Living with a long term multiple pathology

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About 1,131 deaths were attributed to asthma in 2009, and 12 of these were less than 14 years of age (Asthma UK, 2012). For depression, it is considered the fourth leading cause of disability and disease in the world (NICE, 2011). In the UK, the prevalence of this disease in 2006 was 2.6%, and these rates are often higher in cases where chronic illnesses are present and among women, the rates are often higher (NICE, 2011). This study shall first provide a background for the patient’s case. Secondly, a plan of care would be presented. Thirdly, the delivery and evaluation of care shall follow, and finally, a summary and conclusion will end this discussion. This paper is being carried out in order to improve the management of multiple long-term conditions among patients. Background The patient Bruno (not his real name) was admitted into the emergency room after an asthma attack. Before the admission, Bruno was self-managing his asthma attacks through his regular asthma medications. He is now 70 years old. His current admission is also associated with depression. On further evaluation of his symptoms, it was determined that he was feeling very sad and lonely. I met the patient after being assigned to his care as a student nurse on my sixth week of placement. The patient’s heart rate was at 112, but he had low blood pressure at 96/50. His temperature was about 100 degrees while his respiratory rate was 22. He had poor skin turgor and this indicated that he needed immediate medical attention. This is why this patient was chosen for this paper. Based on initial laboratory tests, Bruno had the following condition: Creatinine 14.4 mg/dl, BUN 212 g/dl, bicarbonate 10 meq/l, chloride 145 meq/l, potassium 6.9 meq/l, sodium 176 meq/l, platelets 554 and hemoglobin 18.5 g/dl. Bruno’s life has been a very busy one, he worked as an economist and he was often able to easily work out math problems in his head. In his 50s, his children were all fully grown and he then participated in fund raising activities for local charities (Carrier, 2004). Bruno suddenly noted that he was losing his mathematical ability. He committed frequent mistakes and he often forgot to pay bills, turn water off, and he sometimes burned his meals (Catton, 2006). Bruno has always been mild-mannered and he seldom got angry, however, he started losing his temper especially when tired and stressed. He often held himself together long enough to get home and then lose his temper and his emotions there. This affected his relationship with his family (Titelman, 2003). He never told his doctor everything that was happening and as months went by, his mental health got the better of him and he became more difficult to live with. He finally decided to take time off work to resolve his issues and get well. After the diagnostic exams, he was diagnosed with early onset of asthma (Croghan 2006). He was also diagnosed with depression. Long-term diseases are those which also call for long-term medical attention (London Health Observatory, 2011). These long-term diseases are also diseases which often require constant care, care possibly lasting for years. These conditions include cancer, hypertension, chronic asthma, HIV/AIDS, diabetes, end-stage renal disease, and mental health issues like schizophrenia, senile dementia, and depression (London Health