The woman in question is 65 years old and has diabetes, hypertension, arthritis. After suffering a stroke, she was recently discharged from hospital. It is important that she be assessed as a community nurse and her ability to manage chronic conditions at home. A nurse must assess any limitations in cognitive and physical functioning that could hinder self-care, such as medication management, diet and exercise routines or basic hygiene. To reduce the risk of complications from her stroke, the nurse will be able to provide information on lifestyle changes that can help control diabetes and hypertension.
A nurse can also assist the woman in identifying community resources that could help her manage these conditions at home. These include meal delivery and transportation for appointments. Additionally, the nurse can work together with other healthcare providers involved in this woman’s care (e.g., primary care provider) so that a comprehensive plan of action is developed tailored specifically to meet the needs of this particular patient holistically.