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Case study question and answer (related as a community nurse) Essay Example

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NRSG366 2017 semester 1 Supplementary Assessment TaskSupplementary Assessment CASE STUDY = 70 MARKS

There is one (1) case study followed by related questions

There are nine (9) related questions

Marks allocated are indicated next to each question

Record your answers directly in the examination paper, in the spaces
Case Study 1: Multiple Sclerosis – Ginny Peters
symptom. She was busy cutting a client’s hair when she could not pick up her scissors. It was not like she was paralysed, but her arm just was not able to do the movement that she was telling it to do. Ginny thought she just had a pinched nerve in her neck, and ignored it. She was young and the symptoms would go away or improve with time so she did not think there was anything seriously wrong. Sometimes she had some arm weakness or leg pain, but they meant nothing on their own. Once she lost control of her bladder, but she blamed that on laughing too much. But the symptoms that finally made her seek help were when she started to have problems with her thinking, particularly at work. Ginny started feeling hazy or as if her mind was clouded. Her movements were not quite right and she appeared groggy. Once she cut her hand during dinner preparation because she could not direct the knife, and then she had trouble putting her legs into her pants, unable to direct her legs where she wanted NRSG366 2017 semester 1 Supplementary Assessment Task them to go. Her GP sent her to a neurologist. She had an MRI scan which revealed two lesions. Six months later she had a definitive diagnosis of multiple sclerosis. Ginny has considerable mobility problems and struggles with incontinence, occasionally chokes on her food and her speech has become very soft. She still runs her salon with the help of two hairdressers that do the practical work, but Ginny can no longer cut or style hair effectively. Ginny needs assistance with hygiene, dressing and with household chores and uses a walking frame for stability, but lately she has fallen a couple of times. Ginny is having problems with spasms in her legs, particularly at night. She has also taken to wearing continence aids as she has lost control of her bladder a few times, particularly overnight. This is causing problems for her as Peter is wondering if they should get separate beds and she is worried that would be the end of their relationship. Peter does all the cooking, housework and helps Ginny shower and dress in the mornings. Hannah is responsible for preparing breakfast and getting Sarah ready for school. Peter sometimes needs to return to work after dinner and Hannah then needs to help both Ginny and Sarah get ready for bed.
Ginny Peters is a 42 year old woman who lives with her husband Peter and their two children Hannah aged twelve and Sarah aged eight, in a four-bedroom double story house in a regional town about 100 km outside the main city of the state. Peter is a builder who built their home and Ginny is a hairdresser specialising in weddings and special occasions. She has a salon attached to the house but with a separate entrance to the house. The children attend the local primary school in the same suburb where they live, and they have music lessons and sporting activities after school. Ginny was diagnosed with multiple sclerosis of the relapsing-remitting type when she had just turned 31, but in hindsight, she had been having symptoms since she was in her apprenticeship as a hairdresser. Ginny clearly remembers the first time she had aGinny’s medication regime
: Fingolimod — 0.5 mg Tablet Daily Desmopressin — 200mcg Tablet Nocte Coloxyl and senna — ii Tablets Nocte Amitryptyline — 25 mg Tablet Nocte Diazepam — 10-30 mg Tablet PRN max 30mg per day. The local GP is concerned about Genny’s home situation and contacted the community health centre where you work as a community nurse. The GP has requested if you can assess how the family are coping at home with Genny’s illness. NRSG366 2017 semester 1 Supplementary Assessment TaskQuestion 1
On your initial visit to Ginny in her home, you need to undertake a
comprehensive history and assessment. For each of the assessments listed
below provide a rationale as to why you would undertake this assessment.
Include in your answer information taken from the case study to support your
response. (12 marks)




To understand the kinds of treatment and therapy the patients has gone through wth regards to helping her in movement


The history and assessment will help me to understand the conditions that are favorable to the patient such as the right climatic condition


To provide me with a clear understanding of what makes the patient anti-social and what can be undertaken to enhance her emotional needs.


The information will help me to understand the factors that affects the psychological wellbeing of the patient such as anxiety