A Family Case Study of A 74 Years Old Woman with Type II Diabetes Mellitus

A Family Case Study of A 74 Years Old Woman with Type II Diabetes Mellitus

CHAPTER ONE

INTRODUCTION

Client and health condition

This case study is about Mr. F.O’s family with special attention to Mrs. U.O., a 74 years old woman who hails from Egbegbu village, Njikoka L.G.A of Anambra State but resides at No. 7 obiora street, Abakaliki who was accompanied to the outpatient department of the Federal Teaching Hospital Abakaliki (FETHA II) on 10th February, 2017, where I happened to be on duty. She came in with the complaints of general malaise, excess urination, excess hunger, excess thirst e.t.c. on examination, she had a temperature of 380C, pulse 90b/m, respiration 26c/m, weight 90kg and blood sugar test read 250mg/dl (fasting blood sugar level). The diagnosis of diabetes mellitus was then made by the doctor in charge after proper review of the patient and the following treatments were prescribed: Insulin 10 IU, Glucophage 500mg, Esidrex 25mg, lisinopril 10mg, micopirin 75mg, Diaonil 5mg and multi-vitamins. The doctor ordered that the patient be admitted into the female medical ward for comprehensive observation for three days. At the end of the three days, the patient was found to be stable and was discharged home. Then I assisted the client in getting the drugs and indicated interest on following up the case which she accepted. I also informed the matron in charge of the female medical ward of my interested to follow up the client for proper care and education which she accepted.

 Case study background

 The family composition:

The family is a nuclear family composed of nine members, the husband, wife and their five children (3boys and 2 girls). Mr. F.O. is the head of the family and lives together with his wife-Mrs. U.O. and their little maid- Miss A.C. in a three bedroom apartment built by the man as the children have all married and gotten their own homes. The family is a bit enlightened and can be generally described as an average family. Mr./Mrs. F.O. have finished training their children up to the university level and they have all graduated successfully from their various discipline and have all married and that’s why they now got a maid that stays with their parents while they visits occasionally.

  • Client’s Biodata:

Name:                                        Mrs. U.O.

Age:                                           74years

Sex:                                           Female

Address:                                    No. 7 Obiora Street, Abakaliki

Marital Status:                           Married

State of Origin:                          Anambra State

L.G.A:                                       Njikoka L.G.A.

Nationality:                                Nigerian

Number of children born:          Five (3 boys and 2 girls)

Next of kin:                               Mr.F.O.

Address of next of kin:              same as above

Relationship:                              Husband

Religion:                                    Christianity.

  • The family social history:

Mr. and Mrs. F.O. hail from Egbebu village in Njikoka Local Government Area of Anambra State but reside in Abakaliki, Ebonyi State where he worked as a civil servant until his retirement.  They migrated about 40 years ago from their village. Since then, they have lived and brought up their children in Abakaliki until they are all married.

S/N Name Age (years) Sex Relationship Occupation
1 Mr. F.O. 89 M Father Retired civil servant
2 Mrs. U.O. 74 F Mother A petty trader
3 Mr. A.O. 59 M 1st son Business man
4 Mr. C.O. 52 M 2nd son Rev. father
5 Mrs. J.O. 48 F 1st daughter An economist
6 Mrs. F.O. 44 F 2nd daughter An accountant
7 Mr. S.O. 41 M 3rd son Politician
8 Miss A.C. 16 F House maid Student

 

  • Family health history:
  • Past medical/surgical history: There has been no significant medical or surgical history in the family. My client-Mrs. F.O. had normal pregnancy, labour and pueperium during her pregnancies. All other minor health problems like headache, malaria etc. were being managed at home by a chemist man who resides nearby.
  • Present medical history: My client-Mrs. U.O. was brought by her husband and children to the outpatient clinic of the Federal Teaching Hospital Abakaliki (FETHA II) on 10th February, 2017 where I was carrying out my clinical experience. There I met the family for the first time. We established rapport and her biodata was taken including physical examination (head to toe). Because of the complain of excessive urination, excessive thirst, excessive hunger, general body malaise etc, type II diabetes mellitus was suspected and the case was reported immediately to the doctor in charge who after taking history from her, referred her to laboratory for random and fasting blood sugar check. When the results came out, it showed that her blood sugar level was high (about 210mg/dl). Based on the findings, the following treatment was commenced immediately: 10iu of long-acting insulin daily, Tab. Metformin (glucophage) 500mg daily, Tab. Esidrex 25mg daily, Tab. Lisinopril 10mg daily, Tab. Micopirin 75mg daily, Daily blood glucose check, Meal rich in fruits, vegetables, less carbohydrates and fats and finally 30 minutes exercise for each day.

She was admitted in the female medical ward and the above treatment commenced on her after three (3) days when she has become stabilized, she requested for discharge and was later discharged on the evening of that same day (13th February, 2017).  Mrs. U.O. and the family were assisted to purchase the take home drugs and my intention to visit them at home was made known to her and the matron in-charge of the female medical ward. They accepted and were pleased with it.

 Objectives of the study

The objectives of the study include:

  1. To identify the various types of diabetes mellitus
  2. To highlight the predisposing factors of diabetes mellitus to my client and the family.
  3. To describe the pathophysiology of diabetes mellitus to my client
  4. To give appropriate health education on the cause, predisposing factors, prevention and management of diabetes mellitus to the family during home visit.
  5. To supervise the client on the course of treatment during home visit

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