NRSG366 201830: Andrea Stevenson Case Study - Nursing Case Study Assignment Help

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Andrea Stevenson Case Study

Task: Case Study 1: Multiple Sclerosis – Andrea Stevenson Andrea Stevenson is a 39-year-old woman who lives with her husband Daniel and their three children, Jasmine aged eleven, Olivia aged seven and Sophia aged five, in a two story four bedroom home in a suburb of the capital city of the state 25kms from the city centre. Daniel is a plumber who owns and runs his own business and Andrea is a part-time medical receptionist at the local GP clinic just five minutes from their home. The children attend the local primary school in the same suburb where they live, and they have music lessons and sporting activities after school. Andrea was diagnosed with relapsing-remitting multiple sclerosis just after her 35th birthday. Despite being diagnosed at age 35, she experienced numerous symptoms prior to this from her early 20’s. She recalls that for many years prior to her diagnosis she had noticed some significant changes in neurologic functions, particularly heat intolerance, stumbling and a tendency to fall, visual acuity also seemed to change periodically over the last few years. Additionally, she experienced weakness in her arms and had difficulty at times with fine motor skills. She once had to leave work early because she couldn’t work on her computer, being unable to direct her fingers to type on her keyboard. Sometimes she had some arm weakness and leg pain and once she lost control of her bladder, but she blamed that on laughing too much. The symptoms meant nothing to her on their own but she finally sought some help from her doctor when she started to have problems with her thinking, particularly at work. Andrea started feeling hazy and as if her mind was clouded. Her movements were not quite right and she appeared dazed at times. Andrea saw her GP and was referred to a neurologist. She had an MRI scan which revealed two lesions. Six months later she had a definitive diagnosis of multiple sclerosis. Andrea now has considerable mobility deficits and struggles with incontinence, occasionally chokes on her food and her speech has become very soft. She has reduced her hours at the GP practice that she works at but is having difficulty with the basic tasks of her job and realises that she may have to resign very soon. Andrea needs assistance with hygiene, dressing and with household chores and uses a walking frame for stability but lately has fallen a number of times. Andrea is having problems with spasms in her legs, particularly at night. She has also began to continence aids as she has lost control of her bladder a few times, particularly overnight. This is causing problems for both herself and Daniel as Daniel is wondering if they should start to look at getting separate beds and she is worried that would be the end of their marriage. Daniel does all of the cooking, housework and assists Andrea with her activities of daily living. Jasmine is responsible for preparing breakfast and getting both Olivia and Sophia ready for school. Daniel sometimes needs to return to work after dinner and Jasmine then needs to help both Andrea, Olivia and Sophia ready for bed. Andrea’s medication regime: Fingolimod - 0.5 mg Tablet Daily Desmopressin - 200mcg Tablet Nocte Coloxyl and senna - ii Tablets Nocte Amitriptyline - 25 mg Tablet Nocte Diazepam - 10-30 mg Tablet PRN max 30mg per day. The local GP is concerned about Andrea’s home situation and has contacted the community health center where you work as a community nurse in order for you to assess how the family is coping at home