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Case Study/ Scenarios

Jeremy Case Study

Need

  • Jeremy is a 28-year-old man presenting with a learning disability, depression, and anxiety disorder.
  • The social life of the patient is significantly poor since the patient does not interact with other people.
  • The patient has been experiencing severe abdominal cramps and nausea that require medical attention

Problem statement

  • These learning disabilities have subjected the patient to a myriad of psychological health challenges.
  • He also has significant dysarthria that makes him irritable when people fail to understand him.
  • The patient has a poor social life.
  • Jeremy’s condition has deteriorated to a point whereby he does not appreciate the support from a female social worker.

Goal

  • The goal of the treatment plan is to boost the self-esteem of the patient and improve his psychological wellbeing

Objectives

  • The target of the plan is to ensure that the patient can interact positively with other people besides continuing with therapy.
  • The plan also aims to ensure that the patient is provided with the necessary social support for psychological wellbeing.

Intervention

  • Appropriate interventions that address the psychological and medical needs of the patient should be initiated.
  • The patient should be referred to a physician for proper diagnosis and management of his abdominal condition
  • The patient needs to be administered with Citalopram 20mg OD and Paracetamol 1g PRN to manage the pain associated with abdominal cramps
  • The patient also needs to consume more fruits and vegetables and drink sufficient amount of water to improve his health.

Evaluation

  • It is the nurse’s responsibility to ensure the patient psychological health does not deteriorate further.
  • Many areas revolving around the patient’s psychological stability are yet to be addressed; for instance, the patient has not been counseled on how to manage anxiety.

SARAH CASE STUDY

Need

  • Sarah has several health problems ranging from moderate learning disability, severe epilepsy to Tuberous sclerosis.
  • The medical history of the patient reveals that she was diagnosed with epilepsy at the age of three due to frequent tonic-clonic seizures

Problem statement

  • The patient has been receiving social support from her parents and close members of the family.
  • Her condition, however, is becoming a major hindrance to her involvement in social activities.
  • During childhood, her epilepsy was managed through collaborative care between her parents, a consultant neurologist, and epilepsy nurse.
  • Even though her condition is well managed, she requires support and carried medications in case she suffers an emergency epileptic attack.

Goal

  • The main goals of the treatment plan for this patient are to her health condition through minimizing incidences of seizure attacks.

Objectives

  • The purpose of the care plan is to ensure the frequency and severity of seizures are minimized.

Intervention

  • The patient can be administered with several medications including Sodium Valproate 200mg BD, Lamotrigine 100mg TDS, Carbamazepine 600mg NOCTE, and Buccal midazolam 10mg (base). These drugs are highly effective in the management of seizures
  • The patient also needs to be carefully monitored by the Community LD Nurse.

Evaluation

  • The nursing principles in the management of epilepsy make it clear that the patient should be closely monitored and strict compliance with anticonvulsants observed.
  • Most of her needs and interests are well taken care of. She receives medical support from the Community LD Nurse who visits her regularly.
  • The nurse evaluates the health condition of the patient and makes appropriate medical decisions including whether to refer the patient for specialized treatment.
  • The patient has a proper social support system.
  • This system has contributed greatly to the good health of the patient despite his communication challenges (Atherton & Crickmore 2012).

EMILY CASE STUDY

Need

  • Emily has profound and numerous learning disabilities including epilepsy, Rett Syndrome, dysphagia, immobile and wheelchair user, hearing impairment in the ears, urinary and fecal incontinence.
  • The patient requires support during eating and drinking since she has swallowing difficulties.
  • The patient also has limited communication skills and requires full support for personal care.
  • Emily is also immobile and uses a wheelchair that is controlled by another person.

Problem statement

  • An assessment of the patient revealed that her appetite had deteriorated significantly and she was coughing up sputum.
  • Concerns were also raised on the patient’s fluid intake and concentration of urine.
  • The patient was also observed to be sleeping more than usual and displaying signs of distress.
  • Unfortunately, the nurses did not respond appropriately to the symptoms presented by the patient.
  • The patient’s condition deteriorated until one morning she started experiencing increased shortness of breath and was coughing up secretions.

Goal

  • The main goal of the treatment plan is to improve the health of the patient

Objectives

  • The objectives of the care plan are to ensure that the pneumonia is managed appropriately as well as reduce the risk of recurrence. The other objective is making sure the parents are provided with information appropriate for a better management of the patient.

Intervention

  • The most suitable intervention was to administer the patient with antibiotics since she had been diagnosed with pneumonia

Evaluation

  • It is the role of the nurse to ensure that the parents are educated on how to take care of the patient to minimize cases of health deterioration.
  • The nurse should follow-up on the patient to ensure the bacterial infection is appropriately controlled


 

PETER CASE STUDY

Need

  • Peter, a 44-year-old male presents with a learning disorder, obesity, and type II diabetes
  • These disorders have significantly affected the ability of the patient to engage in basic activities of daily living.

Problem statement

  • The patient has poor reading skills and is unable to observe personal hygiene.
  • Peter also has a poor social life; he lives independently in his flat.
  • This decreases his chances of interacting with friends and family members thus putting his condition in jeopardy; this might be one of the factors contributing to his refusal of social support
  • His diabetes might have gotten worse since he does not adhere to the physician’s prescriptions.
  • The patient does not engage in activities that might promote his health.
  • He has added weight since he neither participates in physical activities nor adheres to healthy diet requirements.

Goal

  • The treatment goal is to provide the patients with medications that are effective in the management of diabetes.

Objectives

  • The objective of the care plan is to ensure the ability of the patient to engage in activities of daily living is improved
  • The other objective is to make sure that the weight of the patient is reduced and an environment that does not lead to an increase in weight is created
  • The plan also targets to increase the patient’s compliance with medications.

Intervention

  • The patient was administered with Metformin 500mg TDS, Gliclazide 80mg OD, and Acarbose 50mg TDS medications which are highly effective in diabetes management.

Evaluation

  • Management of diabetes requires strict adherence to prescriptions and nutritional recommendations.
  • Since the patient is not compliant, the follow-up should be reduced from three months to monthly.
  • The principles of nursing practice make it clear that the needs and interests of the patient should be prioritized during the development of a treatment plan.
  • The patient should be educated on how to manage his condition, besides being given an opportunity to point out his needs and interests (Sperry 2016).
  • An assessment of the medical history of the patient also needs to be conducted to identify the medications which the patient has stopped taking.

 

 

 

 

 

Bibliography

Atherton, H & Crickmore, D., 2012, Learning disabilities: toward inclusion, Edinburgh: Churchill Livingstone/Elsevier.

Sperry, L 2016, Mental health and mental disorders: an encyclopedia of conditions, treatments, and well-being. Santa Barbara, California: Greenwood.

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