Case Study on Mrs. Ethel Simpson

Added on - 04 Oct 2020

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URN:QUT174801 |PATIENT: SIMPSON,Ethel MerleThis case study is based on Mrs. Ethel Simpson who is 64 years old. She attendsthe pre-admission clinic with her grand-daughter to discuss her up-coming leftknee arthroplasty. Later, she undergoes the surgery and is then three days post-operative, in the orthopaedic ward.You will need to access the Mrs Simpson Simulation Case Study resource in yourBlackboard site to view medical documents and the three videos that tell the storyof Mrs Simpson.
Caring for a patient with dementia and arthritis who is at risk of injurySettingthe sceneSocial:Ethel is 64 years old and lives in a Granny flat attached to her daughter’shome. She has good support from this daughter and grand-daughter, andher other two children who visit at least weekly. She was previously aregistered nurse. She has six steps in her house that she needs to negotiate.Her worseningarthritis, particularly the arthritis in her left knee has madeitextremely difficult for her to leave the house in the last two months. Ethelcomplains ofpoor appetite, difficulty sleeping and not wanting to leave thehouse.Ethel wasdiagnosed with Alzheimer’s dementia a year agoand has been partially independent in all herbasic activities of daily living. She is continent but needs assistance with bathing and householdactivities such as cleaning. She can cook basic meals and feed herself. Cognitively she is oriented toperson, place and year. She can recall 3 out of 3 words immediately, but 0 out of 3 words at 5 minutes.Her attention is intact.Mrs Simpson and her family sought advice from her GP because of the worsening pain of her arthritis,particularly in her knee and the impact this was having on her mobility. After being referred to anorthopaedic surgeon for review, the decision was made for a knee arthroplasty to be done.Epidemiology / pathophysiology of disease processesThe National Health Priority Areas of Arthritis and Musculoskeletal conditions, Dementia and InjuryPrevention and Control were established with the aim of improving health outcomes in these areas.Musculoskeletal conditions are conditions of the bones, muscles and their attachments (e.g. joints andligaments). Osteoarthritis, rheumatoid arthritis and osteoporosis are the most commonly occurringmusculoskeletal conditions. They have substantial influence on the quality of life and impose a heavyeconomic burden on the community.Injuries are adverse effects on the human body. They are a significant source of preventable illness,disability and premature death in Australia.Dementiaisdefinedasthelossofmentalprocessingability,includingcommunication,abstractthinking,judgmentandphysicalabilities,suchthatitinterfereswithdailyliving.Conditionsassociatedwithdementiaaretypicallyprogressive,degenerativeandirreversible,forwhichthereiscurrentlynocure.NSB335 Assessment 3Page2of16
Your Task:Use the Clinical Reasoning Cycle on the following pages to review the nursing priorities in relation to the care ofEthel.NSB335 Assessment 3Page3of16
Watch the two videos – Pre-admission Clinic and At homeGain an initial impression of your patientQuestion 1:Review the anatomy and physiology of the three musculoskeletalconditions listed above (osteoarthritis, rheumatoid arthritis andosteoporosis).What type of arthritis do you think that Ethel has?Explain the rationale for your answer.Your Answer:In accordance with the musculoskeletal conditions listed, each one has their own set of problems and causes due towhich affects a person. In this context, osteoarthritis is a joint disorder that is caused by cartilage loss in a joint.Further, rheumatoid arthritis is determined to be an autoimmune disease that causes damage throughout body and jointpain. Lastly, osteoporosis is caused when density of bone decreases (Rohde & Domm, 2018, p. 405). This hasnegative impact over strength and structure of bones and increases the conditions of fractures.Among these, I think Ethel has osteoarthritis as this is a health condition that is faced by old people. Apart from this,she will be undergoing arthoplasty which is a common surgical intervention for osteoarthritisGain an initial impression of yourpatient.Question 2:List three variables that put Ethel at risk of injury. Justify your answer.Your Answer:NSB335 Assessment 3Page4of16
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