CASE MANAGEMENT HEALTH CARE

Case Management Health Care



Case Management Health Care

Introduction

            The aim of this allotment is to investigate the care granted to a persevering on haemodialysis. It will try to discover the personal, psychological and communal desires and to recognise if the care consigned contacted the one-by-one desires of the patient.

            The Nursing Midwifery Council (NMC) Code of Conduct cites that doctors should "protect all secret data in relative to patients got in the course of expert practices and make revelation only with consent". To adhere to this ruling, the pseudonym "Gloria" is utilised to recognise the persevering in this study. (KLANG 1998)

 

Patients Biography and Medical History

            I have selected Gloria as the aim of my allotment because, as her Named Nurse, it is my blame to consider her care needs. She offered with diverse health difficulties, for example diabetes, anaemia, hypertension and disquiet over her sexy function with an changed body likeness due to the formation of her Arterio-Venous Fistula.

            Gloria is a 28-year-old lone woman, who inhabits with her family. She provided up her investigations due to haemodialysis remedy, producing in sentiments of isolation, solitude and depression. Gloria's mother is very supportive and furthermore contends amazingly well with two handicapped daughters. Gloria is 53.5 kgs, 5'5 inches big, slim, fair and exhausts effortlessly due to her anaemia. Before commencing haemodialysis in September 2002 her haemoglobin was 9.9 g/dl. Gloria has been an insulin reliant diabetic since 1980 and has evolved end stage renal malfunction as a outcome of diabetic nephropathy. She was identified with retinopathy in 1990 and has undergone laser remedy in 1991.

            Apart from uninhibited body-fluid sugars, Gloria has seldom been unwell. In December 2001, she conferred her General Practitioner with occasional vomiting and shortness of wind upon effort and bipedal leg oedema. On written check it was found out that her body-fluid force had increased from 140/85 mmHg to 150/90 mmHg. Normal body-fluid force is 120/80 mmHg (www.detecting-hypertension.com). Urine checking displayed proteinuria (+3) and body-fluid trying displayed a stepwise boost in creatinine from 686 umol/L to 783 umol/L. Gloria was commenced on Frusemide 80 PO mg daily. Her localized General Practitioner had mentioned Gloria to the Nephrology Team. She came to the Renal Clinic who found out that there was a worsening in her kidney function and that Renal Replacement Therapy would be required. Regular clinic appointments and the general result of her remedy the hindered with her investigations in the University.

Gloria came to both the Nephrology and Pre-Dialysis Clinic where she was acquainted about the diverse remedy modalities. Dialysis in the pattern of Haemodialysis and Continuous Ambulatory Peritoneal Dialysis were the remedy choices open to Gloria. She determined that haemodialysis would be the best remedy choice for her.

            An Arterio-venous fistula was formed last June 2002. Gloria's body-fluid was supervised monthly and her serum creatinine had increased from 408 to 701 mmol/l. A referral to the Renal Dietician was made and recommendations granted to her considering the befitting ...