Case Study: 70-Year-Old Patient

The care and management of patients suffering with a long term condition is an integral part of the nurse’s role. With approximately 15 million people in the UK suffering from at least one chronic illness (DoH, 2012), it becomes apparent why the Department of Health (DoH) and the National Health Service (NHS) have had to put in to place advice and guidelines in order that the appropriate measures are taken to ensure that these patients are cared for in the most productive way. This essay is going to discuss the issues that are associated with long term conditions and chronic illness. The focus of this discussion is going to be a case study on a patient who is currently

HPI: S.J. is a 67 y/o Caucasian male with a history of left hip pain for two years. He has difficulty walking due to left hip pain and utilizes a cane, can walk five blocks, climbs stairs leading with the right leg. He denies any surgeries on the left lower extremity. He sought physical therapy, but he does not feel that it is improving his pain but does believe it is improving his strength. He is scheduled for a left total hip arthroplasty due to the progression of severe osteoarthritis of the left hip as confirmed by a pelvic x-ray and MRI of the lower extremity without contrast. S.J. has taken various medications that are listed on the current medication section of this note.

The patient is a 74-year-old female who tells me she did see Dr.[____] and she did get a shot into her hip. She states symptoms are "1000 times better". She does tell me he was done ultrasound and thought she might have a [____] tear, which at this point, if this does not work, she will need likely to have a hip replacement, as he did not think this is fixable at her age.

He reports no major changes in his condition, since his last visit. His pain is rated as 3-6/10, described as dull, hard, aching or worse. Pain is increased with sitting, standing, walking, lifting, looking up and down, turning to the sides, bending, and twisting. He is unable to work. He is very limited physically. He has to modify or avoid social and recreational activities to manage the pain. He feels like his quality of life is severely affected. His pain is 80% in the neck and 20% in the upper extremities, mostly on the

Per medical report dated 09/01/2015, the patient presents low back and right hip pain. She rates the pain as 8/10 and characterized as sharp and stabbing. The pain radiates to the right hip, right thigh, knee, leg, calf, right ankle, and foot and is described to be severe and constant. Her condition is associated with joint stiffness, tingling and weakness. Additionally, the pain is aggravated by any activity or movement, doing excessive work, and prolonged sitting. Relieving factors include application

A 59-year-old woman visited hospital for worsening bilateral hip pain for past 6 months. She had been receiving hemodialysis treatment for 12 years. She was admitted to the hospital as she was unable to ambulate due to bilateral hip pain.

The patient is a 44 year old male who presented to the ED via LEO under a IVC through DayMark. The patient reports recent medication changes from his usual medication h had been taking for 9-10 years. The patient was discharged from HPR yesterday for safety and stabilization. The patient denies suicidal ideations, homicidal ideations, and symptoms of psychosis. The patient dos not appear to be responding to any internal stimuli. The patient is calm and cooperative.

The patient’s chief complaint is pain to the left anterior area of his right knee.

The patient is 69-year-old gentleman who presents to the ED because he was unable to follow commands and answer questions. He had similar episode with weakness in February. He was just discharged from the Barnert Subacute Rehabilitation on 3/11/2015. The patient relates he just feels cold and he does not have any complaints, but he is unreliable because of a history of dementia. His medical history is significant for carotid stnosis endarterectomy, had multiple CVAs, dementia, hypertension, prostatic hypertrophy ,insulin-dependent diabetes mellitus, as well as having a left adrenalectomy in the past (reason for that is unknown at present time). His neurologic exam reveals him to be alert and oriented x2 to person, place but not to time.

The patient is an 84-year-old gentleman who presents to the ED complaining of severe chest pain, mostly retrosternal, radiating to the left side essentially with shortness of breath. When first evaluated in the ED they felt he was in atrial fibrillation, however as the later EKGs revealed was really a sinus rhythm with multifocal atrial premature contractions. The patient also has a history of hypertension, dyslipidemia and some prostate issues. He is a smoker, continues smoke but has no alcohol history. On presentation initial blood pressure was 143/70 with pulse of 73, respirations of 14, is febrile and oxygenating well on room air. His laboratory work is essentially unremarkable. Initial troponins were 0.02, 0.03 and 0.026 with CK

The patient is a 93-year-old gentleman who presents to the ED complaining of intractable back pain. The The patient said he has had pain present intermittently for a few weeks, but it was mild and suddenly developed severe mid back pain since Friday which is has affected his mobility. He denies any recent trauma. He has had no falls in the past 3 months. He said the last time he fell was 4-5 months a ago. ER CAT scan revealed new compression thoracic fractures. The patient's medical history is significant for a mediastinal mass, ampullary mass which is an interval palmar adenocarcinoma. He has had stenting to the region, chronic kidney disease stage III, coronary disease status, coronary bypass grafting, He has a permanent pacemaker in

Patient A presents several different types of injuries caused by strangulation. Patient A is a female who has signs of abrasions on the left side of her neck, scratches on her chin and lots of redness on her chest. As proof of possible strangulation you can see a bruise in the shape of a thumb on the side of her neck. She also has present a bite mark on her chest, scratches and petechiae all throughout the areas of her neck chest and chin. Yellow bruising is also present throughout the front of neck from probably a previous strangulation.

The patient is 79-year-old gentleman who is brought in by his family due to complaints of left sided facial droop over the past 7-10 days. He also complained of difficulty swallowing due to pocketing of food on the left side of his mouth. There are no complains of weakness, loss of consciousness or syncope. The patient is also complaining of incontinence occasionally. The patient admits to having difficulty ambulating secondary bilateral lower extremity pain and swelling. The patient was recently in the hospital from April 6 to April the 9th with hypertensive emergency which placed in congestive heart failure. He also has some hearing loss. It is noted that he is noncompliant with medications at home. He walks with a walker at baseline.

The patient is a 69-year-old gentleman who presented to the ED on 9/11 complaining of abdominal pain, constipation and rectal pain. Initial referral was EHR it was determine the patient should be observation Dr. Aqel did not agree with that assessment and therefore this is a second review. As stated he presented with constipation, abdominal pain and specifically anal pain with no bowel movement for approximately 3 days prior to presentation. His medical history is significant for coronary artery disease having had bypass grafting in 2009, hypertension, hypercholesterolemia, diabetes mellitus, previous CVA, also known to have a atrial flutter. He therefore was admitted to the telemetry unit because of the flutter. The patient underwent

The 74-year old seems to be in a moderate stage of cognitive decline of Alzheimer's disease. The diagnosis was given with a possible CT scan, or MRI, as well as the information given by the patient’s wife with regards to the patient’s decline with self-care, and personal finances, and personality change. Research by Townsend (2015) in the moderate stage individuals lose some ability to perform activities of daily living independently such as hygiene, as well as managing personal finances