Case Questions on Medicine

Case Question 1

Having being diagnosed with autism, it might affect Tiana is a variety of ways. According to the Behavioural Neurotherapy Clinic (2009), it affects the patients verbal and non-verbal communication. For this reason, Tiana will not be able to communicate well, even with her young son, as well as the people around her. As such, her social interaction will be negatively affected, and she will develop an obsession over certain objectives. As such, she is most likely to develop an interest in repetitive behaviours, such as being used to a specific physical environments, rigid preferences about things, for example, food, and verbal rituals, where she is most likely be asking similar questions that need a single specific answer. In case she notices changes in her physical environment, including her homes furniture layout and the presence of new individuals or the absence of familiar ones, she will find it difficult to manage. In addition, since she will have rigid preferences, she is most likely to be eating food of certain colour, which might affect negatively on the feeding habits of the child. Her needs will change in a drastic fashion. For example, she will also prefer wearing clothes of a particular fabric or colour, as well as the use of particular items in her everyday life, such as toilet paper and soap. Also, she might get used to arranging items in a particular pattern. In addition, another impact as Scattone and Mong (2013) opine, is anxiety. As such, she will develop anxiety, which will make her to easily lose patience, have difficulty in concentrating and sleeping, depression, as well as becoming more obsessive and preoccupied with one subject.

Case Question 2

Based on her changing needs, it is important to ensure that her needs are well taken care of. The planning services have to ensure that her needs are well taken care of so that her condition is well managed. Since she may not be able to take care of her baby, she needs support. Also, he has to earn a living to support her kid, mainly through employment. She has to receive medical care pertaining to her condition. In relation to planning services, various services can be used to meet Tianas needs. Firstly, advocacy services will ensure that her rights as an individual with a disability are protected, which will be provided through referrals, as well as providing the necessary information. Secondly, day programs can be helpful, where she can attend five days a week, especially during the work hours, and in turn, she will be provided with opportunities to socialize, work, as well as participate in skills training. Employment services will offer her the necessary skills for advancing skills and knowledge for gainful competitive employment. Habilitation services will enable her to maintain the highest level of vocational functioning, and includes paid work among other supports. Medical services will ensure that all her healthcare aspects, as well as those of her child are well taken care of. In addition, recreation services will enable her to relax and meet her leisure goals. In essence, these services will ensure that her condition effectively is managed effectively.

Case Question 3

As per Eriksons model of psychological stages, Tiana can be placed in the young adulthood stage (19-40 years). The stages basic conflict is intimacy versus isolation (Rosenthal, Gurney & Moore (1981). The important events at this stage is building relationships, based on intimacy and love. In addition, success leads to an even stronger relationship while failure results in isolation and loneliness. In line with Eriksons model, Tiana has little interest in others, which makes her prone to isolation. For this reason, she cannot develop intimacy with others. In effect, this might have contributed to her single motherhood status. She is not able to create a connection with people, that is why she avoids eye contact. However, her sense of pride in her accomplishments enable her to connect with people, and thus, her condition has is alleviated to some extent. Considering Piagets cognitive stages of development, Tiana is in the formal operational stage, which as Barrouillet (2015) point out, a patient can intellectually use logic, but she needs concrete objects to do so. As such, she is dependent on objects to make logic. As such, she has not fully matured intellectually, and can easily forget. In effect, she can ask repetitive questions that require similar questions. Using the two models, it is evident that Tiana has not fully matured intellectually and socially even when mates in the same age should have better social skills and solid relationships.

Case Question 4

Different interventions will impact Tiana differently to take care of her baby, socially, and personal care. For instance, behavioural and developmental interventions, such as positive behaviour support, self-management, intensive interaction, functional communication training, as well as social skills will encourage her to adopt appropriate behaviour, for example, how to talk while maintaining eye contact and discourage inappropriate behaviour such as getting used to repetitive obsessions such as asking similar questions. In effect, this will improve her relationships with people; hence, it will advance her social skills of communication. Ln addition, these interventions will lead to better relations with her child. In addition, psychological interventions, including counseling and psychotherapy, as well as cognitive behavioural therapy, will enable her to relate to her child better by changing the way she feels and interacts with her child, as well as other people close to her. Her personal needs will be promoted by adopting interventions that support her well-being, such as special dietary interventions which will make her not to stick to specific foodstuffs, thereby promoting better health. Since she detests being treated as a child, it is important to educate her of the importance of taking any medications, such as antidepressants so that no one will be push her around to take the medicines. Lastly, a combination of these interventions will lead to an increased personal care where she observes aspects such as personal cleanliness, as well as that of her child.

Case Question 5

In the planning of service delivery, it is important to take into consideration her type 1 diabetes. As such, the autistic interventions should not interfere with her condition. Since skipping her meals, taking too much insulin, as well exercising too much will lead to hypoglycaemia, it is paramount that she takes food regularly and take the correct doses of insulin. In essence, this can be rectified through education. As well as behavioural therapy. She should not be obsessive of certain foods or foods of certain colours, especially if they interfere with her diabetic condition. Therefore, there has to be someone monitoring her drug intake, exercises, as well as meal intake. They should be consistent, even when she detests people treating her like a baby. Since she reasons logically, she should be able to know that her health is at risk from her diabetic condition, and thus, her actions are very important. On top of having someone ensure that she takes her medicine and food, as well as safe exercising that does jeopardize her condition, she needs education on the same. In case she adopts to the routine, she can do it on her own, but in the meantime, there has to be someone observing her regularly.

Case Question 6

Situation Person responsible Resources Action

Mild hypoglycaemia

1. Tiana

2. Social community worker on duty 1. Educational resources.

2. Carer and family support

3. Self-management programs.

4. Patient education provision.

5. Emotional support.

5. Financial resources In this instance, Tiana, if she were not autistic, could take care of herself. However, due to her autistic condition, she needs to be educated about mild hypoglycaemia. As such, she will need to have her condition checked by taking food, particularly that which provides instant sugar boot, such as Lucozade, glucose, smooth orange juice, as well as non-diet fizzy drink. However, she needs someone to observe her and give her directions, such as to stop exercising. Also, the person, should also be able to observe her kid, and support her emotionally. Financial resources are necessary to buy whatever is needed to alleviate her condition, including drugs.

Severe hypoglycaemia

Social community worker on duty 1. Financial resources.

2. Patient education provision.

3. Emergency resources.

4. Ambulatory resources.

5. Doctor.

In this instance, the hypoglycaemia is serious and immediate medical attention is needed because she cannot take care of herself. If Tiana is conscious, she should take instant medications as prescribed by the doctor. The social community worker should help her out. However, if she is unconscious, she needs to be taken to the hospital immediately for professional care.

Emergency resources can be obtained by calling for ambulances from the nearby hospital. Financial resources will enable her to cater for buying the needed medication.

Case Question 7

Date and time Patient name Previous patient record Complications Symptoms Treatment

Tuesday, 3.40 PM. Tiana Anderson Tiana suffers from autism. Severe hypoglycaemia 1. Shakiness.

2. Weakness and fatigue.

3. Unconsciousness.

4. Rapid and fast heartbeat.

5. Anxiety.

6. Confusion.

7. Seizures.

8. Nausea and hunger.

9. Dizziness. 1. Tiana should take at least 30 grams of glucose or even simple carbohydrates.

2. The blood sugar levels should be rechecked in 20 minutes.

3. In case the hypoglycaemia continues, she should take additional carbohydrates.

4. Once the blood sugar levels return to normal, she should take snacks or a meal.

Case Question 8

As the senior social worker, I would first appreciate her judgment. Since her problem is mainly with the psychologist, and all the other social workers are doing fine, at least from her perspective, I should request for more information about the psychologist. In effect, Tiana points out areas that she believes that the psychologist is not doing enough. However, since I need to consider the organizational policies and procedures to ensure that any course of action does not deviate from them. As she points out areas where she feels that the psychologist is not doing fine, I take note of them. I also need to mention to her that the psychologist is applying intervention measures that he feels deem fit to her condition. However, I inform her that I will talk to the psychologist to ascertain whether his methods can be changed or revised. In effect, I will talk to the psychologists on adopting better methods to intervene the situation. It is important to consider that her autistic condition is the primary contributor of her dislike. As such, it is important to consider the fact that the psychological interventions adopted by the psychologist may be the reason why she dislikes his services. Therefore, I would recommend that the psychologist should approach his intervention differently. If he had been using counselling and psychotherapy, he would instead use psychodynamic approaches, such as hypnotherapy and psychoanalysis. In addition, other methods worth considering include creative therapy and include approaches such art and dance movement therapy. She might develop an interest into one of these, and therefore develop a liking to the psychologist.

Case Question 9

Tianas records should always be up to date. As such, all records about her autistic history, as well as incidences of hypoglycaemia, should always be up to date. In addition, all information about medication...