Exercise Refferal Case Study for Rheumatoid Arthritis, Depression & Elderly

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Summary of clients details
Name: Ms. Lewis
Gender: Female
Age: 66
Contact No: 01234 5678910
Next of Kin: Mrs Levenhulme

Referral reason: Rheumatoid Arthritis, Depression & elderly
Medication: Acelofenac & Nortriptyline

Physiological Information
Blood Pressure (seated): 122/82 mmHG
Resting Heart Rate: 64 bpm
Predicted VO2max: 24 ml/kg/min

Present physical activity:
Very low, essentially sedentary

Patient’s statement regarding state of change:
“I want to exercise, and I think I can do it, but I will need some support” (Preparation)
Medical conditions
Rhematoid Arthritis – Is an autoimmune disease which can cause chronic inflammation of body`s organs, joints, and the surrounding tissue of the joints. It can
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When these chemicals are released from nerve cells they act to lighten mood. When they are reabsorbed into the nerve cells, they no longer have an effect on mood. Nortriptyline works by preventing this re-absorption of noradrenaline and serotonin back into the nerve cells. Therefore, it helps prolong the mood-lightening effect of any released noradrenaline and serotonin”.
(http://www.tiscali.co.uk/lifestyle/healthfitness/health_advice/netdoctor/archive/100003239.html)
Possible side effects: “dry mouth, sedation, blurred vision (disturbance of accommodation, increased intra-ocular pressure), constipation, nausea, difficulty with micturition; cardiovascular side-effects (such as ECG changes, arrhythmias, postural hypotension, tachycardia, syncope, particularly with high doses); sweating, tremor, rashes and hypersensitivity reactions (including urticaria, photosensitivity), behavioural disturbances (particularly children), hypomania or mania, confusion or delirium (particularly elderly), headache, interference with sexual function, blood sugar changes; increased appetite and weight gain (occasionally weight loss); endocrine side-effects such as testicular enlargement, gynaecomastia, galactorrhoea; also convulsions (see also Cautions), movement disorders and dyskinesias, dysarthria, paraesthesia, taste disturbances, tinnitus, fever, agranulocytosis, leucopenia, eosinophilia, purpura, thrombocytopenia, hyponatraemia

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