56. Articulations permitting some minimal degrees of movemen…
56. Articulations permitting some minimal degrees of movement are ________.
56. Articulations permitting some minimal degrees of movemen…
Questions
56. Articulаtiоns permitting sоme minimаl degrees оf movement аre ________.
56. Articulаtiоns permitting sоme minimаl degrees оf movement аre ________.
56. Articulаtiоns permitting sоme minimаl degrees оf movement аre ________.
Scenаriо оne Rebeccа is а client оf the Primary Care Mental Health Team. You meet her as part of ongoing treatment for depression and anxiety. She has recently been prescribed sertraline and is engaging in structured cognitive behavioural therapy sessions. During your meeting she tells you she has missed her recent asthma review as she doesn’t like the nurse at the practice who usually does this. The GP team have refused to renew her salbutamol inhaler as she is requesting a prescription too frequently and they’re concerned her asthma is not under control or her inhaler technique is inadequate. When you ask her she’s been given some guidance on this but hasn’t looked at as “she’s not stupid”. Rebecca has two young children of ages 2 and 4. She was recently convicted for shop theft and is subject to a supervision order with local probation services. She is not currently in relationship. She maintains a positive relationship with the father of her children who shares custody. Rebecca works part time in a clothing factory. She is currently on leave. She reports her employers being supportive following her recent conviction and ongoing health needs, “I am lucky to have them, they have been good to me.” Rebecca reports several intrusive and impulsive thoughts. She denies risk of suicide but does report intermittent use of deliberate self-harm as maladaptive coping strategy. She scratches and marks the top of her legs. She uses tobacco cigarettes and an occasional cannabis cigarette to help manage her anxiety. Rebecca is expressing her frustration at meeting with you and not sure why she is not meeting with her usual nurse. She is irritable and talking loudly in the reception area. Her usual contact, a community mental health nurse, has just started a period of leave due to illness. Scenario one questions Describe the pathophysiological changes that happen in an asthma attack. You should include how you’d expect a patient to present and what physiological changes you might note. (10 marks) Reviewing Rebecca’s situation, what risk factors does she have specific to her asthma diagnosis and what impact might this have on her condition? (10 marks) Identify 3 care needs Rebecca has, explain why they are relevant and identify a potential care plan for each with underpinning rationale for your plan and an appropriate timeframe for the actions you plan to take. (10 marks) Identify one health promotion initiative that is relevant to asthmatic patients and explain how this could improve the condition and what the impact is on the patient and wider health care service if patients engage with this initiative (10 marks) Scenario two Hilda Chadwick is an 81 year old female residing in a care home. She has been experiencing lethargy, polyuria and thrush over the past few days and the care workers have noticed a decrease in Hilda’s weight. Yesterday, Hilda refused to eat any meals and complained of muscle cramps. The doctor has been to review Hilda and arranged a transfer to the hospital for further monitoring. Hilda’s past medical history consists of Osteoarthritis, hypertension, Type II Diabetes Mellitus, Hypercholesteremia and previous Myocardial Infarction with coronary stenting 10 years ago. Allergies: None Medications: Lisinopril, Atorvastatin, Paracetamol Urinalysis: negative for blood and white cells, but + ketones and ++ for glucose Bloods pending: Full Blood Count, Urea & Electrolytes, Liver Function Tests, C-Reactive Protein, random glucose. Social background: Hilda moved to a care home last year as had been requiring more support with personal care as well as mobilising due to osteoarthritis. She has been living alone following her husband’s death 20 years ago. Hilda has 3 daughters and a son who visit often but do not live nearby. Hilda does not eat regularly; she requires prompts and prefers smaller sweet foods to meals based on complex carbohydrates. Hilda’s diabetes has been diet-controlled, so without the use of medication, and she attends her annual diabetes review. Hilda’s BMI is 33, she is a non-smoker and consumes less than 5 units of alcohol per week. Scenario two questions Describe the pathophysiological changes that happen when an individual develops Type II diabetes. You should include the cellular changes that occur as well as how this affects the body in the immediate term (10 marks) From the details of Hilda’s case explain the risk taking behaviour she’s engaged in and the potential long term implications of this (10 marks) Identify a care need for Hilda and produce SMART goal based care plan, providing a rationale for your decision as well as a timeline for your intervention/s (10 marks) Identify one health promotion initiative that is relevant to diabetic patients and explain how this could improve the condition and what the impact is on the patient and wider health care service if patients engage with this initiative (10 marks)