Roy has been given a new type of blood glucose machine. He makes an appointment with the Practice Nurse as he is not sure how to use it, and his wife is worried that he is not using it correctly.

Case Study: Roy (Further Information)

Presenting situation:

Roy has been given a new type of blood glucose machine. He makes an appointment with the Practice Nurse as he is not sure how to use it, and his wife is worried that he is not using it correctly.

At his clinic appointment, he is given advice on how to use his blood glucose machine. During this appointment, a full assessment of his needs is conducted.

His vital signs are recorded, and relevant assessment tools used. The results from these are as follows:

• Pulse: 75 bpm
• Respiration rate: 18
• O2 Sats: 97% (on room air)
• Blood pressure: 120/72
• Temperature: 36.8°C
• Waterlow Score: 18
• MUST: 0
• BMI: 29
• Pain score: 4/10

During this assessment, Roy provides further information about himself:

Roy lives with his wife. He has been married for 35 years. He has a son, and a grandson who live nearby.  Roy used to be a police officer, however he had to retire early, following two myocardial infarctions. He has type 2 diabetes, rheumatoid arthritis, peripheral vascular disease in his legs and neuropathy in his feet. He has also recently been diagnosed with depression.

Roy has reduced mobility due to pain in his legs and uses a walking stick to mobilise. His experience of pain in his legs keeps him up at night and he estimates that he sleeps for an average of 4 hours per night.

Roy’s wife helps him with his washing and dressing and prepares all his meals. Roy feels bad about his wife having to help him with things as she also has some health problems.

Roy sometimes finds that he becomes constipated and he buys Senna over the counter to help with this. He doesn’t have any difficulty passing urine, but finds he passes urine more frequently sometimes when his blood sugars are high.

Roy and his wife both receive pensions, however these are for small amounts, therefore finances can be quite strained. This causes Roy a large amount of anxiety and stress.  

Roy knows he is overweight and should eat healthier to help reduce his weight but finds this difficult. Roy eats a normal diet and finds healthy eating difficult due to his finances. Roy finds that healthy food is more expensive to buy.

Roy enjoys fishing however is unable to do this due to pain. He would like to go out more often and spend more time with his family but finds this difficult due to his experience of pain and reduced mobility.

Roy takes a large amount of medication:

• Paracetamol 1g QDS
• Ibuprofen 400mg TDS
• Simvastatin 20mg OD
• Metformin 850mg TDS
• Gabapentin 600mg TDS
• Aspirin 75mg OD
• Citalopram 20mg OD

Roy struggles to remember all the medication that he needs to take and their timings and relies on help from his wife to take them correctly.