Jacinta is a 60-year-old Hispanic patient admitted to the hospital with congestive heart failure. The nurse notes that the patient has not eaten any of the food brought to her from the hospital's kitchen for breakfast or lunch. When the patient's family visits they provide her with flour tortillas, beans and rice, which the patient eats without hesitation.

1. What factors may be affecting the patient's eating behaviors during her hospital stay? (Discuss developmental, social, cultural, and/or religious factors that may affect nutritional status while in the hospital).

Mildred, 65 years old, is brought to the clinic by her son. He reports that his mother has had a gradual but progressive worsening in behavior over the last 6 months. Mildred has a past medical history of congestive heart failure, but she has been socially active and able to maintain her home without much help from family. She is taking digoxin daily; her digoxin level is normal. Her son states that lately, "she doesn't keep the house clean and most days she isn't dressing herself." When he mentions bathing, Mildred protests that she does not need a bath. She has had some weight loss, and her clothes are becoming too large. She has not been cooking or attending her weekly bridge game as before. The son mentions he is very concerned, because he works full time and there is no other family nearby to assist his mother.

2. Discuss assessment data that suggests altered mental health in this patient. What further questions would you ask Mildred or her son to clarify their needs for resources or access to further care?