Edna Clinical Case Study Answer

A- Airway

Her airway appears to be normal and clear. She is also having faint bilateral lower lobe crackles. This is mostly observed on inspiration and expiration. This is also indicative of condition of pneumonia. The patient is also of advanced age and thus, she might have a lower immunity due to recurrence of chest infection. Crackles are also observed on auscultation in lung feilds when the lung spaces are filled with mucus or fluid. This is also positive for the condition of pneumonia. Patient is also presneting with the complaint of cough which might have caused accumulation of mucus in the lung spaces.

B- Breathing

The patient is having no difficulty in speaking in full sentences. However, the patient is experiencing certain breathlessness on exertion.The vitals noted for respiration rate is 18 breaths per minute. This can be deemed as normal. Edna is also having normal oxygen saturation rate of 96% which the patient is being able to maiantin on room air. This is despite having active chest infection and accumulation of cough (Liang et al., 2020). The saturation level can however improve a little with supplement oxygenation.

C- Circulation

The patient’s heart rate is observed as 85 beats per minute. The patient is experiencing bradycardia as per the normal heart rate range. This can not be deemed as alarming as the phenomenon is commonly observed with patients of 65 years and above. Edna is 71-year-old and also having mild diffiuclty with breathing. Low heart rate noted for her is not of an alarming concern. The patient is also actively responding to the physician and doesnt reflect on any signs of adverse distress or discomfort. The patient is also presnted with bilateral ankle swelling. This can be due to compensation to the respiratory deficit caused due to the condition of pneumonia. Respiratory problems can also result in impairment of function of heart and lungs and thus, resulting in peripheral odema. Edna is also a known case of diabetes type -2. However, she is regular with her medications and follow-ups with the physician. Her blood glucose level is noted to be 5.7 mmols/L. This is considered within normal blood sugar range and thus, poses no potential threat to the patient (Yang et al., 2020).

D- Disability

The patient is accompanied to the care facility with her daughter. Her GCS readings are noted to be 15/15 which can be deemed as a normal (Rozenfeld et al., 2020). She doesnt reflect on any signs of possible clinical deficit. The patient is also alert and oriented to her current surroundings. She is responding well to the questions and answers. She is also complying with the medical procedures conducted for her benefit. Therefore, the patient reflects on no possible disabilities.

E- Exposure

She can be observed to have faint scars on her face and neck which might have been caused due to chickenpox when she was a child. However, there are no present bruises or skin abrasions that might be of any potential concern for the patient.

Potential Red Flags

The two main potentail red flags observed for the given case study can be noted as bilateral crackles and bilateral ankle swelling. The patient is presenting with the complaint of pnuemonia. The presence of crackles also mark the presence of accumulation of mucus in lung spaces. This also obstructs the normal ventilation pattern and can hinder with the breathing of the patient. Pneumonia also results in pulmonary odema and unwanted secretions which can result in closure of the airways (Bangun et al., 2020). This can also compromise with the breathing pattern of the patient as noted for Edna. The other red flag is the presence of bilateral ankle swelling which can also be caused secondary to pulmonary congestion. This can also be related to advanced age of the patient (Bangun et al., 2020). The patient has been rather sedentary and thus, swelling might have accumulated in lower extermities. Bilateral swelling in ankles can also be on an account of patient being diagnosed with Hashimoto condition. Hashimoto caused hypothyroidism that can result in slowing down of body process which can lead to water retention and thus, leading to bilateral ankle swelling (Perini et al., 2019).

Care Management Plan

The management care plan must be holistic in nature and must comply with the all care demands and need of the patient. The care plan must also focus on the current needs of the individual and on the possible needs that might arise once the patient shifts to her home-based setting. Edna has recited that she enjoys social gathering and she misses the same due to her current illness. The focus and emphasis must be laid on enhacing social gathering for Edna. This can be done with the help of community-based services so ensure continuity of social engagement (Enssle et al., 2020). Edna can also be connected with the healthcare team through telephonic follow-ups to take a regular feedback on her current clinical status. Edna can also be promoted for religious gathering such as offerings to chruch or mass gathering which can enable her with spritual well-being. Along with patient, family education is also vital for peventing such episodic event from happening further. This is also required to be maintained with the help of regular follow-ups as patient is of advanced age and struggles with multiple clinical comorbidities (Jennings et al., 2019). Meaningful activities can also be ensured for the patient that must be structred and spontaneous and must ivolve family and friends (Donovan et al., 2020). This active engagement along with clinical care management can ensure positive outcomes and well-being for Edna.

References

Bangun, P., & Suwarman, S. (2023). Weaning Difficulty in Patient with End Stage Renal Disease Acute with Respiratory Failure due to Pulmonary Edema and Pneumonia. Journal of Society Medicine, 2(2), 32-36.https://doi.org/10.1016/j.envsci.2020.04.008

Donovan, N. J., & Blazer, D. (2020). Social isolation and loneliness in older adults: review and commentary of a national academies report. The American Journal of Geriatric Psychiatry, 28(12), 1233-1244. https://doi.org/10.1016/j.jagp.2020.08.005

Enssle, F., & Kabisch, N. (2020). Urban green spaces for the social interaction, health and well-being of older people—An integrated view of urban ecosystem services and socio-environmental justice. Environmental science & policy, 109, 36-44. https://doi.org/10.1016/j.envsci.2020.04.008

Jennings, V., & Bamkole, O. (2019). The relationship between social cohesion and urban green space: An avenue for health promotion. International journal of environmental research and public health, 16(3), 452. https://doi.org/10.3390/ijerph16030452

Liang, Y., Su, J., & Ran, X. (2020). Study on variation of oxygen saturation based on cluster and multiple regression analysis. International Journal of Frontiers in Sociology, 2(9). 10.25236/IJFS.2020.020924

Perini, N., Santos, R. B., Romaldini, J. H., & Villagelin, D. (2019). Thyroid acropachy: A rare manifestation of graves disease in joints. AACE Clinical Case Reports, 5(6), 369-371.https://doi.org/10.4158/ACCR-2018-0591

Rozenfeld, M., Givon, A., Trauma Group, I., & Peleg, K. (2020). The reliability of the Glasgow Coma Scale in detecting traumatic brain injury: The continuous effect of age. Brain injury, 34(4), 515-519. https://doi.org/10.1080/02699052.2020.1725838

Yang, J., Zhou, Y., Zhang, T., Lin, X., Ma, X., Wang, Z., ... & Zhao, Y. (2020). Fasting blood glucose and HbA1c correlate with severity of coronary artery disease in elective PCI patients with HbA1c 5.7% to 6.4%. Angiology, 71(2), 167-174. https://doi.org/10.1177/0003319719887655

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