Audrey Williams is an 89-year-old lady with a history of Diabetes Mellitus Type 2, obesity, and Peripheral Vascular Disease (PVD). Audrey lives in her own home with community nursing services who assist her with meals, blood sugar monitoring, medications and showers as she has chronic pain in her legs from the peripheral vascular disease causing decreased mobility. Recently Audrey has become increasingly debilitated and severely depressed and her family wants to move her into an aged care facility, however, Audrey wants to stay in her own home. She has been asking her GP to increase her opioid medication and asking ‘please just knock me off’, however, Audrey is already on maximum pharmacological therapy and her GP is reluctant to add further medications. Both Audrey and her family are becoming increasingly distressed.
Select EITHER Option A or Option B and answer and discuss the associated questions as a member of the community nursing team:
Option A: After a family conference with the GP and the community nursing team, Audrey’s family decide to manage her care in her home with Primary Health Care.
Briefly discuss what assessments are involved for Peripheral Vascular Disease, including pain. Identify the pathophysiology involved in pain transmission applied to PVD.
Using clinical reasoning discuss how Audrey’s quality of life could be improved when managed in her own home. (You will find every thing about nursing clinical reasoning in this link)
https://www.newcastle.edu.au/Resources/Research%20Centres/Health%20Education/Publications/Pub-8-2010.pdf
How could person centered care be facilitated for Audrey, including the self-management of her chronic disease.
Option B:
Audrey’s family is concerned for her physical and mental well-being and decide to move Audrey to a high care facility. Once in the home Audrey’s physical and mental condition deteriorates as Audrey becomes withdrawn and refuses food and medications resulting in malnutrition, increased pain and distress.
Briefly discuss what assessments are involved for Peripheral Vascular Disease, including pain. Identify the pathophysiology involved in pain transmission applied to PVD.
Using clinical reasoning discuss how Audrey’s quality of life could be improved when managed in the high care facility. . (You will find every thing about nursing clinical reasoning in this link)
https://www.newcastle.edu.au/Resources/Research%20Centres/Health%20Education/Publications/Pub-8-2010.pdf
What are the safety and quality interventions for Audrey in the high care facility? How would these be communicated amongst the team?