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NSG2NCI Nursing Patients With Chronic Illness

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Liz is a 49 year old woman from the East Java province of Indonesia. She weighs 87 kg and is 165 cm in height. She was diagnosed with chronic bronchitis five years ago and has been trying to cut down on the number of cigarettes she smokes since then. At present, she smokes an average of 3 sticks of cigarette per day, usually after meals. She drinks occasionally (average of 2 standard drinks per week) and denies use of illicit drugs. She exercises by walking their dog around the neighbourhood for 15 minutes each day. Liz has ongoing hypertension and high blood cholesterol, for which she takes Metoprolol 50mg every morning and Pravastatin 10mg every night. Liz reports that elevated cholesterol levels are very common among the members of her father’s family.

Liz has migrated to Australia with her 22 year old son, Bernard, to get away from her partner from whom she has experienced domestic violence. Bernard works as a cook in a popular local café but Liz is struggling to find a job. As such, she has started driving their car for Uber to generate income for their household. They live in a rented apartment near the café where Bernard works. At present, Liz is admitted in the acute care adult medical ward where you are working as a registered nurse. According to the admission documents, she was rushed to the emergency room 3 days ago due to sudden onset of dizziness and weakness of the right side of her body that lasted for 6 hours. She underwent a CT scan, ECG and blood tests and was told that she had a transient ischaemic attack (TIA) and atrial fibrillation. Warfarin has been added to her medications and is being prepared for discharge.

Liz has been free from symptoms in since the TIA episode. She appears quiet and withdrawn. When asked how she is, she provides short responses such as "I'm good" and "I honestly feel normal." In private, Bernard tells you that Liz started acting this way since she was instructed by her doctor that she cannot drive until her next appointment with the neurologist 2 weeks from now. Liz has told Bernard that she regrets going to the emergency room because she thinks that the symptoms would have just gone away on its own like it did in the emergency room.

Part 1: What chronic illness is Liz at risk of developing? Explain by using details from the scenario.

Part 2: Identify the health services available in Australia that could help Liz selfmanage her risk of developing the chronic illness you’ve identified in part 1. Clearly describe what the services involve and who are the health professionals that can help? Discuss why you think Liz would benefit from having access to these.

Part 3: Reflect on the services you’ve identified in  Part 2. Discuss what challenges there could be for Liz to access the services you’ve discussed. What are the gaps in our healthcare services for people like Liz that could be addressed?

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