Case Study Mr. Johnson

Ackley: Nursing Diagnosis Handbook, 9th Edition

Case Study – Mr. Johnson (Renal Failure)

Case Studies

Case Scenario

“I’m exhausted. How much do I have to give? It isn’t fair.” Mr. Johnson’s daughter sighed and looked over at her father.

You are admitting Mr. Johnson to the med-surg unit where you work as a staff nurse. He is a 77-year-old patient who was admitted to the hospital with a diagnosis of new-onset renal failure. At his side are his frail elderly wife, who has been ill for years, and his only daughter.

The daughter looks exhausted. She is a teacher and has two children, ages 7 and 11. She has been caring for both her parents in their home for 8 months. The daughter does all of the cooking and laundry for both families. She sleeps in the same room with her parents every night because her father is restless at night and gets up. He has fallen before, and her mother does not hear him when he calls.

The daughter explains that her husband is angry because she spends so much time with her parents. She would like to stop working, but it is not possible financially, and she is worried that she is not spending sufficient time with her own children. Her home is no longer as clean as she would like; her parents’ home is no longer clean.

As you listen to the daughter you notice she has black circles under her eyes. “”I’m at the end of my rope,” she tells you. Her shoulders are slumped. When you talk with the daughter about hiring some help to care for her parents, she says, “No, no, it is my responsibility.” You feel the tension that the daughter is under and her fear.

Nursing Assessment

Mr. Johnson is a 77-year-old man who was admitted to the medical unit with a diagnosis of renal failure. He had been hospitalized previously with the medical diagnosis of cerebrovascular accident. Mr. Johnson has minimal ability to speak and does not appear aware of what is happening.

Admission information is needed. Mr. Johnson’s wife is unable to help with this...