Ms Aamira Agar is a 66-year-old Sudanese

Ms Aamira Agar is a 66-year-old Sudanese lady, who resettled in Australia as a refugee in 2002, following displacement by the second Sudan civil war. Aamira has poor English language skills, and relies on her Sudanese community to translate. Her husband died during the conflict in 1999. She has no surviving children. Aamira has just been admitted to your medical ward as a direct admission via GP (no admission to ED). She has been admitted for investigation and management, of suspected poorly controlled new diagnosed diabetes, by the GP. It is currently Ramadan which complicates management. The GP also suspects Aamira may have underlying early heart failure, and has requested further investigation in hospital. She has no previous admissions for this condition, but is currently experiencing significant shortness of breath, particularly lying flat, a persistent cough, nocturia, and has some swelling of her lower legs, and feet. Aamira has no known allergies. You are the primary Registered Nurse providing care for Aamira. PMHx: o Hypertension o Osteoporosis o Gall stones 2005 o Chronic leg ulcer, left lower leg o Ex-smoker, 10/day x 20years, quit 1995 o Suspected PTSD Social History: o Widowed o One niece – lives in Melbourne to attend uni, sees Aamira x 3 times per year. Was due to visit this week but had to cancel due to VIC COVID border closures. o Currently living in own home utilizing community nursing services. 2 times per week. Assistance with cleaning and dressing of chronic leg ulcer. o Strong ties to the local Sudanese community who check on Aamira daily. Also rotate helping with meals as needed. o Minimal exercise due to shortness of breath on exertion (SOBOE). o Practitioner of traditional medicine within her community, has a small garden where many Sudanese herbs grow, recently unable to attend to garden. o States she has moderate appetite. Some recent weight gain. Often thirsty. Assessment Findings: o Items not attended by GP as direct admission to ward; CXR, Pathology, ECG. o RR 30, labored breathing, speaking in short sentences. Some wheezing heard. Persistent cough, has been getting worse for the last month. o Observations at the GP’s; SpO2 96% on RA, HR 99, BP 145/85 o Noted bilateral oedema to lower legs o Short of breath, worse when lying flat o Increased need to urinate at night. o Fasting blood glucose I month ago 10.7 mmol/L today at GP’s 11.7 mmol/L Medications: o Peridopril 2.5mg Daily o Colecalciferol 1000IU Daily. o Alendronate 70mg once weekly (Wednesdays) o Paracetamol (Controlled Release 665mg) 1330mg TDS . ï‚· Reviewing the patient information, describe the aetiology of the conditions we suspect in Aamira, and discuss what the likely causes of the conditions are in Aamira’s case . ï‚· Discuss your initial health history taking, and nursing care for Aamira on her admission to your ward, taking into consideration what has and has not been attended already – think what is the role of the nurse in the care of a new admission, what information are you going to need to care for her?ï‚· What client education you will provide for the suspected diabetes, as this is her first admission for this condition, and what recommendations, or lifestyle changes, you would recommend for Aamira – how will you communicate this information to her, so that she understands it? What impact with Ramadan have on her care and management? ï‚· Discuss what services you will refer Aamira to, and engage with for Aamira’s discharge? Think about what she will need to return home, be safe and cared for, and continue to live independently. SCIENCE HEALTH SCIENCE NURSING

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