Profile of Learning Difficulties Cases pages 37-41
Profile of Mental Health Cases pages 41-52
Profile of Paediatric Cases pages 52-57
Profile of Physiotherapy Cases pages 57-59
Profile of Adult Patient Case 00-002
No admission notes. Unclear why or where from admission took place.
Diagnosed as suffering from a carcinoma of the lung confirmed as being an undifferentiated small cell carcinoma from biopsies taken at the time of bronchoscopy.
Nursing care issues predominantly relate to care of the terminally ill patient and palliation. Marked weight loss associated with nausea a key case feature.
Patient ultimately discharged to care of District Nurse, McMillan nurse and GP.
Profile of Adult Patient Case 00-004
71 year old male admitted via outpatients with Shortness of Breath and diagnosed as exacerbation of Asthma. Known asthmatic, three previous admissions for flare up of his asthma.
Treatment included 02 therapy a range of bronchodilators, steroids and antibiotics. Sputum incubated Haemophilus parainfluenza. Allergic reaction to Singulair resulted in quite marked Angio Oedema.
Nursing care input focused on management of the marked and prolonged breathlessness and its impact on his ability to self care. Gradually improved over the course of his eighteen day admission and was discharged care of GP.
Profile of Adult Patient Case 00-005
This fifty nine year old gentleman was admitted to the ward with a two-week history of increasing dyspnoea and a cough. He has no known documented medical history although he is on medication. Following a diagnosis of Pneumonia of the left lung, he is treated with Intravenous and Oral antibiotics, nebulised bronchodilators and oxygen therapy.
This patient is reported to have smoked between thirty to forty cigarettes per day over a period of approximately forty years and he has developed a chronic productive cough.
Following treatment throughout the period of hospitalisation his condition improves and there is evidence that he expresses a desire to stop smoking and the medical team prescribe nicotine patches. He is discharged from hospital after a period of six days.
This fifty-seven year old gentleman was admitted into hospital via his GP with increasing shortness of breath, a cough and abdominal pains.
His previous medical history is complex and includes Ischaemic Heart Disease, a Coronary Artery Bypass Graft (CABG), Aortic Aneurysm Repair and Insertion of an Internal Defibrillator. He previously smoked twenty cigarettes a day up until twelve months before this admission.
Whilst in hospital he is placed on a cardiac monitor and a series of investigations are performed but each proves to be negative. His medication is amended to increase the diuretic medication, which he takes.
After several days in hospital his breathing improves and the pain appears to resolve. He is discharged home following an eleven-day stay in hospital, an Abdominal Ultrasound scan is arranged on an Out Patient basis.
Profile of Adult Patient Case 00-008
Acute emergency admission via A&E. History of chest pain and fluttering sensation in the chest. Assumed to be a myocardial Infarction but this was discounted on ECG tracings and negative Trop I blood tests.
Main complaint of liquid diarrhoea associated with severe stomach cramps/spasms. Recently underwent Heller’s Myotomy for oesophageal stricture requiring further surgical revision for dysphagia. Caught Norwalk Virus following surgery.
The diarrhoea is intractable with only short periods of relief with Octreotide medication, but leading to constipation, withdrawal and return of symptoms. A battery of tests including barium studies, pancreolauryl test, microbiological studies all fail to demonstrate aetiology for the diarrhoea. One suggestion is that the diarrhoea is attributable to vagus nerve damage during surgery for his oesophageal stricture.
Known sufferer of Rheumatoid Arthritis with associated mobility problems requiring him to use a Zimmer Frame.
Patient discharged without a firm diagnosis or explanation for the diarrhoea. Sense of the patient is ‘fed up’ and low and wants discharge with or without resolution for his diarrhoea.