1 Clinical Scenario You are working in a community clinic as a…

Question Answered step-by-step 1 Clinical Scenario You are working in a community clinic as a… 1 Clinical ScenarioYou are working in a community clinic as a registered nurse. Your next patient is Ms Florence ‘Flo’ Ljukuta and her husband Lionel. Flo is 70 years old, and Lionel is 84 years old. Flo is the primary carer for her husband who has physical disabilities due to a stroke and was recently diagnosed with dementia. Flo would normally attend the clinic regularly, but you notice in her records she has not presented in nearly 12 months. The last entry on the eHealth record is a hospital visit due to a fall last year.When Flo and Lionel arrive, you notice that Flo is limping and they both appear underweight. You also notice Flo and Lionel looking untidy wearing clothes which appear to be dirty, which is very unusual for them. You read both Flo and Lionel’s medical file and identify no services are currently linked to them and Flo is looking after a lot of family in her house.When you ask Flo, what has brought her in, Flo tells you she has a wound on her right foot which she has been dressing at home for three months, but it is not getting better. Flo tells you she hasn’t seen a doctor about her foot earlier because it was only a small wound and she didn’t want to trouble anyone. Flo also stated because she doesn’t drive, she is finding it difficult to catch public transport with Lionel. She can’t leave him at home because he sometimes becomes agitated and upset plus the children are so busy looking after their little ones, she doesn’t want to bother them.Patient profile Presenting complaint History of complaint :Florence ‘Flo’ Ljukuta 70-year-old female from Alice Springs Diabetic foot woundPhx : Hypertension, Type 2 diabetes, Angina, Hypercholesteremia, Asthma, Osteoarthritis. Complete hysterectomy 30years ago for treatment of endometrial cancer.Allergies :Nil Known AllergiesAssessment data : Small wound appeared over 3months ago, unsure what caused it. Applying pawpaw ointment and dry dressing every few days.MedicationsAspirin 100mg manePerindopril 2mg maneMetformin XR 2g maneGTN 600mcg tablets S/L prnOsteo paracetamol 1330mg TDSCodeine 60mg QLD as required for acute painAtorvastatin 40mg maneSalbutamol inhaler 2-4 puffs PRNEthnicity/language : Aboriginal. Speaks Waramungu, Walpiri, Eastern and Western Arrentre, EnglishAlcohol use Tobacco use : Few wines or beers with family and friend 3-4 times per week Smoker 1⁄2 packet per day/ whole family smokes. Regular exposure to campfire and passive smokeDrug use : NilWork environment : Retired 10 years. Previously manager of community health clinicEducation : VET level certificateEconomic status : Family land and house in remote community but staying in town to be with children and support needs for husbandReligion/spirituality : Baptised Catholic by missionaries when youngADLs : IndependentIADLs : Does not drive anymore due to decreased vision (diabetic retinopathy). Starting to develop cataracts. Had glasses a few years ago but they don’t help much now.Cognitive function : No concerns identifiedDiet : Diabetic diet when ableSleep : 5-6 hours a night, broken sleep. Gets up several time to assist Lionel with toileting. Falls asleep in the chair whilst watching TV most eveningsHealth check ups : Last checkup 11months agoVital signs : Temp 36.8oC, HR 84bpm regular, Resp 24, SpO2 93% RA, BP 145/80, BGL 11.0 mmols/L, Pain 6 out of 10StressCurrently eldest daughter receiving treatment for breast cancer. States she is doing very well. Teenage boys have been a little naughty – two are heading to boarding school soon. Eldest son is working in the mines ‘FIFO’ which helps financially.NeurovascularBilateral feet appear normal colour, cool to touch, cap refill >3sec, Pedal pulse diminished bilaterally, Numb sensation bilaterally, Weak strength but full range of movement. Skin to heels very dry and cracked.Question 1: Aged care services and interdisciplinary care to maintain independence (recommend 1250words)Students must:Identify TWO (2) aged care services/packagesIdentify TWO (2) interdisciplinary referralsDetail the goal or purpose of each of these services/packages/referralsProvide a rationale for each service/referral you have selectedExplain how each service/referral relates to Flo’s presentationExplain the impact of Flo’s geographical location may have on accessing these services andinterdisciplinary referrals      Health Science Science Nursing NUR MISC Share QuestionEmailCopy link Comments (0)