Posted: February 25th, 2016

Daisy case study

Background information

Daisy is a 70 year old widow who lives alone. She has a fairly active life doing part-time volunteer work for the CWA and local heritage museum. Her daughter lives nearby and works full time. She relies on Daisy to look after her 3 year old son on Fridays. Daisy is a non-smoker, occasional social ETOH drinker (1 – 2 standard drinks) though was a moderate risk consumer of ETOH in her middle- age.

Health history:

• Hypertension

• Hyperlipidemia

• Mild obesity

Surgical: hysterectomy at 42 years of age

Diet: Does some cooking but prefers instant microwave meals. Enjoys a daily pastry or cake from the local bakery.
Exercise: Recently started walking every 2nd morning following GP advice to lose weight. Minimal exercise for last 30 years.
Medications

• Perindopril 5mg daily

• Atorvastatin 20mg daily

• Aspirin 150 mg daily

• Progynova 2mg daily

Daisy was recently diagnosed with colorectal cancer following complaints of lethargy, abdominal discomfort and episodes of frequent diarrhoea. She was admitted to hospital for elective surgery to remove the tumour and required the formation of a temporary colostomy. On day two post- operatively, Daisy complained of sudden dizziness and palpitations. Her nurse found that she was tachycardic and hypotensive and called a Rapid Response.

Vital signs:

• Pulse 130-150 irregular

• BP 100/65

• RR 24

• SpO2 98% on 2L NP.

• Temp 37.2

PCA – moderate wound pain

Following the Rapid Response, Daisy was transferred to the High Dependency Unit for treatment and monitoring.