Jeremy Case Study

Jeremy is a 28-year-old man presenting with a learning disability, depression, and anxiety disorder. These conditions have subjected the patient to many psychological health challenges. An assessment of the patient’s health reveals he has significant dysarthria that makes him irritable when people fail to understand him. The patient has a poor social life. Even though the patient has a healthy BMI of 24.3, he rarely engages in social activities that might boost his self-esteem and improve his psychological wellbeing (Atherton & Crickmore 2012). However, he receives support from a local health and social care agency. Jeremy’s condition has deteriorated to a point whereby he does not appreciate the support from a female social worker. In this case, it would have been important for the social to speak with the library supervisor concerning Jeremy’s condition to ensure a healing environment is created both at home and at work. The patient has also been experiencing abdominal cramps and nausea, which appears to have been misdiagnosed. Jeremy was initially advised to consume more fruits and vegetables and drink sufficient amount of water. It would have been better for the patient to seek medical attention once the symptoms were detected. This is an indication there is a disconnect in the treatment plan for this patient. Many areas are yet to be addressed; for instance, the patient has not been counseled on how to manage anxiety. The patient is scared he might die like his grandfather due to abdominal cramps.

Sarah Case Study

Assessment of the patient’s health reveals she is suffering from several health conditions including moderate learning disability, severe epilepsy, and Tuberous Sclerosis. The medical history of the patient reveals that she was diagnosed with epilepsy at the age of three due to frequent tonic-clonic seizures. The patient has been receiving social support from her parents and close members of the family. Her condition, however, is becoming a major hindrance to her involvement in social activities. During childhood, her epilepsy was managed through collaborative care between her parents, a consultant neurologist, and epilepsy nurse. The nursing principles in the management of epilepsy make it clear that the patient should be closely monitored and strict compliance with anticonvulsants observed. The treatment plan for this patient is aimed at improving her health condition through minimizing incidences of seizure attacks. Some of the medications that the patient has been administered with include Sodium Valproate 200mg BD, Lamotrigine 100mg TDS, Carbamazepine 600mg NOCTE, and Buccal midazolam 10mg (base). Even though her condition is well managed, she requires support and carried medications in case she suffers an emergency epileptic attack. Most of her needs and interests are well taken care of. She receives medical support from the Community LD Nurse who visits her regularly. The nurse evaluates the health condition of the patient and makes appropriate medical decisions including whether to refer the patient for specialized treatment. The patient has an appropriate social support system. This system has contributed greatly to the good health of the patient despite his communication challenges (Atherton & Crickmore 2012). The patient has limited verbal communication skills even though she understands easy-read information.

Emily Case Study 

Provision of care to patients with multiple learning disabilities is one of the daunting tasks that face family members and nurses in nursing facilities. Fortunately, nurses are appropriately trained to handle various issues associated with the care of patients presenting with almost all forms of disabilities. In the first scenario, the care provided to Emily clearly indicates the application of high-level decision-making process. For instance, nurses have realized that she has swallowing difficulties and therefore food and oral medications are provided in a suspension form. Nurses also use various forms of communication tactics to understand the needs of the patient. In this scenario, the health condition of the patient appears to have been deteriorating. An assessment of the patient revealed that her appetite had deteriorated significantly and she was coughing up sputum. Concerns were also raised on the patient’s fluid intake and concentration of urine. The patient was also observed to be sleeping more than usual and displaying signs of distress. Unfortunately, the nurses did not respond appropriately to the symptoms presented by the patient. The patient’s condition deteriorated until one morning she started experiencing increased shortness of breath and was coughing up secretions.

At this point, a decision was made to contact the Community Learning Disability Nurse (CLDN) for specialized assistance. The CLDN responded appropriately to the patient’s deterioration and referred her to the local general hospital through accident and emergency where she was admitted. At the hospital, the necessary investigations were started as the patient was suspected to have aspiration pneumonia. Antibiotic treatment was initiated for the patient as a means of health promotion. This treatment was appropriate for the condition of the patient. Further assessment of the patient after three days revealed that she was making positive progress (Sperry 2016). The patient was then transferred to a respite care unit before being returned to the supported living home. The patient was also prescribed with medications to enhance recovery before being discharged from the hospital.

Peter Case Study

It is extremely challenging to provide care to patients with learning disabilities who present with other health conditions. In this case, Peter, a 44-year-old male presents with a learning disorder, obesity, and type II diabetes. These disorders have significantly affected the ability of the patient to engage in basic activities of daily living. The patient has poor reading skills and is unable to observe personal hygiene. Peter also has a poor social life; he lives independently in his flat. This decreases his chances of interacting with friends and family members thus putting his condition in jeopardy; this might be one of the factors contributing to his refusal of social support. He has been administered with Metformin 500mg TDS, Gliclazide 80mg OD, and Acarbose 50mg TDS for his diabetes, which is poorly controlled. His diabetes might have gotten worse since he does not adhere to the physician’s prescriptions. The patient does not engage in activities that might promote his health. He has added weight since he neither participates in physical activities nor adheres to healthy diet requirements. Management of diabetes requires strict adherence to prescriptions and nutritional recommendations. Since the patient is not compliant, the follow-up should be reduced from three months to monthly. The principles of nursing practice make it clear that the needs and interests of the patient should be prioritized during the development of a treatment plan. The patient should be educated on how to manage his condition, besides being given an opportunity to point out his needs and interests (Sperry 2016). An assessment of the medical history of the patient also needs to be conducted to identify the medications which the patient has stopped taking.

Bibliography

Atherton, H & Crickmore, D 2012, Learning disabilities: toward inclusion, Edinburgh: Churchill Livingstone/Elsevier.

Sperry, L 2016, Mental health and mental disorders: an encyclopedia of conditions, treatments, and well-being. Santa Barbara, California: Greenwood.

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