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Chronic and Complex Nursing Care - Case Study Example

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Chronic and Complex Nursing Care Name of Tutor Systemic Sclerosis Systemic sclerosis (SSc) is defined as a multisystemic disease that is autoimmune affecting microvessels, small arteries and fibroblasts resulting in collagen accumulation, vascular obliteration and scaring of the skin and internal organs…
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Download file to see previous pages The musculoskeletal symptoms include pain, tendonitis, joint contractures, muscle weakness and arthritis. Urogenital symptoms include an increase in bladder wall, deposition of connective tissues and proliferative vascular lesions. In women, vaginal symptoms include tightness, dyspareunia and dryness. In men, there is a reduced penile blood flow leading to erectile dysfunction (Vlachoyiannopoulos, 2009). Prevalence The distribution of SSc is worldwide affecting all races. The prevalence of scleroderma has been estimated to be between 4 and 253 cases per million persons. Its susceptibility is influenced by factors such as sex, age, environmental exposure and genetic background. Family members may be affected by other connective tissue diseases meaning that a genetic factor might be an important factor in expression of the disease. The peak incidence is normally within the third and fifth decade of life. The ratio of male to female is approximately 5:1 while annual incidence being 14.1 cases per million. The highest prevalence for SSc has been found to be in Choctaw Native Americans in Oklahoma (Vlachoyiannopoulos, 2009). Treatment Therapy is normally individualized to each patient’s needs and clinical presentation due to the heterogeneity of SSc. The treatment is done for organ specific complications including: Raynaud Phenomenon This is done using long-acting channel blockers and angiotensin II receptor blockers. Phosphodiesterase-5 inhibitors are mostly used in the treatment of secondary Reynaud phenomenon. An oral endothelin-1 receptor inhibitor can be useful to the patients having recurrent ischemic ulcers (Eisenberg M.E. et al. (2008)). Scleroderma Renal Crisis Patients with systemic sclerosis are advised to regularly check their blood pressure at home. ACE inhibitors are used to control hypertension since they are essential in preserving and restoring of the renal function (Eisenberg M.E. et al. (2008)). Gastrointestinal Complications Therapies are essential in the control of gastrointestinal symptoms while preventing GERD complications. Patients with SSc and gastrical antral vascular ectasia normally require coagulation of the endoscopic laser to reduce the bleeding risks. Intestinal pseudo-obstruction is normally diagnosed during the laparotomy time while bacterial overgrowth is treated by antibiotics. The mainstays of therapy for the intestinal overgrowth are the antibiotics and correction of nutritional deficiencies (Eisenberg M.E. et al. (2008)). Pulmonary complications patients having an early and progressive interstitial lung disease may benefit from oral or intravenous cyclophosphamide. Symptomatic pulmonary arterial hypertension is treated by oral bosentan, parenteral epoprostenol, sidenafil, inhaled iloprost and treprostinil. Continuous oxygen is also necessary for patients with hypoxemia (Eisenberg et al, 2008) Lung cancer Lung cancer refers to cancer that forms in the tissues of the lungs, mostly in the cells that are lining air passages. The main types of lung cancer are: small cell lung cancer and non-small cell lung cancer. These types are normally diagnosed on the basis of how the cells look under the microscope (Wender R. et al, 2013). Symptoms Lung cancer may either present with symptoms or found incidentally on the chest imaging. Symptoms of lung cancer may result from the local invasion or the compression of adjacent thoracic structure like the compression involving ...Download file to see next pagesRead More
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