Morbidity Dual Diagnoses., Symptoms, Assessment, Impact, Treatment Case Study

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morbidity dual diagnoses., symptoms, assessment, impact, treatment June Porter. The purpose assessment undertake assessment a clinical scenario, demonstrating consolidating assessment problem solving skills.

Clinical case scenario -- Co-morbidity for neuropathy

The case of June Porter manifests many of the clinical complications associated with Type 2 diabetes mellitus. June's diabetes is attributed to her significant weight gain and inactivity. June's foot abrasions and blurred vision are causes for alarm, given that they are symptoms of neuropathy. (What you need to know about diabetic neuropathy, 2013, Scottsdale Neuropathy Institute). Smoking can further exacerbate neuropathy by causing narrowing and hardening of the arteries and smokers like June who take birth control pills while smoking further run the risk of blood clots (What you need to know about diabetic neuropathy, 2013, Scottsdale Neuropathy Institute; Cornforth 2009). To improve June's health, it is necessary to control her diabetes. Unfortunately, treating the symptoms of diabetes is further complicated by June's co-morbidity for both substance abuse and depression and smoking.

Substance abuse is defined as a pattern of behaviour "accompanied by 1 or more of the following…failure to fulfil major work, school, or home responsibilities" because of the substance abuse; consuming the substance in situations which are dangerous to the self and others (such as driving); having legal problems related to the substance abuse; and having significant social problems due to the substance (Ringold, Lynm & Glass 2006).

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June's alcohol abuse and smoking are putting herself at significant risk because she is unable to exercise enough control over her blood sugar because of her denial of the significance of both her diabetes and alcohol abuse. Drinking makes it more difficult for diabetics to monitor their blood sugar and also interferes with glucose metabolism.

A critical component of treating June is the necessity of making her take her condition seriously. At present, there are many factors which complicate effective self-care. June has a job which requires her to dine out in restaurants, which makes it difficult for her to control the fat, sugar, and carbohydrate content of her meals and also makes smoking and drinking part of her 'job.' She exacerbates her foot problems with high heels and with being in a sitting position while driving for most of the day. She is in denial of the severity of her problems, mistakenly thinking that it will 'go away' like her gestational diabetes and fails to appropriately monitor her vital signs. She is no longer exercising or moderating her weight and alcohol use lowers her inhibitions in terms of consuming unhealthy food and reduces her ability to judge her blood sugar levels.

June also shows signs of….....

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