case study

Mrs. Kendall is an 81-year-old female from
nursing home brought in by ambulance to ED
at 0500hrs.Ventolin nebulisers given enroute.
Severe SOB, productive cough. Denies any
urinary or bowel symptoms, fever or chest pain.
Appears unwell. Pleasantly confused, thinks
she is 42 years old.
• Poor historian? Due to confusion.
• Past Medical History: IHD – multiple
NSTEMI’s, Previous ICU admissions for
exacerbation of asthma, Atrial Fibrillation, DM,
dementia, HFpEF- previous admission for APO
last year.
• On anticoagulation- Apixaban. On digoxin.
• Spirometry 3 months ago demonstrated
restrictive defect.
• Fully vaccinated against COVID

ASSESSMENT
Airway. – Patent, unable to speak in full sentences.
Breathing. – Spontaneous, RR-30/mt, SPO2-95% on 4L NP, was on 15L NRB weaned, bi-basal crepts,
widespread wheeze, moderate work of breathing.
Circulation- Appears flushed, tepid peripheries, BP-195/155 mmHg, HR- 120/mt, irregular,
b/l pitting pedal edema+++, peripheral edema- upto 2/3 shins b/l
Disability – GCS-14 E4V4M6, not oriented to time, place or person, PEARL- 2mm.
Exposure – Temperature 37.8 deg Celsius. Abdomen soft and non-tender, b/l pitting pedal edema+++,
peripheral edema- up to 2/3 shins b/l,
Fluids – Unable to tolerate oral fluids, on 1.2 L fluid restriction
Glucose – BGL- 13.7

INVESTIGATIONS
• ABG: pH: 7.34, PaO2- 66 mm Hg, PaCO2- 32 mmHg, HCO3: 16 mmol/L, Base Excess: –
(minus)8.1mmol/L, Lactate: 1.5 mmol/L
• Bloods: Hb- 120 gm/L, WCC: 10.3×10^9/L, digoxin level: <0.1 μg/L, Troponin I: 96 ng/mL • CXR: wet, APO, upper lobe diversion • ECG: some p waves visible, irregularly irregular, ?ST with premature atrial complexes • Diagnosis: Acute Pulmonary Edema due to exacerbation of CCF, acute exacerbation of asthma • A MET call was activated at 0630hrs. Assessment requirement Discuss TWO diagnostic results and relate them to the underlying pathophysiology. My choice EXRAY AND ABG RESULTS. 500 words Peer reviewed articles from 2021-2026. Intext reference apa7 Apa7 reference list Minimum 3 references. PLEASE NO AI. TURNIT IN CHECK. Thanks

Case study

Maria is a 30-year-old single mother living with her two children, ages 5 and 8 in a mid-sized country town. Maria has recently lost her job due to company downsizing and is struggling to meet basic needs such as food, rent, and utilities. She has been in counselling for the past six months after experiencing domestic violence in her previous relationship. Despite her challenges, Maria is motivated to improve her situation for her children’s well-being.
A social worker, Rachel, is assigned to Maria’s case to assist her with finding housing, connecting to financial aid programs, and providing emotional support. However, due to funding constraints, the agency limits contact to four months, meaning a lot has to be achieved in a short period of time.
During one of their sessions, Maria confides that her ex-partner has been contacting her again and threatening to harm her if she doesn’t return to him. Maria is scared but says she doesn’t want to involve the authorities because she fears retaliation. Rachel knows that Maria’s safety is at risk and must decide whether to break confidentiality, being aware that the agency places a lot of importance on confidentiality and duty of care in its Code of Ethics, to ensure her protection.
Rachel has a limited number of resources available to help Maria. There is a program that can assist with housing, but there are multiple families in need. Maria qualifies for the program, but so do other families with equally pressing needs. Rachel has to decide how to prioritize who receives assistance, and whether Maria should be given priority because of her history with domestic violence.
Maria expresses that she does not want to pursue further counselling or participate in job training programs, feeling overwhelmed by the demands of daily life and her children. Rachel believes that continuing therapy and exploring work opportunities would significantly improve Maria’s long-term well-being. However, Maria’s decision to not engage in these programs leaves Rachel questioning whether she should push for further interventions.
As the four-month deadline approaches, Maria, overwhelmed by her situation, asks Rachel if she can stay with her temporarily while she looks for permanent housing. Rachel empathizes with Maria’s situation but is aware of the ethical boundaries that must be maintained in a professional relationship. While Rachel wants to help, agreeing to her client’s staying with her could blur the professional boundary between social worker and client.
Task
Analyse and discuss two of the ethical dilemmas in this scenario.
Include in your discussion the following:
• the impact of the professional and organisational environment on this situation,
• identify which principles and sections from the AASW Code of Ethics are most relevant to the situation,
• discuss how you would approach this situation using your own values, the values of the organisation and the AASW Code of Ethics. How might the code of ethics be used to resolve the dilemmas in this situation?
• discuss how your personal values relate to the professional values expressed in the code in relation to this situation. What differences exist between your own values and those of the code? Which did you act on?
• having reflected on the situation, would you have acted differently before undertaking studies in ethics? Do you think the situation would have had a different outcome? Justify your answer with reference to the AASW Code of Ethics.

Grading outline:
Criterion 1: Demonstrate understanding of personal, organisational and social work values and the ethical dilemmas encountered in practice, showing that you know what each one means and what it refers to and includes
Criterion 2: Apply the principles contained in the AASW Code of Ethics to the case in a thoughtful, careful way, clearly showing how – in your view – the right balance is to be struck between the demands of the different values, and why this is the right balance; and showing how, therefore, the dilemma should be resolved.
Criterion 3: Presentation of the essay in a well-organised discussion, written in good clear English.

APA Referencing

case study

counselling