Case Study Edward (Ted) Williams is an 82year Old 2022

Running Head: CASE STUDY
CASE STUDY
Name of the Student
Name of the University
Author’s Note

CASE STUDY1
Question 1
This case study is about Ted who is an 82 year old widower. He lives alone because his children
live in different cities away from him. The clinical reasoning cycle has to be applied in this
situation to evaluate the bio-psychosocial, spiritual and cultural impact in his life. In the past he
went through a surgery of bowel resection and before 4 days, he had a formation of temporary
colostomy and due to which he is in his post-operative care. He had gone through bioscopy and
colposcopy, which indicated that he has a malignant mass and after that he had his surgeries. His
medical history shows that he had an episode of heart failure previously, type 2 diabetes mellitus,
obesity and gout. Ted’s health history has been complicated and is a reason for his current health
condition (Jangland, Kitson & Muntlin Athlin, 2016). His social background shows that he has
been living alone since his wife died because his daughter lives with her husband and three
children in another city, and his son lives with his wife overseas. A year ago Ted moved to a
retirement village had a partner known as Gwen, a 78 year old. Ted went through a bio-
psychosocial impact due to his surgery as he already used to live alone after his wife died so he
had no one to share his dilemma. He had to depend on others for his medical needs (Arigo, Suls
& Smyth, 2014). After using the RLT model for nursing, it was seen that an efficient nursing
practice includes assessment, diagnosis, planning, intervention and evaluation. Ted was assessed
for his condition, which suggested that he needed a bowel resection. After his surgery, he was
not given food for the next 48 hours. He started vomiting when he was given his regular diet and
it was not a positive implication for his health. The care plan given to him will be linked to the
planning, intervention and evaluation done for his surgeries. His family will get affected from the
spiritual and cultural aspect as it will make an impact on their lifestyle seeing their loved ones
going through pain. The major reason for his family to get affected is because he lives alone.

CASE STUDY2
Question 2
The evaluation of this patient and identification of the health problem will be done according to
the information given in the case study. He has a BMI of 37.6 m2, which is under the category of
obese grade III. This is not an ideal weight for him considering his health history, which includes
heart failure and diabetes. The chronic diseases he is suffering from is due to the excess fat in his
body and it is also the reason for further complications he is going through such as kidney
dysfunction, bowel obstruction, and cardiovascular diseases. His other tendencies include nausea
and vomiting when he started with his usual diet, which indicates that his bowel resection still
needs to be observed because it might not have healed properly. The symptoms of improper
bowel resection includes bloating, abdomen pain, no flatulence and no bowel movement
(Rottenberg, Jacobs & Stessman, 2015). The abdomen is distended, and he has more pain due to
the palpitations he is suffering from, which is measured in the scale of 7/10. People with non-
cardiac surgery can also suffer from palpitations, which includes vascular surgeries and
abdominal operation. Ted is having an abdomen pain due to the surgery and the occurrence of
palpitation is common in patients post-surgery. The vital signs of this patient showed that his
SpO2, heart rate and temperature was normal, his blood pressure was above the range (135/85)
mmHg and his respiratory rate was also higher (26). The elevation in his blood pressure indicates
that it happened due to the side effect of the surgery, and that happens because of the anesthesia
given before the surgery (Erb, Hyman & Osler, 2014). However, the palpitation could also be a
sign of arrhythmia because he has suffered heart failure. The respiratory rate is above the range,
which is due to the palpitations as irregular heart beat is due to pulmonary hypertension. Further
observation also indicated that he has signs of right sided inspiratory coarse crackle and a moist
cough, which is an indication of fluid in his lungs due to pulmonary oedema, pneumonia or