Case Study 2-1
Simone Walker
Lakeview College of Nursing
Nursing of the Gerontological Client
January 15, 2012

1. What might you suspect about Mrs. Johnson’s financial situation?
    Mrs. Johnson is African American, widowed, does not have any children, and she lives alone. These are all the factors that lead me to believe that she lives below poverty line. “Older people who lived alone had higher poverty rates than those who lived with their spouse” (Mauk, 2010, pg. 31). “The median personal income for African American men $14,960, and $9,884 for African American women, compared to $21,102 for all elderly men and $12,080 for all elderly women” (Mauk, 2010, pg.32). 
2. What might you suspect about Mrs. Johnson’s home situation?
     Mrs. Johnson home situation is not very stable. She does not have any immediate family to look after her. She may be very lonely and depressed because she does not have anyone around to talk to or keep her company. She does not have anyone making sure that she is taking her medications or helping her with the activities of daily living. Her neighbors make sure that she is okay and has food, but she needs more than that. For instance, she needs a home health aide who can help her with activities of daily living and a nurse who can make sure that she is compliant with taking her medications. 
3. How might these factors contribute to her hospital admission? 
    Well, having someone who brings you groceries and making sure you are okay is good. For Mrs. Johnson, she needs more than just that because she has congestive heart failure and is taking medication to help manage it. Mrs. Johnson does not have people making sure that she is taking her medications or if she is following up with her doctor/specialist about her congestive heart failure. Especially, to see if she develops any new diseases/disorders or has any other complications that has developed from her congestive heart failure.
4. Based upon your suspicions, what questions might you ask Mrs. Johnson as you admit her to   
    your unit?
     When was she diagnose with congestive heart failure? When was the last time she has seen her doctor? Has she been taking her medications? Is she taking any other medications over the counter, vitamins, herbal? Having any pain anywhere? Is she having any other problems like coughing, nocturia, etc? What does she like to do? How long has she had shortness of breath? “Patients with heart failure may be short of breath from fluid accumulation in the pulmonary bed” (Jensen, 2011, pg. 498). 

References
Jensen, S. (2011). Nursing Health Assessment: A Best Practice Approach (pg. 498).  
	Philadelphia, PA. Lippincott Williams & Wilkins.
Mauk, K.L. (2010). Gerontological Nursing: Competencies for Care (pg. 31-32). Sudbury, MA.
	Jones and Bartlett Publishers.