Case study 1: Mrs James, 65-year-old, was admitted to your residential aged care facility three days ago with extensive Alzheimer's disease. Mrs James generally appears tired and sleepy in the morning. Mrs James takes a single dose oral Frusemide 20mg daily along with her antihypertensive medication. The medication is being administered at 2000 hours everyday.
1. What is the effect of Frusemide on Mrs James especially when administered at night time?
2. What adjustments can you make in the administration of Frusemide in this situation and whom should you liaise with to make any adjustments?

Case study 2: You are taking care of a newly admitted 78-year-old resident, Ms. Wong, in the low care wing of a residential aged care facility. She suffered a stroke last year resulting in right sided weakness of both her right arm and right leg. She now walks with the help of a 4-wheel frame and needs assistance with her ADLs due to the weakness of her right arm. She is a retired Registered Nurse. She has a past medical history of Type 2 diabetes mellitus, hypertension and osteoporosis. She is currently on multiple drugs for all these conditions and is worried about forgetting to take her medications on time. When her medication was checked, it appeared that she had missed her doses on several occasions. She lives alone and has always been single. Her mother passed away 2 years ago and Ms. Wong, who was much attached to her, deteriorated both mentally and physically after the incident. Ms Wong was living alone after her mother's death, occasionally being visited by her daughter who lived 400km away.
3. Identify and discuss 3 chronic health problems faced by Ms. Wong.
4. Briefly discuss the possible impacts of osteoporosis on Ms Wong's capacity to perform daily living activities.
5. What are the implications of Ms. Wong's admission to the residential aged care facility? How will you ensure Ms Wong's family and/or carers (who are visiting her now) understand these implications?

Case study 3: Imagine that you are working with Kevin Mills, 78 years old, who lives alone in an independent living unit. Mills has type 1 diabetes. You visited Mills today to check his blood sugar and ensure that he maintains his health in his best possible way in relation to the agreed nursing care plan. Mills' daughter is at home now and she visits Mills two days a week to check on his welfare. Mills' blood sugar is 10.2mmol/L at 10:00 am. He had his breakfast at 08:30am (two toast, raspberry jam and tea with two sugars). Mills stated that he did not document the previous blood sugar values and doesn't want to follow the diabetic diet plan as he feels the diabetic diet is 'boring'.

-Provide two (2) examples of strategies you would implement as a nurse in promoting the health maintenance of Mills.
-Identify and describe a community service/resource Mills and his daughter could access in promoting his health maintenance in relation to the identified issue in addition to the home nursing services.
-Briefly describe how you could apply advocacy skills in relation to this scenario.

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