Describe the major health concerns of this woman and what role the community health nurse might play in this situation?

A 65-year-old woman with arthritis, diabetes and hypertension. Recently, she was discharged from hospital following a stroke. In your role as a nurse in community health, you would need to evaluate her level of function and assess whether she is able to effectively manage chronic conditions at home. Nurses should evaluate any cognitive or physical limitations which may hinder self-care, such as taking medication, adhering to diet and fitness regimens or basic hygiene. She can educate her on how to better manage diabetes and hypertension to lower the risk of further stroke-related complications.

The nurse may also be able identify resources in the community that can help manage this condition at home. These include meal delivery services and transportation to medical 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.