Case study

Jordan Ramsey

Client Anthropometrics
Sex: Female
Age: 70
Ethnicity: African American
Weight: 150 lbs.
Height: 52
BMI: 27
Blood Glucose lvls: 80-90 (daily)

Medical Health History

Arthritis

High cholesterol

Edema

Cataracts Hypertension

Fibromyalgia
Incontinent
Ostomy-bag
Depression

Asthma
Brain surgery 9/10
Diabetes

Medication History
Simvastatin Helps lower high cholesterol and triglyceride levels
Doxazosin In combination it helps with Hypertension
Insulin Helps treat diabetes, regulates blood glucose
Warfarin Blood thinner, helps keep blood clots from forming
Hydrocodone An opioid, helps with pain relief
Docusate Sodium - Docusate is a stool softener. It works by helping fat and
water into the stool mass to soften the stool
Metformin Helps in treating type 2 diabetes
Citalopram Is an SSRI (selective serotonin reuptake inhibitor) This
medication helps treat depression

Daily diet
Breakfast
Bacon (turkey bacon)
Eggs

Dinner

Yogurt cup

Soup

Coffee (16 oz.)

Tea or water (16 oz.)

Lunch

Snacks

MOW meal

Banana

8 oz. juice

Peanut Butter and crackers

Spinach

Coffee

16 oz. bottle of water

4 or 5 bottles of water (16 oz.)

Client situation
Client is 70 yrs. old, married, stays at home but does not
work due to limited abilities. needs a walker to assist in
activities. Pt has history of falls, neuropathy, brain surgery,
diabetes, and asthma. Client takes more than 9 medications
daily. Currently has Ostomy bag.

Etiology
Client is experiencing Edema
Related to clients diabetes
As evidence by fluid buildup around her feet

Treatment
It is recommended that the client

Stick to a low sodium diet

try to stay mobile to reduce the swelling
Drink plenty of fluids. Fluid consumption will help move the
other fluid accumulation back into the kidneys to be
processed and excreted.

Disease Impact

Disease Complications
Living with diabetes is no easy task. Along with the
daily struggle of maintaining your blood glucose,
other complications can occur. Such as:
Neuropathy Causing a numbing sensation in feet
Ketoacidosis Altering the PH of your blood and can
lead to diabetic coma or even death
Kidney disease (Nephropathy)
Hypertension (High Blood Pressure)
Stroke When blood glucose, blood pressure, and
cholesterol levels become severely altered
Hyperosmolar Hyperglycemic Nonketotic Syndrome
(HHNS) This can cause severe dehydration leading
to seizures, coma, and eventually death.
Gastroparesis Delayed gastric emptying. Effecting
the vagus nerve.

Daily life
Independence
Living with edema can be very
restricting. For my client it effects
their mobility therefor they are forced
to use a walker for every activities.
This directly effects their safety.
client has experienced many falls.
Being confined to a walker also
impedes their social interaction.
Client is unable to walk or stay away
from home for extended periods of
time.

Other factors

Client also has an ostomy bag

that makes mobility and every
day activities even more difficult
to perform.
Client is living with their
significant other which helps with
certain tasks. And also adds extra
security incase of falls.

How clients been doing

Client said that she was doing pretty good
She hasnt had any falls recently
She checks her glucose levels every morning and evening
She went to the doc on the 21st or 23rd
Doc said her A1c is just below where it should be
She has fluid buildup around her feet
The meds shes been taking for fluid buildup have been working
Shes been doing a lot more walking around the house
She has been eating a lot more dairy and calcium containing foods as
requested by the dietician.