Theory assignment

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NUR_337_SP18_Week5CaseScenario.pdf

Application of Nursing Theory to Practice

What would _(Place any nurse theorist or theory here)_ do?

Case Study:

Abigail Goldberg is a 46-year-old female who has recently been admitted to the hospital

after falling down the stairs and breaking her ankle. Her ankle has been repaired with an

open reduction and fixation device. Currently she has unable to bear weight on that

extremity. Physical Therapy is working with Mrs. Goldberg to assist her in advancing

her mobility.

While talking to Mrs. Goldberg the nurse finds out that she has been experiencing muscle

weakness in her legs for the last two months. She has a history of scoliosis and believed

the weakness was due to an “alignment” problem. Upon admission Mrs. Goldberg has

bilateral weakness in her lower legs. You are unable to assess her gait due to the fractured

ankle, but she states she has been “unsteady on her feet for the last few weeks”. Upon

further history taking you find out her appetite has diminished over the last three weeks,

she states she is hungry but when she tries to eat she fatigues easily then quickly losses

her appetite. She has lost 10 pounds in the “few” months and now weighs 120lbs. Her

CBC and CMP are within normal limits with the exception of mild anemia with an H&H

of 11.5 and 32.9.

Testing is currently being undertaken for a definitive diagnosis of the weakness that lead

to Mrs. Goldberg’s fall. Her physician strongly believes she experiencing symptoms

common for multiple sclerosis. The physician has shared this with Mrs. Goldberg. The

physician has ordered further blood work to evaluate any elevation in antibodies. The

physician has also ordered a CT scan and a spinal tap to assist with making the final

diagnosis.

Mrs. Goldberg has no other significant medical history. She takes only a multi-vitamin

daily. She has never had surgery. She has three children, all girls, ages 18, 15, and 11.

The girls are very active and rely on Mrs. Goldberg to take them to most of their

extracurricular events. The oldest has just started college and this is the first time any of

her children will live away from home. She has been looking forward to traveling to her

daughter’s college for visits. Her religious preference is Judaism. Her family of origin

practices Conservative Judaism. While Mrs. Goldberg participates in religious holiday

celebrations she does not actively practice Judaism nor does she attend temple regularly.

Mrs. Goldberg has been married 5 years to her second husband and states they have a

“good relationship” but that they “have not been intimate for 2 months” because she has

not been feeling well. Mrs. Goldberg was married to her first husband for 15 years. That

marriage ended in divorce after she discovered her first husband was gay.

When the nurse enters Mrs. Goldberg’s room to discuss the plan for the shift and day the

nurse observes Mrs. Goldberg’s affect to be sad. She states she has not been able to eat.

She verbalizes fear for herself and her family at the possible diagnosis and states to the

nurse ”What did I do to deserve this?’

You are the nurse taking care of Mrs. Goldberg. You must provide care that she needs:

help with ADLs, give her support, and prepare her for her test. Pick a nursing theory that

you have learned about and write how you will use the theory to help guide the nursing

care that you will render to Mrs. Goldberg.