Case Presentatio n Mr. Robert

Case Presentatio

n Mr. Robert Holton, 74 years old and retired, spent his entire working career as a self-employed carpenter. He has a 22-year history of type 2 diabetes; he also has hypertension and emphysema. He is an active smoker (52-pack-year smoking history), although he has aempted to stop smoking on several occasions. He wears a hearing aid in each ear because of hearing loss as a result of working around machinery for many years.

 Robert presents for a routine 3-month visit with the nurse practitioner accompanied by his wife. Mrs. Holton reports that Robert’s feet smell very bad, but he does not seem to notice the odor. The nurse practitioner removes Robert’s shoes and socks; a large infected foot ulcer is observed on the boom of the foot. Robert is surprised that he was unaware of the wound. When asked about other changes, Robert does not respond. Mrs. Holton reports that he recently failed his visual acuity test for driver’s license renewal and now must depend on her for transportation. She adds that he has become increasingly withdrawn over the past 6 months and does lile to communicate with her or others; he is also not interested in leaving the house. She asks the nurse practitioner if he is depressed.

Case Analysis Questions

1. What risk factors are present in this case that relate to the concept?

 2. What sensory and perception impairments are exemplified in this case?

 3. Review Fig. 27.4. Which interrelated concepts apply to this case? Are there other interrelated concepts that apply to this case?

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