Clinical Case Studies in Home Health Care

Leslie Neal-Boylan, PhD, RN, CRRN, APRN-BC is a certified family nurse practitioner, rehabilitation nurse, and home health nurse. She developed the Neal Theory of Home Health Nursing and has published and presented widely on issues related to rehabilitation, disability, chronic illness, home health, and nurse workforce. Dr. Neal-Boylan has edited four books, one of which won the American Journal of Nursing Book of the Year Award. She was also the consulting editor for the 2010-2011 edition of the Visiting Nurse Associations of America's Nursing Procedure Manual.

Contributors ix

Preface xiii

Acknowledgments xvii

Section 1 Introduction 3

Chapter 1 Theoretical Frameworks That Support Home Care 5
By Leslie Neal-Boylan, PhD, RN, CRRN, APRN-BC, FNP

Chapter 2 Managing the Complexities of Home Health Care 13
By Mary Curry Narayan, MSN, RN, HHCNS-BC, COS-C

Chapter 3 Transitioning 23
By Jeanie Stoker, MPA, RN, BC

Chapter 4 The Home Visit 33
By Pamela Teenier, RN, BSN, MBA, CHCE, HCS-D, COS-C, and Lelah R. Marzi, RN, MBA, BSN, COS-C, HCS-D

Section 2 Cardiac 43

Case 2.1 Congestive Heart Failure 45
By Jeanie Stoker, MPA, RN, BC

Case 2.2 Atrial Fibrillation 55
By Jeanie Stoker, MPA, RN, BC

Case 2.3 Wound following a Coronary Artery Bypass Graft (CABG) 65
By Jeanie Stoker, MPA, RN, BC

Section 3 Peripheral Vascular Disease 75

Case 3.1 Peripheral Vascular Disease 77
By Linda Royer, PhD, RN

Section 4 Pulmonary 87

Case 4.1 Chronic Obstructive Pulmonary Disease (COPD) 89
By Lisa A. Gorski, MS, HHCNS, BC, CRNI, FAAN

Case 4.2 Pneumonia 99
By Leigh Ann Howard, RN, MSN

Case 4.3 Tuberculosis 107
By Leigh Ann Howard, RN, MSN

Section 5 Gastrointestinal 113

Case 5.1 Stomach Cancer 115
By Sharron E. Guillett, PhD, RN

Case 5.2 Malnutrition/Anemia 123
By Linda Royer, PhD, RN

Section 6 Genitourinary 135

Case 6.1 Neurogenic Bladder 137
By Kathleen Francis, RN, MSN, CWOCN

Case 6.2 Urostomy Care 151
By Kathleen Francis, RN, MSN, CWOCN

Case 6.3 Urinary Tract Infection and Functional Incontinence 163
By Kathleen Francis, RN, MSN, CWOCN

Section 7 Psychiatric/Mental Health 173

Case 7.1 Bipolar Disorder 175
By Joanne DeSanto Iennaco, PhD, PMHCNS-BC, APRN

Case 7.2 Personality Disorders 185
By Debra Riendeau, MN, APRN, BC, PMHNP-BC

Case 7.3 Schizophrenia 195
By Joanne DeSanto Iennaco, PhD, PMHCNS-BC, APRN

Case 7.4 Schizoaffective Disorder 203
By Joanne DeSanto Iennaco, PhD, PMHCNS-BC, APRN

Section 8 Musculoskeletal 215

Case 8.1 Muscular Dystrophy 217
By Sharron E. Guillett, PhD, RN

Case 8.2 Cerebral Palsy 225
By Sharron E. Guillett, PhD, RN

Case 8.3 Osteomyelitis, Decubitus Ulcer, and Paraplegia 235
By Linda Royer, PhD, RN

Section 9 Neurological 247

Case 9.1 Brain Stem Infarct 249
By Shelia Spurlock-White, MSN, RN

Case 9.2 Multiple Sclerosis 259
By Leslie Neal-Boylan, PhD, RN, CRRN, APRN-BC, FNP

Section 10 Maternal Health 267

Case 10.1 Antepartum Care 269
By Ruth Smillie, RN, MSN

Case 10.2 Postpartum Care following Uncomplicated Delivery 281
By Ruth Smillie, RN, MSN

Case 10.3 Postpartum Care following Complicated Delivery 291
By Ruth Smillie, RN, MSN

Section 11 Pediatrics 299

Case 11.1 Premature Infant with Apnea and Reflux 301
By Teresa LaMonica, PhD, MSN, RN, CPNP

Case 11.2 Asthma 311
By Teresa LaMonica, PhD, MSN, RN, CPNP

Case 11.3 Adolescent with Neurodevelopmental Disability 319
By Teresa LaMonica, PhD, MSN, RN, CPNP

Section 12 Pediatric Intensive Care 329

Case 12.1 Alpha-Thalassemia X-Linked Mental Retardation Syndrome 331
By Lannette Johnston, RN, BSN, MS, CPST

Case 12.2 Anoxic Brain Damage/Achondroplasia 341
By Lannette Johnston, RN, BSN, MS, CPST

Case 12.3 Cerebral Palsy/Acute Respiratory Failure 353
By Lannette Johnston, RN, BSN, MS, CPST

Section 13 Infectious Disease 365

Case 13.1 Clostridium difficile-Associated Disease (CDAD) 367
By Debra Riendeau, MN, APRN, BC, PMHNP-BC

Case 13.2 Community-Associated, Methicillin-Resistant Staphylococcus aureus (MRSA) 377
By Debra Riendeau, MN, APRN, BC, PMHNP-BC

Case 13.3 Influenza 387
By Sharon D. Martin, RN, MSN, PhD(c)

Section 14 Endocrine 399

Case 14.1 Diabetes Mellitus Type 1 401
By Caryl Ann O’Reilly, CNS, CDE, MBA

Case 14.2 Diabetes Mellitus Type 2 411
By Caryl Ann O’Reilly, CNS, CDE, MBA

Section 15 End-of-Life Care 421

Case 15.1 Grief 423
By Debra Riendeau, MN, APRN, BC, PMHNP-BC

Case 15.2 Palliative Care 437
By Susan Breakwell, APHN-BC, DNP

Case 15.3 Hospice 447
By Susan Breakwell, APHN-BC, DNP

Case 15.4 Amyotrophic Lateral Sclerosis 459
By Susan Breakwell, APHN-BC, DNP

Index 467