The plan of care for a selected patient, within an inpatient setting Essay Example

European New Zealand citizen, prefers to be called Joy. She is an Anglican with strong religious beliefs. Eight years ago, she became a widow and now has three adult children - two daughters and one son who lives in Australia. Her two daughters currently live with her, and she resides with her youngest daughter. Joy considers her family to be very close. Before retiring at the age of 60, she worked as a librarian for 35 years. After retirement, she looked forward to annual visits to Australia to spend time with her son until her health started declining.

Joy is an outdoor enthusiast who loves gardening and spending time with her grandchildren. She also enjoys cooking and has a passion for tapestry. Despite pausing due to a health scare, she intends to continue working on her unfinished art project. Additionally, Joy actively participates in the women's club and eagerly joins the annual flower arrangement competition held in November.

Joy has been suffering from severe abdominal pain for the last three years, with different levels of severity. The pain is sometimes so intense that it leads to excessive diarrhea lasting two to three days, followed by constipation in the following days. When these symptoms started occurring regularly, Joy's doctor became worried and referred her to a specialist for additional tests.

These tests involved sending Joy's feces to the laboratory, which revealed elevated levels of white blood cells and red blood cells in 2006. However, no disease-causing microorganisms were found in her feces.

In June 2007, an endoscopy was performed to investigate persistent symptoms. The procedure involved inserting an endoscope, a small tube-like device, through the rectum to capture images of

the ventral body (Marieb, 2001). The results of the endoscopy revealed that Joy had sigmoid diverticulosis, which is typically seen in individuals over seventy years old and involves the development of pouches in the sigmoid colon due to weakening of its mucosal wall (Marieb, 2001). Common causes of diverticulosis include a lack of dietary fiber, decreased physical activity, aging, and poor bowel habits (Porth, 2002). Joy's symptoms are consistent with typical manifestations of diverticulosis such as altered bowel habits with constipation and occasional episodes of loose bowel movements.

Joy was told to follow a high-fiber diet, but her symptoms persisted. On September 14, 2008, while shopping with her daughter, she collapsed abruptly from intense pain and was swiftly taken to the emergency department by ambulance. Joy also experienced excessive watery diarrhea. The assessment demonstrated that Joy had abdominal distension, tenderness upon palpation, fever, vomiting, and stool tests confirmed the presence of blood. As a result, Joy was admitted to the acute surgical ward where she received analgesics and Intravenous fluid.

During endoscopy, diverticulitis was detected and a feces culture confirmed the growth of Yersinia enterocolitica. Yersiniosis, caused by consuming contaminated food or contact with animal wastes and poor hygiene practices like the fecal-oral route (Bishop, 2002), can be a result of these infections. To prevent cross-infection within the ward while taking care of Joy because Yersiniosis is infectious in nature, she had to be isolated in a separate room.

Diverticulitis is a complication of diverticulosus, characterized by inflammation and small microscopic perforation of the colon (Porth, 2002). Joy has been diagnosed with both diverticulitis and colitis, which specifically refers to inflammation of the colon.

Joys current medications include:

• Meteronidazole –
  

an antibiotic prescribed for treating colitis caused by Yersinia enterocolitica.

(Mims, 2007)

She has severe allergic reactions to multiple drugs, including Pencillin, Clindamycin, Ciprofloxacin, Pethidine. She also has less severe reactions to Doxycillin, Codiene, cephalosporins, and zopiclone.

From September 16th to September 24th, 2008, I provided care for Joy in the ward. During this time, my focus was on addressing her chronic pain, enhancing her nutrition readiness, managing constipation and diarrhea, and alleviating her anxiety. It is crucial to mention that Joy has explicitly stated her preference not to receive resuscitation if she experiences cardiac arrest. She has expressed a desire to avoid living a life reminiscent of a vegetative state and would prefer death.