ABSTRACT
Nurses frequently take a lead role in the management of chronic diseases. Please reread the introduction to Chapter 4 about your need to be qualified for a specialist role.
Case study 6.1 Mr Marrow grumbles as you check his blood pressure, ‘I’m getting old, I’ll have to give up the gardening, can’t do it anymore’. He tells you that he is getting out of breath when he works in the garden and has developed an irritating cough, especially when he wakes in the night and in the morning. He had an admission to hospital six years ago with a myocardial infarction and has been taking aspirin, a beta-blocker, a statin and an ACE inhibitor since. He has not smoked since the shock of being admitted to hospital with chest pain, as his father and his elder brother both died from heart attacks. Although overweight with a BMI of 30, he has always been a keen gardener, growing much of his own food, especially since his retirement. He is now aged 68 years. On further enquiry, he has noticed the tops of his socks leave a dent all round his ankles by the end of the day, but he sleeps on two pillows - always has done - and there is no change in his appetite or bowels. He takes occasional courses of a non-steroidal anti inflammatory drug when he has overdone things in the garden.
