four times for exacerbation of her CHF. She was discharged home last Saturday from the hospital after a 3-day stay to treat increased dyspnea, an 8-pound weight gain, and chest pain. Ms. Fisher is recently widowed and lives alone. She has a daughter, Thelma Jean, who lives in town but works full time and has family issues of her own. Therefore, family support is limited. Hospital Discharge Instructions Mountain Top Home Health to evaluate cardio-pulmonary status, medication management, and home safety. Medical Equipment Company to deliver oxygen concentrator and instruct patient in use. O 2 at 2 liters per nasal prongs PRN. Prescriptions given at discharge: Digoxin 0.25 mg once a day Lasix 80 mg twice a day Calan 240 mg once a day Order written to continue other home meds. Sallie Mae’s Home Medication List Zocar 50 mg once a day Minipres 1 mg once a day Vasotec 10 mg twice a day Prilosec 20 mg once a day Furosemide 40 mg once a day Effexor 37.5 mg at bedtime Lanoxin 0.125 mg every other day Multivitamin once a day Potassium 40 mEq once a day Ibuprofen 400 mg q 4 hours as needed for pain Darvocet N 100 mg q 4 hours as needed for pain Nitroglycerin ointment, apply 1 inch every day Scripted Dialogue Portion Utilizing the information learned from the home visit, health histories, and discharge orders, write a scripted dialogue in which you provide Sallie Mae with education that describes her problems and the interventions identified to improve her condition. Consider Sallie Mae’s physiological, psychosocial, educational, and spiritual needs when developing your dialogue. Your dialogue should resemble a script. The following is an example of a few sentences from a scripted dialogue: Nurse: “Good morning, Salle Mae, my name is ______ and I will be your nurse today. I understand you are experiencing problems with ________.” APA format is not required for this part of the assignment, but solid academic writing is expected. Refer to “Home Visit With Sallie Mae Fisher Grading Criteria.” Please feel free to ask any questions if you have any.

Nurse: “Good morning, Sallie Mae, my name is Sarah and I will be your nurse today. I understand that you have been recently discharged from the hospital for exacerbation of your congestive heart failure, atrial fibrillation, and hypertension. Can you tell me a bit about how you have been feeling since you’ve been home?”

Sallie Mae: “Well, I’ve been feeling a bit short of breath and my chest has been hurting more than usual.”

Nurse: “I see, that can be a common symptom of your conditions. To help manage these symptoms, we will be working with Mountain Top Home Health to monitor your cardio-pulmonary status and manage your medication. A medical equipment company will also be delivering an oxygen concentrator for you to use as needed. Additionally, we will be continuing your home medications, including Digoxin, Lasix, and Calan, as well as monitoring your potassium levels and continuing to use your nitroglycerin ointment.”

Sallie Mae: “Okay, that all sounds like a lot to keep track of.”
Nurse: “I understand it can be overwhelming, but we will work with you to make sure you understand how to properly use and manage your medications and equipment. We will also be providing education on how to recognize signs of exacerbation and when to seek medical attention. Is there anyone that can Help you with managing all of this, such as a family member or friend?”
Sallie Mae: “My daughter, Thelma Jean, lives in town but she works full time and has family issues of her own, so I’ll be mostly on my own.”
Nurse: “I understand that can be difficult. We will make sure to check in with you regularly and provide you with resources for additional support. Is there anything else you would like to discuss or any questions you have for me?”
Sallie Mae: “No, I think that’s everything for now. Thank you for explaining all of this to me.”
Nurse: “Of course, Sallie Mae. Remember, if you have any questions or concerns, don’t hesitate to reach out to us. We are here to help you manage your conditions and improve your health.”

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