Complex Client Care Situations, Research Paper Example

Abstract

This case study presentation embraces the exploration and report of a patient’s basic demographic data explanation of health conditions according to Erikson’s stage, reasons for hospitalization due to medical diagnoses, and surgical procedures. Further a pathophysiological description of the medical surgical problem accompanied by a diagram will be given. Laboratory tests values will also be interpreted along with a charted display of medications; outline of critical nursing interventions and a display of data gathered on a concept map.

Basic Demographic Data

Mrs. M.K is an 82 year old female, who lives in a long term care facility. She was admitted due to weakness and sepsis; pneumonia/bradycardia. This patient has been suffering from Chronic Obstructive Pulmonary Disease (COPD); diabetes mellitus type 11 and has contracted a urinary tract infection. Presently she has a Foleys catheter inserted. Also, she is experiencing limited range of movement (ROM) and a cardiac monitor has been installed.

Erikson’s stage, reasons for hospitalization

 Medical diagnoses and surgical procedures

According to Erikson’s psychosocial stages of development Mrs. M.K has reached a phase whereby wisdom virtue is prominent. With respect to the psychosocial crisis she is suspended between ego integrity and despair as attachments to mykind of humankind are strengthened. Here developmental tasks present merely as a reflection on life in determining whether it was worthwhile living in a body (Crain, 2011).

In relating these theoretical assumptions to Chronic Obstructive pulmonary Disease (COPD), Diabetes, possible pneumonia among other physical dysfunctional abilities, it is clear that Mrs. M.K has arrived at the late stages of life when bodily functions begin to deplete due to years of wear and tear as well as life style. Even though she may be full of wisdom from past experiences ego integrity fighting with despair forces decisions to be made for her protection in a long term care facility.

Explanation of the medical/surgical problem

There are two major health crises facing Mrs. M.K .They are Chronic Obstructive Pulmonary Disease (COPD) and type 11 diabetes mellitus each requiring intense medical interventions.

Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Lung Disease also known as Chronic Lung disease manifests as persistent poor airflow due to massive lung tissue destruction called emphysema. These physical changes are accompanied by small airway dysfunction worsening with poor management of symptoms. Symptoms include cough; shortness of breath and sputum production. The most common cause of this condition is tobacco smoke. Other etiological factors include air pollution; genetics; occupational hazards and unknown sources (Decramer et.al, 2012).

There is no cure for COPD, but quitting smoking and removal from hazardous exposures helps in control of the disease. People suffering from this condition usually experience sudden death as lung and heart complications worsen. It is the 4^th leading cause of death globally. Three hundred and twenty nine million people are affected, which accounts for 4.8% of the world’s population having Chronic Obstructive pulmonary disease. Epidemiological estimates show where there is a slightly higher incidence in males than female (Decramer et.al, 2012).

Type 11 diabetes mellitus

Type 11 diabetes mellitus is a nutritional disease whereby the pancreas does not produce insulin required for adequate carbohydrate metabolism in the body. As such, manifestations include high blood glucose levels. Other symptoms are thirst, hunger, frequency in urinary, unexplained loss of weight and sometime changes in vision. The cause of diabetes is still being researched, but with the increasing incidence scientists have attributed its etiology to hereditary factors and nutrion (Smyth & Heron, 2006).

Two hundred and eighty five million people are affected with type 11 accounting for 90% of diabetes cases and 6% of the world’s adult population. Prevalence is high among developed and developing countries, but low in underdeveloped nations. The prognosis suggests that it reduces life expectancy by 10 years due to the serious complications, which develop as a consequence of high blood sugar level. However, with modern interventions diabetes are living longer in the twenty-first century (Smyth & Heron, 2006).

Pathophysiology diagram of the problem

Chronic Obstructive Pulmonary Disease

Type 11 Diabetes Mellitus

Brief description of lab tests/lab values and interpretation

Initial lab values are as follows; Sodium – 142; Potassium – 3.8; Chloride- 108; Co2 Total 33 (High); BUN- 18; Creatine, serum- 0.8; Glucose- 121; Calcium- 8.7 (Low); Egfr – >60; Fingerstick Glucose – 141 (High). A brief interpretation detects elevated finger stick blood glucose level, while a venous specimen was normal. Calcium levels were also low and the carbon dioxide levels showed a slight elevation too. Other values are normal for a person with COPD and Diabetes type 11.

Medication Tracking Sheet

Tracking Medications across the Curriculum

Critical nursing interventions

Critical Nursing interventions related to Mrs. M.K’s admission due to weakness and sepsis possibly pneumonia/ bradycardia relate to symptoms connected to possibility of pneumonia and sepsis. As such, critical care is managing vitals and observations for exasperation due to a history of COPD. Even though she is diabetic at the moment there is no crisis. From her laboratory the finger stick was elevated but her venous specimen was normal. A tabulated explaining of critical nursing interventions can be viewed in the cart below:-

Concept map detailing the information

Conclusion

The foregoing case study presentation embraced the exploration and report of a patient’s basic demographic data; explanation of health conditions according to Erikson’s stage; reasons for hospitalization due to medical diagnoses, and surgical procedures. Further a pathophysiological description of the medical surgical problem accompanied by a diagram was given. Laboratory tests values were also interpreted along with a charted display of medications; outline of critical nursing interventions as well as a display of data gathered in this presentation was given in the form of a concept map.

References

Crain, W. (2011). Theories of Development: Concepts and Applications (6th ed.). Upper Saddle River, NJ: Pearson Education, Inc.

Decramer, M. Janssens, W. Miravitlles, M. (2012). Chronic obstructive pulmonary disease. Lancet 379 (9823): 1341–51.

Smyth, S., & Heron, A. (2006 ). Diabetes and obesity: the twin epidemics. Nature Medicine 12 (1): 75–80