HLTENN012: Implement and Monitor Care for Chronic Health Report

This report presents a case study focused on the implementation and monitoring of care for a patient diagnosed with multiple chronic health problems, including Cholecystitis with biliary sepsis, PPM, T2DM, Osteoporosis, and OA. The report details the patient's medical history, clinical manifestations of these conditions, and current treatments. It outlines nursing interventions performed based on the continuum of chronic disease, the patient's understanding of their conditions, and the involvement of interdisciplinary teams and agencies in supporting the patient's care. The report also includes an action plan, emphasizes patient involvement, clarifies the nurse's role and responsibilities, addresses variations in patient needs, and discusses the contribution of family and carers. The conclusion summarizes the importance of comprehensive support for individuals with chronic health conditions, referencing supporting literature.

HLTENN012 Implement and
monitor care for a person
with chronic health problems

Table of Contents
1. INTRODUCTION.......................................................................................................................3
2. Complaint, assessment data and diagnosis..............................................................................3
3. Past medical and health history................................................................................................3
4. Clinical manifestations of the chronic health problems on the body systems.........................3
5. Health issues of the patient......................................................................................................3
6. Current treatments for the identified chronic problems...........................................................4
Resources and support services which can be utilised to meet patient's care needs....................4
7. a. Nursing interventions you performed based on the patient's needs according to continuum
of chronic disease.........................................................................................................................4
7. b. Patient's understanding of the conditions and its impact.....................................................4
7. c. Agencies and interdisciplinary team members involved in supporting patient's care.........4
8. Action plan...............................................................................................................................5
9. Involvement of Patient.............................................................................................................5
10. Own role and responsibilities.................................................................................................5
11. Variations in person's needs and response to these variations...............................................5
12. Level and type of contribution and support made by family or carer....................................5
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

1. INTRODUCTION
Patient has been diagnosed with Cholecystitis w/ biliary sepsis and was having history of
diseases like PPM, T2DM, Osteoporosis, OA. For the patient several assessment were done t
accurately diagnosis medical condition. This is a case report that involves different aspects of
care for a person with chronic disease.
2. Complaint, assessment data and diagnosis
Patient has been diagnosed with Cholecystitis w/ biliary sepsis and for the purpose of
diagnosis assessment performed include QID obs and BGL & 0200 1.2 LFR, DW. Insulin S/S,
Daily Weight. Measurement of drain output and educate patient on how to empty bag.
Investigation was made about blood and blood culture 14/3, chest discomfort, ECG/Trop – NDA,
W/ temp of 38 c.
3. Past medical and health history
Past medical history of patient includes PPM, T2DM, Osteoporosis, and OA. PPM is
Primary-progressive multiple sclerosis, it is a disease of central nervous system in which
condition of patient keep worsening. T2DM is Type 2 diabetes mellitus, Osteoporosis is a bone
disease which occurs when body loses too much bone. OA is Osteoarthritis most common form
of arthritis. History of medication involves telmisartan 20 mg, novorapid, ryzodeg, palexia IR,
and paracetamol, Aspirin (Malhotra and et.al., 2020).
4. Clinical manifestations of the chronic health problems on the body systems
Chronic health problems of patient has several impact on body systems. PPM causes pain
in body such as headache, pain in legs and back pain. Type 2 diabetes mellitus can cause heart
and blood vessel disease and increases possibility of stroke and high blood pressure.
Osteoporosis causes bones to get weak and brittle that little stress can cause fracture.
5. Health issues of the patient
Actual
 Trouble with bowel and bladder control
 Weak bones and brittle that mild stress on bone or even bending can cause fracture
Potential
 Injury to bile ducts draining the liver
 Gallbladder gangrene

6. Current treatments for the identified chronic problems
GTN- sublingual (300-600 mg), palexia Ir 50 mg, enoxaparin 20 mg.
Resources and support services which can be utilised to meet patient's care needs
For T2DM support services is available in form of Diabetes Australia National Health
Office and National Diabetes Services Scheme (NDSS) contact. Other than this, there are several
other services and resources available to manage chronic health conditions. Resources for
managing chronic health condition includes Books, Guides, and brochures. Along with this, there
are programs that are run by community health services or support groups and community based
services that are available to assist people with chronic disease to help with daily life
(Oguntibeju, 2019).
7. a. Nursing interventions you performed based on the patient's needs according to continuum of
chronic disease
Nursing intervention for needs of patient according to continuum of chronic disease
includes encouraging afternoon nap, aggravation of muscle weakness. Along with this, diet
control, exercise are included in nursing intervention for T2DM. Nursing intervention for
Osteoporosis includes managing diet, exercise, lifestyle choices and avoid smoking. For
Osteoarthritis nursing intervention includes weight loss, assistive devices, and physical therapy.
Nursing care for Cholecystitis includes relieving pain and promoting rest, maintaining fluid and
electrolyte balance and preventing complications.
7. b. Patient's understanding of the conditions and its impact
Patient has good understanding of different diseases that they have. In their knowledge
patients are aware about different signs of diseases and what impact does their disease have.
Impact of this understanding is improved awareness of patients regarding their care and also
about medication that patients should get and this also increases their regularity about
medication.
7. c. Agencies and interdisciplinary team members involved in supporting patient's care
Patient have different chronic diseases and this is why for supporting care of patient
team-members of interdisciplinary teams are involved. In this care providers in different areas of
expertise are involved in treatment of patient (Sinaki, 2021). This means that patient have
chronic diseases that are from different areas and this is why support of different experts is
required to provide quality care to patient. Regarding agencies involved in supporting patient

care include Hospital, Laboratories & Diagnostics Clinics and nursing homes and assisted living
facilities.
8. Action plan
9. Involvement of Patient
Involvement of patient can be done in several ways such as communication about disease
and its effects and causes and communication about medication. Along with this involving them
in medication and treatment of disease.
This patient was also involved in similar ways in which their treatment was finalised after
consultation with patient to ensure they can actively participate in their care.
10. Own role and responsibilities
Role and responsibilities in communicating and reporting person's response to nursing
intervention includes-
 Regular observation of patient to understand how are they responding to nursing
interventions
 Recording of nursing intervention and actions taken in nursing intervention and care
 Recording of condition of patient on different times and after different nursing
intervention
11. Variations in person's needs and response to these variations
Variation in need of patients include-
Relieving paid and promoting rest- In this patient is encouraged to take rest to avoid pain and
get adequate rest (Chow and Chin, 2020).
Balance of fluid and electrolyte- In this patient is provided with adequate fluid and record is
maintained so that excess and limitation of fluid can be maintained.
12. Level and type of contribution and support made by family or carer
Support of family and care can make significant difference in condition of patient with
chronic diseases. Contribution and support by family was identified through condition of patient
after meeting family and interacting with them. In addition to this, engagement of family and
carer of patient in their treatment was also one of the way to identify level and type of
contribution and support made by them.

CONCLUSION
On the basis of above discussion, it can be concluded that person with chronic health
condition require considerable support of carers and this is why understanding of different
aspects of chronic health can improve care giving to person.

REFERENCES
Books and Journal
Malhotra, S and et.al., 2020. NLRP3 inflammasome as prognostic factor and therapeutic target in
primary progressive multiple sclerosis patients. Brain. 143(5). pp.1414-1430.
Oguntibeju, O.O., 2019. Type 2 diabetes mellitus, oxidative stress and inflammation: examining
the links. International journal of physiology, pathophysiology and
pharmacology. 11(3). p.45.
Sinaki, M., 2021. Osteoporosis. In Braddom's Physical Medicine and Rehabilitation (pp. 690-
714). Elsevier.
Chow, Y.Y. and Chin, K.Y., 2020. The role of inflammation in the pathogenesis of
osteoarthritis. Mediators of inflammation. 2020.