Crohn’s Disease
This disease is a bowel disease that is caused by the inflammation of the wall of the bowel. Crohn’s affects the digestive system which includes the mouth down to the stomach, bowels and anus. If a person has Crohn’s disease they will receive swelling in the affected areas of their bowel and ulcers may form, this is the area of the bowel that bleeds. The bowel wall will be thickened, this may cause blockages. An individual is likely to get Crohn’s disease if the person’s immune system overreacts to bacteria within the bowel. Just like diabetes Crohn’s disease can run in the family (genetically influenced), the disease can be caused by smoking, bad intake of foods (diet that is high in sugar and low in fibre). Long term effects can be server such as a fistula this is an abnormal connection between the bowel and the skin or a slightly increased risk of developing bowel cancer.
P3
Describe the clinical investigations carried out and measurements made to diagnose and monitor the disorder in each individual.
In terms of understanding the signs and symptoms and the influence of the disorders of both Karishma (Diabetes) and Pauline (Crohn’s), I now need to research on the measurement made to diagnose and monitor/condition their disorders.
As Karishma has shown signs and symptoms has been showing of diabetes, she would probably go to seek medical attention from her personal GP. Once Karishma explains her case the GP will inform her of her Physiological disorder and how she may treat this disorder. The GP would state that if diabetes is not treated, it could cause long term health problems because the high glucose levels will damage other parts of her body. The types of treatment GP’s will suggest involve, changing a person’s lifestyle- eating healthy and taking regular exercises this will improve/ gain glucose control. Type 2 diabetes tends to get worse so over time it is usually necessary to increase the dose of tablets, add in new treatments and to combine different types of glucose-lowering tablets being referred to insulin. Metformin is usually the first medicine that is advised for Type 2 diabetes if lifestyle changes haven’t brought blood glucose levels down this medication reduces the amount of glucose that the liver releases into the bloodstream. is a vaccine that increases the amount of insulin produced by the pancreas and helps to make body cells more sensitive to insulin. is usually given as an alternative or in addition to metformin if blood glucose levels remain high on metformin. After seeing the GP, Karishma will be referred to see a nurse/doctor. The Doctor would carry out blood tests to confirm her disorder, once Karishma is diagnosed hospital clinics which involve diabetologist /specialists will be available to provide treatment, help and support.
Pauline may also seek medical advice from her local GP, in regards of her signs and symptom being displayed. In similar cases Pauline would get advice from her GP who will inform her of her disorder and how she may treat her disorder. The GP may state that if Pauline’s disorder is not treated in the long term she could develop bowel cancer. Pauline’s GP would refer her to a gastroenterologist this is a doctor that specialises in conditions that affect the digestive system, this doctor will carry out blood tests, faeces tests, sigmoidoscopy-this is a telescope that is inserted through the anus and into the bowel to view the lining, also x-rays such as CT scans-this scan shows dimensional images of the bowel. The treatment that is advice to be carried out include, diet – eating and drinking healthy is essential the food intake must be high in fibre starchy foods such as pasta should be avoided. Medication is also advice as a source of treatment, corticosteroids is used to reduce inflammation, medication to suppress Pauline’s immune system (merthotrexate) and infiximab is advised by doctors if Pauline has or develops severe Crohn’s disease.
P4
Describe the care processes experienced by each individual case and the roles of different people in supporting the care strategy.
Both Karishma and Pauline have challenging disorders that have a process in which needs to be carried out by professions in order to treat their physiological disorders.
General practitioners
GP’s examine patients at a surgery or even at the patient’s house, with a view to diagnose the patient’s disorder. In relation towards Karishma and Pauline’s situation After making a diagnosis the GP of the two individuals may give professional advice as to what the patients should do, giving a description of their disorder prescribing medication or treatment or they may carry out minor surgical operations. GP’s sometimes are not able to produce a diagnosis or give out any treatment if this is the case they refer the patient to a specialist for further investigations. GP’s will also monitor the course of the patient disorder through visits and working with other professions involved in care team such as nurses, health visitors, midwives, physiotherapists, counsellors, dieticians and administrative support staff. In suspicion of Karishma being identified with diabetes
Clinical specialists
Clinical specialist are experts that have the knowledge and understanding of physiology, their job is to investigate, diagnose and prescribe treatment for patients who have been referred by general practitioners , give advice to the patient and ensure that their disorder is managed by monitoring the course of the action taken e.g. through consultants, investigations and adapting treatments.
Nurses
Nurses work in care homes, hospitals, health centres, schools, prisons and so on, nurses plan and promote health care they also monitor patients disorders using observations and the evaluations of patients progress, adapting care management if necessary and the consultation of doctors. The practical care that nurses give include health screening this is taking measurements of weight, temperature and taking blood and urine samples. Nurses can also give out medication, treat injuries, assist doctors with physical examinations, give out blood transfusions and drips the can also give out advice in regards to the patient’s disorder. Other professions such as physiotherapist (takes care of physical disorders) occupational therapists, dieticians and nutritionist all work together to help treat or care for when physiological disorders occur.
Pharmacists
Pharmacists specialises in research and develop new medicines, community pharmacists work with GP’s to support patients in the course of their disorder by monitoring the effectiveness of their medication. Both community and hospital pharmacists prepare medication from prescriptions, give advice professionally and information on how to use medications correctly.
P5
Explain difficulties experienced by each individual in adjusting to the presence of the disorder and the care strategy
As I have identified the signs and symptoms of Karishma and Pauline’s disorder stated the types of care in which they may encounter as well as the treatment, it can be very difficult for the two clients to adjust to the source of information received.
In adjusting to the strategy of care Karishma may find difficulty in changing her life style, this is because she has responsibilities such as attending the needs of her three children and attending work. In trying to adjust to treatment may mean having to sacrifice the responsibilities, in terms of having checked up Karishma may need to take time off of work. In having diabetes Karishma can get tired, as an effect of that she may not be able to spend time with her children (a discharge in relationship bond). As the GP has subjected that she takes regular exercises, Karishma may find is hard to find time to participate in regular activity as her schedule is tight. In terms of the intake of Medication as her GP has stated the a change in her lifestyle is relevant and her lack of insulin can be resolved by taking insulin secetagogues which will help the production of insulin, Karishma may not understand how to used the medication effectively and as her schedule is tight she may forget when to take the medicine. In regards toward her diet as Karishma works in a hospital she could focus more on the needs of residents at the care home, Karishma could forget to eat or could forget to eat healthy.
Some people with Crohn’s disease have frequent flare ups and others have attacks as life goes on. In Pauline’s case she also has responsibilities as she work as a receptionists she is always busy, in treating Crohn’s can become challenging it takes time and patients. In having Crohn’s Pauline would have to regular checkups and participate in surgery to help control her disorder as a result in this Pauline may need to take some time off of work. In terms of her intake of food has to be limited as certain food sources could provoke inflammation foods such as potatoes, bread, pasta and other starchy carbohydrates, Pauline has to change the way in which she eats. In taking medication require allot of time and effort, in taking medication can sometimes make provoke the situation if Pauline is not aware of how she should take is, when and how it works making matters worse.
Reference
P6
Compare the possible future development of the disorders in the individuals concerned.
To understand the progression of a Physical disorder and its impact on an individual and how care strategies changes in the course of time is to come to a conclusion of what may happen in the future in terms of treatment being carried out, this is known as recorded prognosis.
Diabetes
Having diabetes can be crucial if not treated; uncontrolled high blood sugar (hyperglycaemia) is caused by the entreating of diabetes this could lead to a number of long term complications. As time proceeds small blood vessels become damaged, this causes damaged to the eye and kidneys which leads to blindness and kidney failure if left unidentified. Nerves in the body can also be spoilt the ability of Karishma feeling sensations and pain e.g. loss of feeling in the hand or feet (touching a burnt pan without feeling the burn). Blood sugar not being controlled can damage the large blood vessels, it can make the lining of the arteries narrow in this disruption heart disease and or a stroke can occur. Having diabetes treated is a life time change as diabetes cannot be cured but maintained diabetes can be controlled by lifestyle change only, consisting of diet changes, exercise and medication all these types of changes should be maintained to prevent hyperglycaemia from occurring.
Crohn’s
Crohn’s disease is also a life frightening disorder and is also a lifelong disease, if the disorder is not treated it can become sever. Crohn’s disease is due to inflammation in the wall of the bowel in saying this Crohn’s being active can cause other problems to occur, problems such as mouth ulcers, joint pain the inflammation as Pauline is a female it may also cause fertility problems and could increase the risk of having a miscarriage. Having the disease and not treating it can cause crucial complications long term inflammation such as a fistula which is an abnormal connection between the bowel and the skin and an increased risk of bowel cancer. Having Crohn’s treated also takes a lifetime that consists of treatment, consisting of continual checkups, blood test, CT scan, x-rays these are used to see the progression of the disorder.
References
Btec National Health and Social Care Book 2; Nelson Thornes
M1
Explain how the course of the disorder in each individual relates to the physiology of the disorder.
Physiological disorders can change from time to time, by this I mean that having disorders such as diabetes and Crohn’s can be crucial.
Karishma has diabetes type 2 having this sort of condition takes a life time of treatment, diabetes is a chronic illness, in which the body is exposed to continual high levels of blood glucose, this condition is called hyperglycaemia. Glucose is sugar that is an important source of energy, Low levels of blood glucose causes generalized weakness, and if the hypoglycaemia is severe and lasts longer than 30 minutes or so, brain cells will begin to die.
Diabetes is a disease that unbalances the metabolism of . Normally, one of the central sources of metabolic energy is the simple sugar glucose, which is carried throughout the body in the bloodstream which is stored mainly in the liver and muscles. Glucose is the source of quick energy that the body needs for a minimum amount of glucose in the bloodstream. Any excess blood glucose can damage tissues that are present in the body. Insulin is the hormone that keeps blood glucose levels from getting too high, but diabetes disrupts the body's ability to use insulin effectively.
On the other hand, too much blood glucose is also a serious health problem. In the short term, very high blood glucose levels can lead to life-threatening dehydration or even cause an individual to have a coma. Over the long term, hyperglycemias could damage the capillaries and larger blood vessels by thickening their walls and narrowing their inner diameters. This reduces the blood flow to many areas of the body and causes permanent tissue damage, notably to the retinas and kidneys. Long-term high blood glucose levels also damage nerve endings.
Pauline has been identified as showing signs and symptoms of Crohn’s disease, Crohn’s disease is an inflammatory bowel disorder which exists in the digestive system that is often unknown as to what causes the disease but involves genetic and even environmental influence on the gastrointestinal tract’s ability to tell between foreign from natural. Cohn’s disease tends to mostly appear within abdominal pain and perianal disease, ulcerative colitis which is another form of bowel disease is more often causes gastrointestinal bleeding to occur. Cohn’s is a chronic illness that requires allot of attention in terms of treatment just as diabetes it is a life time illness but has the potential to progress extensively. This illness usually appears early in life most patients have the illness at the age of 15 but he average age at diagnosis is 27 years, Pauline is between those ages. Individuals who have crohn’s disease show symptoms of abdominal cramps, diarrhoea, weight loss, fever, , within Pauline’s case it stated that Pauline was experience these types of symptoms. It also stated that her condition of the pain would come and go and sometimes the pain would become worse, these are conditions of having crohn’s.
References
www.medic8.com/healthguide/articles/crohns.html
M2
Explain possible difficulties involved in making a diagnosis from the signs and symptoms displayed by the individuals and the results of their investigations.
Figuring out a diagnosis for individuals is a challenging task especially in the early stages of a disorder, diabetes can be easily diagnosed but can be confused in terms of its sign and symptoms e.g. a common symptom of having diabetes is an individual feeling tired but feeling tired could amount to theories of a lack of sleep, its natural for their age and so on so the symptom of feeling tired does not necessarily diagnose the individual in terms of having diabetes. Diabetes is often associated with being over weights their could be theories/diagnosis of in taking too much fatty foods, having a slow metabolism or even a reaction of taking certain treatments (females on the pile) this symptom could also hinder or mislead a doctors diagnosis for this is one of the early symptoms of having diabetes.
The sign and symptoms of disorders in its early stage displayed in a patient can be similar e.g. the symptoms of crohn’s are the same as Chlamydia they both cause Painful urination and Lower abdominal pain. Doctors investigating these symptoms can mistakenly diagnose the patient with the wrong disorder due to early stages, it is very important that care professions take their time in diagnosing a patient it takes a series of investigation to locate the problem.
Diabetes is usually not diagnosed until health complications have occurred investigating on diabetes includes blood testing where blood is drawn and sent to a lab for analysis, some people have a normal fasting blood glucose reading, but their blood glucose rapidly rises as they eat. These people may have glucose intolerance. If their blood glucose levels are high enough, they may be diagnosed with diabetes in this in which doctors/ nurse/GP’s are involved may get different readings as to what the blood test is indicating slowing down the process of diagnosis. Investigations for crohn’s include physical examination this includes a pelvic examination where the doctor checks the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum for any changes in their shape or size this examination can also be interpreted wrong or differently which could add towards difficulties of diagnosis.
References
M3
Explain how the care strategies experienced by each individual have influenced the course of the disorder.
Care strategies are set methods that are used to help condition individual disorders what ever the disorder may be. Within the two case studies I have identified karishma as having diabetes and Pauline having crohn’s, the care strategies I have chosen to help care for the two individuals are:
General Practitioners Surgery
This is the start of care strategies; this method is used to provide answers to patients who seek guidance for symptoms they may be experiencing. General practitioners can have a long term relationship with service users that can add to an advantage e.g. patient may have a history of illnesses where they have a personnel GP which helps to see the pattern of the disorder through the history of diagnosis. The GP will ask relevant question on the symptoms and can witness the signs, then come to conclusions of what the disorder may be carrying out a physical examination to support their theory of diagnosis. The physical examination involves measurement that may go towards the theory of diagnosis e.g. Karishma has sign and symptom of diabetes so the measurement that will be carried out include her taking a blood test, body temperature and breathing and the same will be carried out for the theory of Pauline having Crohns. In this the General practitioner has given additional information to Karishma and Pauline as to what their condition may be who they must see to confirm, what investigation may take place.
Professionals allied to medicine
This profession includes, Occupational therapists who are experts in looking towards employment or getting back to work e.g. Pauline is a solicitor and due to her experience of abdominal pain and diarrhoea she is no longer able to work an occupational therapist could help provide solutions as to how Pauline can work again after treatment. Occupational therapists will assess the patient and if necessary visit their home to see their progress.
Radiographers are professional health care workers that are present in diagnostic x-ray departments or radiotherapy departments. The perform their diagnosis by positioning the service user in a correct angle of the radiation the process of radiography or radiotherapy this could serve of good use in term of Pauline in suspicion of crohn’s (radiotherapists will be important to cancer patients in particular).
Pharmacists
This type of professions can be joint with hospital settings supplying medication for patients with in the hospital care or patients who are not in care. Pharmacists give out advice and treatment and can offer extra services such BP and blood glucose monitoring e.g. Both Karishma and Pauline could not only seek help or advice from her GP but they could go to a local pharmacist and get tested. Most people go to seek advice from a pharmacist because it seems less frightening and more informal than going to a surgery.
References
http://en.wikipedia.org/wiki/Clinical_Nurse_Specialist
D1
Evaluate the contributions made by different people in supporting the individuals with the disorders.
Care professions aim to provide the most effective care for individuals in society who are in need of care although this is their aim there are some strengths and weaknesses in regards towards care applied.
General practitioners aim to help, advise, guide and provide primary care for service users; they assist users by interacting and examining to identify any problems they may have these are some of the positive aspects of a practitioner. Another positive aspect of this type of profession is that the problem has been identified the practitioner will try and come up with a conclusion as to what the individual should do about their discovered disorder e.g. the GP may give a patient a prescription in which the patient is referred to go to a pharmacy where they can receive treatment (medication). A practitioner will describe the disorder to the patient making the aware of their problem giving tips on how the can cope or manage with their disorder, they will also monitor the course of patients disorders through visits and working with other professions who are involved with care e.g. nurses, health visitors, dieticians and other care providers. A negative side of a general practitioner in supporting their patients they can be limited in terms of figuring out a diagnosis for individuals e.g. a practitioner may not know what type of disorder the patient may have as they have show signs and symptoms of many disorders but a positive side is that if this is the case patient can be referred to of specialists for further investigations.
Clinical specialist’s strengths are that they have an in-depth knowledge and expertise of physiology; they set their role of investigating, diagnosing and prescribing treatment for patients particularly who are referred by GP’s. They don’t only give suggests or advice to their patient but they are able to provide information of the patient to GP’s and other care team professions and ensuring that the disorder is being managed by monitoring its course. A weakness of care, specialist may not come to a conclusion as to the disorder may be, in the time of investigations when consulting with consultants in terms of the disorder they may different views which could add to confusion.
The strengths of Nurses are that they have four branches to suit patients needs these include an adults, children, learning disability and mental health departments. Nurses can work with communities e.g. care homes, GP surgeries, health centres, schools, prisons and in hospitals. Nurses come up with methods of implementing care; they monitor the course of disorders through research, observation and evaluation of patient’s progress. They provide support to the patient and their families this is a form of practical care e.g. nurses promote health and wellbeing for diabetes by taking blood tests, injections (insulin), medication and so on. The weaknesses in of supporting service users, nurses can be limited of technical assistance e.g. service user at care homes may weigh a considerate amount care workers find it a struggle and are in need of a hoist but are not supplied with one.
Counsellor supplied by the NHS in GP surgeries, health centres, and hospitals. The strengths of the support of counsellors are that they work with patients who find it difficult to adjust/except or cope with their disorder e.g. patients who find out they have cancer may feel anxious, depressed, afraid counsellor are to listen allowing patient to express their feelings supporting their social and emotional needs. In listening to the thoughts service users counsellors help support them a safe environment keeping their personal detail (problems) confidential, helping patients find solutions and develop a lifestyle enabling them to cope with their disorder and helping them to understand their problem allowing them to see different perspectives. A weakness of a counsellor is that they are not able to give advice or any sort of feedback they are there just to listen.
References
Bibliography
Btec National in Health and social Care Book 2: Nelson Thornes
D2
Evaluate alternative care strategies that might have been adopted for each individual.
D1
State the strengths and weaknesses of the assistance given to the individuals by the careers, state what specialists do and whether it has brought satisfaction the patient.
Expensive medications, often hospitalisation and/or surgery, and results in a heavy social and economic toll.
