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Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease – Nursing Assignment Case Study

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Review the following case study and in a written paper, respond to the questions that follow. Bob Smith is a retired banker. He is 72 years old. After retirement, Bob became very active as a volunteer, driving patients for treatment at the local cancer center. He attended church regularly and was involved with church activities. Bob has a 10-year history of chronic obstructive pulmonary disease (COPD) and a recent diagnosis of dementia, most likely Alzheimer’s.

Mary Smith is Bob’s wife. She is 69 years old. They have been married for 46 years. Mary stayed at home and cared for their children. Mary has diabetes and is legally blind. She is very dependent on Bob.

John Smith is Mary and Bob’s son. He lives 120 km away and has never married. Carol is Mary and Bob’s daughter. She lives in the same community as her parents. Carol is divorced and has custody of her three children. Robert is 24 years old, lives at home, and works in a warehouse; Sarah is 22 years old, lives at home, and attends university; Melanie is 16, lives at home, and goes to school. Carol works fulltime as a legal secretary at a local law firm.

During your initial visit you learn that Bob is vague and anxious. He also exercises less initiative than he used to in pursuit of activities he used to enjoy. One year ago he couldn’t seem to work out how to plant his garden. Carol has been helping with shopping and driving and has taken responsibility for his banking. She is also organizing her parents’ medications, helping her mother with bathing, and providing meals. Carol is very stressed and desperate for some help.

You are Bob’s home care case manager. See Questions and Marking Criteria for “Home Care Case Manager” on the following page. Two months after you have admitted Bob to your caseload, Carol calls and tells you Bob has been admitted to hospital with an exacerbation of his COPD and possibly has pneumonia. His respirations are wheezy and he is extremely short of breath when he talks. Bob has a productive cough and is expectorating thick, greenish sputum.

You become Bob’s case manager in the hospital. See Questions and Marking Criteria for “Acute Care Case Manager” on the following page. Bob’s pneumonia has resolved and he is ready for discharge home. You have noticed, however, that he tends to wander around and sometimes appears to become lost on the ward. He doesn’t always recognize his family members when they come to visit. Carol tells you his dementia “seems worse” and doesn’t think he can be discharged home. Carol is concerned her mother will not be able to cope with Bob’s behaviour and that her parents will not be safe if they do not have constant care. Bob is transferred to a long-term care facility. Mary has applied to the same facility but there no beds are available. She is receiving services from home care.

You become Bob’s case manager in the long-term care facility. See Questions and Marking Criteria below.

As you work through the case study, answer the following questions. This is not a formal style, written scholarly paper. Number the question, type the questions, and answer each question briefly in complete sentences. Must use size 12 Times Roman font and double space. No introductory or concluding paragraphs are needed. See marking criteria below.

Questions:

Home Care Case Manager 
1. What information do you need to gather to complete your assessment of Bob?
2. What is your plan of care?
3. Who will you involve in developing and implementing your care plan?
4. How will you evaluate the outcome of the services Bob receives?
5. As a home care case manager, what is your responsibility to the Smith family now that Bob is in hospital?

Acute Care Case Manager 
6. As Bob’s care manager in the hospital, what information do you need to gather to complete your assessment of Bob?
7. What is your plan of care?
8. Who will you involve in developing and implementing your care plan?
9. How will you evaluate the outcome?
10. What is your responsibility to the Smith family now that Bob cannot be discharged home?
One reference required for this section.

Continuing Care Case Manager 
11. As Bob’s case manager in the long-term care facility, what information do you need to gather to complete your assessment of Bob?
12. What is your plan of care?
13. Who will you involve in developing and implementing your care plan?
14. How will you evaluate the outcome of the services provided? One reference required for this section.

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