Case Study, Chapter 9, Chronic Illness and Disability

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1. Mr. Edwards is 20-year-old male patient who is admitted for treatment of recurring pyelonephritis (kidney infection) and surgical treatment of a urinary stricture, which has decreased the urinary stream. Mr. Edwards has paraplegia; he is paralyzed from the waist down secondary to an automobile accident when he was 16. He came by ambulance to the hospital, leaving his wheelchair and wheelchair pressure-relieving cushion at home. According to the nursing history, the patient is a nonsmoker and he does not drink alcohol or take any illegal drugs.  What nursing considerations should be made for Mr. Edwards related to his disability? What health promotion and prevention education does Mr. Edwards need?

2. Ms. Fulton is a 38-year-old mother who was recently diagnosed with myasthenia gravis, a chronic disease of the neuromuscular system. Management of this disease process requires strict adherence to a medication regimen. The disease also affects ADLs for the patient and her family. Additionally, because myasthenia gravis is characterized by exacerbations that may require hospitalizations, Ms. Fulton has had to resign from her position as president of a marketing firm. She has remained as an employee of the same company, but now serves as a consultant with more flexible work hours.  In discussing management of her chronic disease, the nurse focuses on what types of strategies? Describe supportive nursing care that may be helpful to Ms. Fulton.

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