Plan nursing care for patients with complex co-morbidities demonstrating rationale for how one affects the other.
CASE STUDY REPORT
Case Study Report: Length: 2000 Words
Case Study for Part A
Angela is a 69 year old lady who was born in England and moved to Australia when she was 14 with her family. She is married and lives with her 74 year old husband, and has three daughters who live close by, and has seven grandchildren that she helps care for when her daughters work.
Angela has a 24 pack per year history of smoking and has been diagnosed with Chronic Obstructive Pulmonary Disease (COPD), with an FEV1/FVC ratio of 52%. She quit smoking 6 years ago, but her husband continues to smoke. Her inhalers for COPD include Symbicort 400/12mcg (Budesonide and Eformetorol) and Spiriva 18mcg (tiotropium Bromide). She uses salbutamol via inhaler as required.
Angela worked as a cleaner for many years and has some arthritic changes related to the wear and tear secondary to this work. She takes paracetamol only to manage this. Angela is compliant with all medications and efforts to manage her COPD and arthritis.
On a routine visit with her GP, Angela was noted to be hypertensive with a BP of 164/96. She has been commenced on an angiotensin converting enzyme inhibitor, perindopril arginine, 2.5mg daily, to be reviewed in 4 weeks. Her weight has increased from 64kg to 72kg in the 3 months since her last review and she reports increased discomfort when mobilising, particularly from her spine. This is limiting her ability to exercise and she is now finding she is increasingly breathless when walking any distance, and is finding caring for the grandchildren more difficult.
It is known that chronic disease is the leading cause of death across the world (Johnson & Chang, 2014). Nurses need to be able to provide care to all health consumers, with a significant role in assessing a person, planning care, communicating with colleagues and ensuring that the holistic needs are met and evaluated. The ongoing nature of the conditions can result in longer term debilitating outcomes if not addressed appropriately. Children, young people, adults and older adults all experience the full range of health issues yet manage them differently.
This assessment task addresses the following subject learning outcomes:
• Plan nursing care for patients with complex co-morbidities demonstrating rationale for how one affects the other.
• Plan nursing care of a patient with a co-morbidity in consultation with individuals/groups significant others and the interdisciplinary health care team in the clinical setting.
• Explain and describe common physiological, mental health and developmental chronic conditions.
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