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Case Study 1

Monday, 25 September 2017 / Published in Uncategorized

Case Study 1

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Case Study 1
Jozef is a 53 year old man who lived the first part of his life in the Slovak Republic, but moved to the UK about 8 years ago.  Jozef was trained as a carpenter.  He came to the UK seeking work in the building trade leaving his wife and two sons back home.  When he first arrived in the UK he returned home frequently, but over the years has begun to lose contact with his family.  About two years ago he broke his wrist in an accident on a building site, and was not able to work for a period.  Jozef had always gone out for a drink after work, often with friends at a local social club, but with the loss of his employment his alcohol use became a more prominent feature in his life.  He found himself spending his time in the local park with a group of other men from Eastern Europe drinking throughout the day.  After visiting his GP with flu, and being asked about his alcohol use, he was referred to the local Community Alcohol Team where he was seen by a social worker and put through a detoxification programme and then into a rehab.
Jozef is now living back in the community and his case is being reviewed by the social worker from the Community Alcohol Team.  Whilst in rehab he lost his privately rented accommodation and his social worker has supported him to find a one bedroom housing association flat.  Although he is very anxious, he has not started drinking again.  However he sees the world in very negative terms.  He feels at his age and having been away from work for a while he will not find employment again (although he would like to work). He is anxious about going out and has deliberately avoided contact with friends he knew in the past because he is worried about relapsing.  His relationship with his family has deteriorated and he has not told them about his recent problems. He avoided contact with his oldest son (now 18), when he made a recent visit to London, which has led to an estrangement between them.  The flat itself is in a chaotic state, and Jozef is clearly finding coping day to day difficult.

Case Study 2
Gemma is a white 15 year old who lives with her mother Kitty and her brother Jake who is 9 years old.  Kitty’s husband Tony left the family home after discovering that Kitty had been having a relationship with a woman she met through the PTA at the comprehensive school Gemma attends.  Tony now lives with a new partner some distance away and they have a three month year old baby.  He only sees his two older children about once a month.  Before Tony left, Gemma had been a model daughter and pupil at school and not given any cause for concern.  However recently she has been spending more time away from the family home, staying out until late at night (and on one or two occasions not returning).  She has started cutting herself and Kitty suspects she may be experimenting with drugs.  Gemma denies this and says she has only cut herself two or three times, and that there is a craze for it at school.  She does not see why she should not be allowed to stay out late.  Kitty is worried that her arguments with Gemma may be having an impact on Jake, who seems more worried and withdrawn.
Gemma has been involved with an ongoing quarrel with a couple of girls in her class. At a local youth club there has been an altercation between Gemma and another girl, who Gemma says has sent her bullying emails and texts, and two community police officers who were passing had to calm everybody down. Then very recently Gemma has been involved in a fight with the same girl outside the school gates to which the police were called. As a consequence she has been excluded from school and referred by police to a social worker in a voluntary sector project working with young women who are at risk of becoming involved in the criminal justice system.
Case Study 3
Leonardo and Andrea are South American couple both in their early 60s who have been together for 40 years.  They both came to the UK from Venezuela when they were in their 20’s, Andrea working as a nurse and Leonardo as an engineer and then a lecturer in a Further Education College.  About five years ago Leonardo was diagnosed with Huntingdon’s disease.  As a result of his condition and the uncontrollable movements associated with it, he can find it hard to spend very long in a sitting position and spends quite a lot of his time lying down.  He has difficulties eating and needs help with his food at times.  His speech is slow but he is able to communicate.
The illness has taken a toll on Andrea and Leonardo’s relationship.  Home Care workers who come in every couple of days have reported arguments between them and that there is often no food in the house.  As he has become less mobile, Leonardo has become more angry and irritable, and sometimes found it difficult to remember things.  Andrea has become more withdrawn and often shouts at her husband.  Andrea did receive regular visits and help from her daughter Sheila, until a couple of months ago. Sheila tried to persuade her to get more support in caring for Leonardo.  For example, the local church, which Andrea and Leonardo used to attend have offered to provide volunteers to sit with Leonardo.  There is also a local carers group that Andrea could attend.  However Andrea says she does not want help and following an argument between them about her father’s care, Andrea has told Sheila she is not welcome any more.  A week ago Andrea told the Home Care workers they were also not welcome and refuses to answer the door.  The case has been referred to a social worker in the Adult Services Team.

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Thursday, 03 August 2017 / Published in Uncategorized

Case Study 1

Get An Answer to this Question.

Case Study 1

Ms. A. is an apparently healthy 26-year-old white woman. Since the beginning of the current golf season, Ms. A has noted increased shortness of breath and low levels of energy and enthusiasm. These symptoms seem worse during her menses. Today, while playing in a golf tournament at a high, mountainous course, she became light-headed and was taken by her golfing partner to the emergency clinic. The attending physician’s notes indicated a temperature of 98 degrees F, an elevated heart rate and respiratory rate, and low blood pressure. Ms. A states, “Menorrhagia and dysmenorrheal have been a problem for 10-12 years, and I take 1,000 mg of aspirin every 3 to 4 hours for 6 days during menstruation.” During the summer months, while playing golf, she also takes aspirin to avoid “stiffness in my joints.”

Laboratory values are as follows:

Hemoglobin = 8 g/dl

Hematocrit = 32%

Erythrocyte count = 3.1 x 10/mm

RBC smear showed microcytic and hypochromic cells

Reticulocyte count = 1.5%

Other laboratory values were within normal limits.

Question

Considering the circumstances and the preliminary workup, what type of anemia does Ms. A most likely have? In anessay of 500-750 words, explain your answer and include rationale.

Case Study 2

Case Study 2

Mr. P is a 76-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. He has no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is overwhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken him.

Question

Considering Mr. P’s condition and circumstance, write an essay of 500-750 words that includes the following:

·

Describe your approach to care.

·

Recommend a treatment plan.

·

Describe a method for providing both the patient and family with education and explain your rationale.

·

Provide a teaching plan (avoid using terminology that the patient and family may not understand).

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