Asthma: Mr Copper
Mr Copper is suffering from an acute severe asthma attack. As he is an intelligent patient who understands his condition well and knows when to approach the hospital for additional treatment, this recent attack is unlikely to have any psychological implications upon his health. However, it is important to consider that he may be concerned about the possibility of requiring another prolonged stay in hospital, and in particular the implications a prolonged stay would have upon his family and employment. Fortunately Mr Copper reported having an extremely supportive family and employer. However, these are undoubtedly important issues to consider in asthmatic patients, especially as emotion stress is itself a proven trigger factor.
Depression: Miss Black
The management of Miss Black’s care should continue along current lines. Her conditions are well managed and she is happy with the level of care provided. Routine communication is open and effective, not only between Miss Black and the healthcare professionals, but equally importantly within the healthcare team. It is vital for her continued well-being for her depression to be managed effectively. In this case it is clear that both the healthcare team and Miss Black are working towards the same goals.
An ankle injury: Mr Grey
In the case of a fracture, most patients would expect to be placed into a plaster cast to enable the fracture to heal. However, this is not always the case, and if the fracture does not require a cast it is important to explain to Mr Grey the reason why. The decision will partly depend on the type of lifestyle Mr Grey leads. If he is unlikely to be able to rest the fracture, a cast may help to improve healing by preventing excessive movement of the injury which could lead to non-union.
Hallucinations: Mrs Gold
Mrs Gold was required to remain in hospital until her jaundice had subsided and her hallucinations had stopped. During her stay, it is important to monitor her blood results and make sure that her liver function tests are not worsening. Monitoring the presence and occurrence of her hallucinations will be an indication of how well the chlordiazepoxide is working and whether the dosage is correct. It is important to have a team in place to work with Mrs Gold in order to help her abstain from alcohol and prevent further liver damage and progression of cirrhosis.
Stroke: Mr Green
Mr Green was transferred to the specialist stroke unit where he should receive regular observations including oxygen saturation, heart rate and ECG monitoring. Neurological function should be regularly assessed. Respiratory, cardiovascular and renal function should be optimised prior to discharge. His pain relief should be adequate to keep him comfortable whilst in hospital. He should be closely monitored for complications. Mr Green was reasonably nourished and hydrated prior to admission. However, since suffering his most recent stroke he has not yet regained full swallowing function. On admission and transfer to the stroke unit he remained nil by mouth and was fed via a nasogastric tube, but concerns have been raised about his ability to tolerate this. Dietary intake is currently supplemented with thickened fluids.
Rosie is a one-year-old girl who pulled a cup of recently made coffee on herself and scalded her lower face and right shoulder. She was admitted to a children's ward and a patient profile has been created which aims to normalise the child by keeping as many aspects of her home routine as possible. Her general condition should be observed and any significant changes to her condition should be reported. A dressing should be applied to her shoulder and soft white paraffin to her face. Analgesia should be given regularly to aid pain relief.
A drinking problem: Mr Brown
It is likely that Mr Brown is consuming far more than 6 units per week. Acceptance of a drinking problem by the patient is the first step in conquering the addiction. If he can be encouraged to stop drinking then his physical health will improve. The key to this is psychological; the precipitating event seems to be the divorce from his wife and the death of his parents. Mr Brown may require some counselling about these events to overcome his addiction.