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Advanced Pathophysiology
Competency 724.2.4
Safety, Communication, and Placement for the Older Adult
Darcie M. Walker, RN
February 12, 2013

Part A: Assessment of the Situation:
Mr. Trosack sustained injuries from an accident that occurred while falling down stairs taking out the trash while at his apartment. Upon review of the information given, a case manager would find that discharge to home is uncertain and could cause more problems with a high potential for injury.

One issue that needs to be identified is the probability of Mr. Trosack having a pre morbid self-care deficit. He had expired medications in his cabinet, was unaware of the vitamins he takes daily, and has not been to a physician in ten years for a regular wellness check. He was unaware he had hypertension and non-insulin dependent diabetes. These diagnoses can be asymptomatic, but they would have been found during a routine physical. According to Mr. Trosack, he was in perfect health. Collectively these concerns are showing a lack of self-care, and the ability to doubt if Mr. Trosack will be able to maintain his needs properly after discharge.

Another issue Mr. Trosack is at risk for is medication noncompliance. He has stated that he does not want to take his “darn” medications, but insists that he will be able to care for himself and administer his own prescriptions. The expired medications in his cabinet were previous prescriptions that he was not compliant in finishing, and the fact he isn’t able to verbalize the type of vitamins he is taking shows a high risk for needing education. If he is not provided with the appropriate information, he will be at a very high risk of overdose, or not taking the medication at, all leading to an exacerbation of his current issues with hypertension and non-insulin diabetes.

There is a clear safety risk for Mr. Trosack with several topics. Living in an apartment without elevator access is a large fall risk. His assistive device will be a walker...