Mr Tsakoumagos Case Study

45 years old man from Greek background. He is a farmer and spend a lot of time sitting in his tractor. He is 170cm tall and 130kg weight. He is a type2 diabetic and currently has a leg ulcer that has been quite slow to heal. He lives alone and has a very unhealthy diet, eating few vegetables. he is a long-term smoker and smokes approximately 20 cigarettes per day. Previously his doctor said loos his weight and stop the smoking. Today he is driving the car one hours to visit the rural community clinic. for the appointment to review his leg ulcer. Today whether is 40 to degrease temperature and very humid. his car air-conditions not working and he didn’t bring any water with him as well.

10 minute later a nurse escorts him to the observation room to take BP, BGL and assess his legs, then nurse notice he is sweaty, pale, and rubbing his chest.

Nurses ask the Tsakoumagos if anything wrong? He says his feeling nauseous, and chest is very tight it hurts. he raises the pain 9/10 and describes the pain as tight, squeezing and in the centre of this chest.

Case study 2

Mr Smith is 76 years of age and lives alone. He has large house and is socially isolated. He doesn’t like the socialize. He has recently been diagnosed with dementia. There is a evidence that he does not eat properly. Often, meal consist of cup of tea and toast. And he reluctant to upwash dishes, clothes, and unopened mail. He has smoked his entire adult life and often smoked inside the house. He has been proposed to nursing home give his recent dementia diagnosis and his pre-existing chronic obstructive pulmonary disease. He has two recent admissions to hospital for an exacerbation of the COPD. Mr Smith have an appointment to the hospital to assess his lung function and he also has another appointment with a geriatrician scheduled for one month’s time. Mr Smith does not want to attend this appointment.

Case study 3

Mrs Jeffery is 81 years of age and lives in her own two-story home. Which she has lived in 45years. Her medical history include type2 diabetes ,hypertension and osteoarthritis. She was recently admitted to the hospital following a stroke. that result in moderate left arm and leg weakness. This admission was her third hospital admission in the past three months.

Her others admission has been for a urinary tract infection and fall in the context of hypoglycaemia of delirium. which prolonged her length of stay in the hospital? She has been discharging and you are now seeing her as an enrolled nurse together with a home care registered nurse. Another registered nurse has performed a cognitive assessment and documented that cognitive decline has occurred following the stroke. she has global cognitive deficits primally affecting memory attention and executive functioning, so this includes planning, problem solving, mental flexibility and abstract reasoning.at discharge from the recent admission it was recommended that it was in her best interest to be discharged to a residential care setting due other need for assistant with the care tasks associated with daily living. Mr Jeffery was adamant that she wanted to return home to live. Mrs Jeffrey very privet and her closet family, her daughters live close by Mrs Jeffry took much persuasion to accept any home services. but now has cleaning and shopping assistance once a week. She lacs insight into her care needs and believes that she will feel better. Less confused and stronger ,once she is more settled back into her own home.

1.1

This is an emergency situation, as the patient has high-level chest pain.

Given the critical nature of the scenario, outline a minimum of  five (5) steps you would take to ensure Mr Tsakoumagos is appropriately cared for. In your response, consider who you would involve and any assessments or nursing interventions you may need to include. 

Response:

1.

2.

3.

4.

5.

 

1.2

Explain how you would undertake effective decision-making to initiate action for Mr Tsakoumagos in collaboration with members of a multidisciplinary team, which is based on the clinical assessment of the client (). In your response, include:

·      Immediate treatment actions

·      Referrals

·      Longer-term actions.

Note: You should show sufficient detail to indicate how you undertook the decision-making process and what evidence or results the decision was based on. Your response should provide brief details of what information would be discussed, which team members would be involved in the discussion and the outcomes and recommendations of the discussion. Identify the roles and professional expertise of nominated members of the multidisciplinary health care team.

Response:

1.3

Considering your knowledge of Mr Tsakoumago’s lifestyle, identify a minimum of six (6) potential environmental and other health issues that may impact Mr Tsakoumago’s health.

Response: