J. B.: A Nursing Case Study

Social History

J.B. grew up in rural West Virginia on a small tobacco farm with no running water. They grew their own food, drew their water from a well, and made their own clothes. She left home at the age of 18 and married her first husband. The marriage was not successful, and seven years later they divorced. J.B. remarried and she and her husband became involved in a conservative Baptist church in southern Ohio. They raised three children, while he worked in a metal alloys factory and she operated the church’s daycare center. They both retired early and followed two of their children when they moved out of the area. After moving, her husband had several hospitalizations due to cardiac issues, and since they weren’t old enough to qualify for Medicare, they collected a great number of medical bills. Instead of claiming bankruptcy, they foreclosed on their house, moved to one of their son’s rentals, and

has intermittent pain and weakness in her right knee, she is at risk of falling. To address this concern, an appropriate nursing diagnosis is the risk of falls related to altered mobility from pain and weakness. Subjective data related to the risk of falling are the self-report of seasonal dizziness and intermittent increases in pain and weakness. The objective data that support this diagnosis are her age, unsteady gait and difficulty rising from the chair and low toilet. The desired outcome for J.B. is that she will be free from falls while under my care. Interventions for J.B. include instructing her about the effect of exercise on the progression of osteoarthritis, obtaining a physical therapy order for strengthening exercises, collaborating with her primary care physician to develop a pain medication regimen for times when her pain increases, using cold therapy on her knee during flare-ups, exchanging her non-slip bath strips in the bathtub for a non-slip bath mat, and installing a raised toilet seat (Durham, Fowler, & Edlund,