CASE STUDY 2: Chronic case study Deborah Peters is a 57-year

CASE STUDY 2: Chronic case study Deborah Peters is a 57-year-old… CASE STUDY 2: Chronic case study Deborah Peters is a 57-year-old woman attending her General Practitioner (GP) for her annual health check. Deborah lives in regional Queensland, about 400km from a metropolitan hospital. She lives with her husband and pet dog. Deborah has 3 adult children who live in Brisbane. Her parents are no longer living, and she has a history of breast cancer on her mother’s side, and heart disease on her father’s side. Her only brother passed away unexpectedly from a myocardial infarction at the age of 52 years, six months earlier. Deborah worked as a high school teacher until 2 years ago when she retired early due to painful osteoarthritis in her knees. This pain has limited her mobility and she now uses a four wheeled walker for support when walking outside the house. Deborah likes to cook but finds it painful to stand for long periods of time and reports recently relying more on packaged meals. She states that she would not be consuming the recommended daily serve of fruit and vegetables. She does have a sweet tooth and when she cooks it is often cakes and biscuits as her husband also enjoys home cooked baked goods. Deborah takes Ibuprofen and paracetamol PRN to manage her arthritis pain, and antacids PRN to manage her occasional gastroesophageal reflux. She also experiences periodic constipation that she manages with Macrogol 3350 PRN. She says that she does not sleep well most nights and finds her reduced mobility and worries about money and health create additional stress. Deborah states that she often feels low in her mood and that her problems seem too much sometimes.  As part of her annual health check, Deborah’s GP requests permission to measure Deborah’s weight and waist circumference. Deborah agrees and is surprised to learn that she has gained 10kg since her last appointment (current weight 113kg), and her waist circumference is now 95cm. Deborah’s height is 175cm. Her current blood pressure is 140/82mmHg. Examining Deborah’s recent pathology results, her GP tells Deborah that her fasting glucose is 7.8 µmol/L (reference range 3.0-5.5 µmol/L) and her HbA1c is 7.9% (reference range 4.0-6.0%). Other tests show that her total cholesterol is 6.1 (=5.5) and is comprised of HDL cholesterol 0.9 (=1.2) and LDL cholesterol 5.2 (=3.0). Her triglycerides are 2.9 (=2.0).    Health Science Science Nursing NSB 231

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