NSR390 Alex Case Study Assessment 2 Answer
Complex Clinical Case Study
Charles Sturt University
Overview
Mr. Alexander (Alex) Richards is a 78-year-old male with a 5-year history of Parkinson’s disease and a 15-year history of Chronic Obstructive Airway Disease, who has been admitted to the medical ward you are working on a registered nurse. Alex has a three-day history of increasing shortness of breath and a productive cough and has been commenced on intravenous antibiotics for exacerbation of COPD. Alex is accompanied by his wife Sally and Son Michael.
Medical Background
Alex is a retired train driver and continues to maintain steam trains with the local historical society. Alex lives with his wife, Sally in their own home. Sally assists Alex as much as possible.
Alex was diagnosed with COPD 15 years ago and was a smoker of 20- 30 cigarettes per day. Despite much encouragement, Alex continues to smoke 5-10 cigarettes per day, which he attributes to helping him cope with his current conditions.
To add to the complexity of Alex’s conditions, he was diagnosed 5 years ago with Parkinson’s disease, following a short period of worsening tremors is his right (dominant) hand, predominately at rest, as well as bradykinesia in the fingers of both hands, making daily activities such as turning switches to drive the train difficult.
Recently Alex has developed a shuffled gait which is impacting on his ability to ambulate safely. Alex manages short distances at home, however, prefers to use a wheelchair when leaving the house.
Alex remains continent of urine and faeces, however, wears an incontinent aid when away from home. Alex is easily fatigued and breathless, and sleeps when he can as he reports not being able to sleep at night for longer than 4 hours at a time and since the episode of COVID (2 months ago) becomes breathless quickly and finds it easier to sleep in a recliner.
•Provide responses to following questions •Introduction ( 150 words)
identify to the reader what the paper will discuss. Who, what
how.Does not need references.
E.G. Mr Alex Richards is 78, an ex train driver who has a 5 yr history of Parkinson’s disease and a 15 yr History of COPD. This assessment will discuss the pathophysiology of these two conditions, discuss advanced care planning and discussion and the roles these decisions have in the patients well being and acollaborative team member that could be included in his care in regards to sorting his medications.
Underlying pathophysiology
Discuss the pathophysiology of Parkinson’s Disease and Chronic Obstructive Pulmonary Disease (COPD).
Identify and describe the pathophysiology (at a systemic level) of two clinical manifestations that are common to both Parkinson’s Disease and COPD.
Nursing management
Identify what an advanced care directive is and describe its purpose. Describe how instigating advance care planning discussions can assist the patients and their families who are living with complex conditions.
Collaborative management
Polypharmacy is a risk factor for the older person. Define the term polypharmacy, identify one collaborative care team member ( for example Physiotherapist, or Occupational therapist) and justify their role in the care of the patient regarding medication management and complex conditions.
