HSNS363 : Meet Liam Case Study - Nursing Assignment Help

Assignment Task:

Task:

Introduction
Liam is a 15-year-old male who lives in Westtown with his mother, Erica. Liam is a patient of Dr Jones and moved to the clinic when her practice merged with another local practice to form the Youbeaut clinic late last year.
Liam has a history of Juvenile Idiopathic Arthritis (JIA) and Asthma. Liam attended the Accident and Emergency department at the Westtown Hospital four times last summer, including one overnight admission, due to acute exacerbation of Asthma. The Westtown region has been drought declared for the last two years and is experiencing large dust storms which triggered Liam condition. Liam fractured his right hand three years ago when he fell of his bike.

In addition to his recent asthma exacerbations Liam has also been experiencing pain related to his JIA, particularly in his right wrist and right knee. Dr Jones has referred him for review with his regular paediatric rheumatologist in Sydney which is located 500km away. Liam is to have an MRI prior to attending the appointment. In light of his recent Asthma exacerbations Liam is also due to visit his regular paediatrician to review his Asthma Action Plan. His paediatrician is located in a rural service centre 250km from Westtown.

Background
Medical History
 JIA – diagnosed at the age of 8, four joints involved
 Asthma – diagnosed at the age of 10
 Right carpel/scaphoid fracture 3 years ago (cycling accident).
Medications
 NSAIDS - BD naproxen 250mg
 Paracetamol PRN for pain.
 Inhaled corticosteroid preventer (daily)
 Salbutamol PRN

Family
Liam lives with his mother Erica (37), step father John (39) step-brother Sam (7) and step- sister Molly (4). Liam has a god relationship with Erica, John and his younger siblings however, this is a busy household with both parents working and all children attending different school/childcare facilities. John is a supervisor at the local mine. He is a shift worker and his hours include evening and weekend work. Erica works full time at the local ank.

Medical Summary:
History
Liam’s has JIA (polyarticular) which was diagnosed age 8. Liam reports increasing pain levels in the joints, particularly R wrist, which was fractured in a cycling accident 3 years ago. He also reports increasing discomfort in his shoulders and knees over the last 6 months. Erica reports that prior to this latest exacerbation Liams’ symptoms have been well controlled with regular medications since his last flare up two years ago.

Liam has allergic Asthma diagnosed aged 10. His primary triggers are dust and pollen. Liam had 4x attendances at the Westtown Regional Hospital A&E department last summer. Three acute exacerbations were associated with large dust storms in the area (currently in drought) and once after being exposed to large amounts of dust while assisting his farther load cattle onto a truck in the stock yards.

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