essay
Ms Aamira Agar is a 66-year-old Sudanese lady, who resettled in Australia as a refugee in 2002, following displacement by the second Sudan civil war. Aamira has poor English language skills, and relies on her Sudanese community to translate. Her husband died during the conflict in 1999. She has no surviving children.Aamira has just been admitted to your medical ward as a direct admission via GP (no admission to ED). She has been admitted for investigation and management, of suspected poorly controlled new diagnosed diabetes, by the GP. It is cu
ently Ramadan which complicates management. The GP also suspects Aamira may have underlying early heart failure, and has requested further investigation in hospital. She has no previous admissions for this condition, but is cu
ently experiencing significant shortness of
eath, particularly lying flat, a persistent cough, nocturia, and has some swelling of her lower legs, and feet. Aamira has no known allergies.
You are the primary Registered Nurse providing care for Aamira
PMHx:
Social History:
Medical Findings
Medications
Hypertension
Widowed
CXR – not attended. Direct admission
Coversyl 2.5mg Daily
Osteoporosis
One niece – lives in Melbourne to attend uni, sees Aamira x 3 times per year. Was due to visit this week but had to cancel due to VIC COVID border closures
Blood tests – not attended. Direct admission
Colecalciferol 800IU daily
Gall stones 2005
Cu
ently living in own home utilising community nursing services x 2 times per week. Assistance with washing and dressings to leg ulce
RR – 30 – laboured
eathing. Some wheezing heard. Persistent cough - has been getting worse for the last month
Fosamax 70mg weekly
Long term ulcer on L lower leg
Strong ties to the local Sudanese community who check on Aamira daily. Also rotate helping with meals as needed
SpO2 – 96% on RA (at GPs) HR – 99 – no ECG (at GPs) BP – 145/85 (at GPs)
Panadol Osteo 1330mg TDS
Ex-smoker. 1 pack per week x 20 years – quit 1995
Minimal exercise due to shortness of
eath on exertion.
Noted bilateral oedema of calves
Suspected PTSD
Practitioner of traditional medicine within her community – has a small garden where many Sudanese he
s grow – recently unable to maintain this
Short of
eath – worse lying flat
States she has moderate appetite. Some recent weight gain.Often thirsty
Increasing need to urinate – especially at night
Fasting Blood Glucose 1 month prior – 10.7 (mmol/L)
Fasting Blood Glucose today – 11.7 (mmol/L)
Has not yet been seen by an admitting physician
1.
Reviewing the patient information, describe the aetiology of the conditions we suspect in Aamira, and discuss what the likely cause of the conditions are in Aamira’s case. (Approx 300 words)
2. Discuss your initial health history taking, and nursing care for Aamira on her admission to your ward, taking into consideration what has and has not been attended already – think what is the role of the nurse in the care of a new admission, what information are you going to need to care for her? (Approx 500 words)
3. What client education you will provide for the suspected diabetes, as this is her first admission for this condition, and what recommendations, or lifestyle changes, you would recommend for Aamira – how will you communicate this information to her, so that she understands it? What impact with Ramadan have on her care and management? (Approx 550 words)