Daughters Anne and Jenny. Husband deceased 30 years ago.

NURS 3003 Dynamics of Practice 3
CASE A
Patient: Mrs Mabel Winter
DOB: 07/01/1930
Weight: 45 kgs
Height: 155cms
Family/Significant others
Daughters Anne and Jenny. Husband deceased 30 years ago.
Background
Mrs Mabel Winter is an 90-year-old widowed woman admitted to hospital following a fall at home resulting in a fractured right hip (# R) NOF or neck of femur). She lives alone (with her two cats) in her own home, without any community supports.
Mrs Winter has two supportive daughters who live nearby. Each week, they take turns visiting their mother although they have been concerned about her increasing disinterest in caring for herself. Mabel used to play cards with her friends but has lost interest in any social activity. Mable lives in house in the metropolitan area of Elizabeth Vale in South Australia and says that she is happy to remain at home with her cats, watching television and pottering in her small garden. Mrs Winter is reluctant to eat because she has been experiencing dizziness when she stands, especially after eating. Following a fitness to drive assessment by her general practitioner, Mabel has not had her drivers’ licence renewed partly because her HbA1C has been consistently high and also because of her recent operation and reduced mobility. This has caused Mabel some distress as she is used to being reasonably independent.
Hospital stay
Mrs Winter has now had a hemiarthroplasty (Austin Moore prosthesis) and has been cleared to return home.
Mrs Winter has been on the rehabilitation ward for two days and staff are concerned about her weight loss, poor concentration and general well-being. She is malnourished and has had several falls in the past, however, this is the first requiring hospitalisation. During her hospital stay, her diabetes has been uncontrolled and her doctor has commenced her on insulin in the short term until her blood glucose levels stabilise. She is eager to return home as soon as possible.
Past medical history
L) colles fracture, 2014,
R) humerus fracture 2016,
Orthostatic hypotension
LSCS X 2
Type 2 Diabetes mellitus (HbA1C 2 months ago = 9.8)
Osteoarthritis
Osteoporosis
Past family history
Father – cerebral vascular accident (CVA) – deceased
Mother – myocardial infarction (MI) – deceased
Sister – breast cancer – deceased
Allergies:
Nil known
Medications
PO Atorvastatin 10 mg daily
PO Captopril 25mg b.d
PO Paracetamol 665 mg 8 hourly prn
PO Ostelin 1000 10mcg daily
Previous PO Metformin (Javumet) 50/500 b.d.
Insulin (Lantus) 8units 2 hours preprandial at night commenced during hospital stay
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