PUP 2224 Scenarios

1. The Gallaghers
PUP 2224 Module Assessment Scenario

2. PLEASENOTE
 The Gallagher's have been developed for the sole
purpose of the PUP 2224 Module Assessment. All
scenarios are the work of the module team and are
fiction. The characters do NOT exist. Any resemblance to
persons living or dead is purely coincidental.
 However, to ensure professionalism the PPT must only
be viewed by the student during the preparation of the
PUP 2224 module assignment in order to maintain
confidentiality.
 All pictures used are Creative Commons Zero (CC0)
license. This means the pictures are completely free to
be used for any legal purpose.

3. PUP2224
Assignment
Question&
Guidelines
Assignment Essay: 3500 words
 Choose a member of the family and using the information given in the scenario, analyse the role
of the nurse to promote independent living and self-care.
Guidelines
 Choose ONE member of this family and, using the information given in the
scenario, provide an individual health profile stating the health determinants
that impact the condition. (LO1)
 Provide an overview of the long term condition i.e. explain the altered
physiology of the long term condition relating this to assessment of health
needs. (LO2)
 Analyse the lifestyle and the elements of this, that impact upon their condition
and care.
 How do their health choices affect them? (e.g. smoking & diet) How does their
condition affect the individual holistically? (e.g. mobility, socialising etc.). (LO1
and 2)
 Discuss the scope for collaborative working with patients living with a long-term
condition, their families/carers across health, social and voluntary/private sector
providers. Therefore, consider the initiatives (national and local) that are in place
to support this individual, i.e. What agencies are involved in the care of the
patient? (LO3)
 Throughout your discussion be sure to analyse the role of the nurse in promoting
independence and the management of the chosen long-term condition. (LO4).

4. TheGallagher’s
Streetand
Homes

5. Profile
 The Gallagher family are well known to local health and social care services
as they are a family with complex long term health needs.
 The Gallaghers live on the same street in four bedroom terraced housing
with small front and back gardens.
 They have access to transport, local shops, a supermarket, play areas,
schools, a gymnasium and the area Health Care Centre .
 Mary, Jack, Harry and Helen all left school at 16 with no qualifications.
 Paul is a secondary mathematics teacher who was the first in the family to
go to university and gain a degree.
 Zack is at university in his third year studying Computer Science
 Sarah is due to do her A levels this year and is predicted to get good grades
 Mary and Jack’s Annual Income= £27,000, they have 2 years left on their
mortgage and run a car.
 Helen and Harry’s Annual Income= £30,000, they have paid off their
mortgage and run a car
 Both Gladys and George receive state pensions and no longer live in their
own homes. Gladys stays with Mary and Jack and George stays with Helen
and Harry
Health Determinants

6. HelenGallagher
Age56years
Occupation
Unemployment
Stress and Hypertension

7.  Helen Gallagher has been diagnosed as suffering with hypertension –
her last recorded blood pressure was 175/95mmHg and the time
before that it was 170/100mmHg on three separate occasions during
the past six months.
 Helen reports that before this her B.P. was always around
110/65mmHG.
 Helen describes herself as very stressed due being a full time carer to
her dad George whilst at the same time trying to cope with the
devastating news that her husband Harry has cancer.
 Helen’s dad has ongoing health problems and has just been
diagnosed with Parkinson Disease which is making him very
frustrated and short tempered as he cannot do the things he would
like to do.
 Helen is reluctant to express her concerns for fear of causing more
upset to the family – she does however divulge her worries to the
family priest who is worried that this is the cause of her stress which
is manifesting as severe bouts of breathlessness.
Health Profile

8. HarryGallagher
Age61
Occupation:
Plumber
Bowel Cancer

9.  Harry has just been diagnosed with cancer and is currently
undergoing chemotherapy at the regional cancer center each
week.
 Harry is unable to maintain adequate nutrition and fluids due
to the side effects of the chemotherapy and is becoming
increasingly frustrated that he cannot enjoy everyday
activities.
 As a result, of the need to have time off from work to receive
his chemotherapy treatment, Harry was made redundant from
his job. This has made him very angry as he wants something
in his life that helps him forget his illness.
Health Profile

10. PaulGallagher
Age31
OccupationSchool
Teacher(Maths)
Motor Neuron Disease

11.  Paul Gallagher lives opposite his mum Mary with his partner,
Raymond.
 Paul works full time as a secondary school teacher, as well as
acting as the main carer for Raymond who has HIV.
 Paul is hiding that he has Motor Neuron Disease which he is being
treated for at the specialist Regional Neurological Centre.
 At the moment his symptoms are mild so he is able to hide them
from his family. His symptoms include fatigue, which manifest as
slight slurring of his speech & mild muscle weakness.
(Paul notes that on days that require more energy such as exercise
or illness such as the common cold, his symptoms occur )
 Paul is very aware and understands what will happen to his body
as a result of having motor neuron disease. Therefore he has
decided to avoid planning his future and take each day as it comes
and will tell his family when he feels the time is right.
Health Profile

12. RaymondStanley
Age30
OccupationBar
Staff
AIDS/HIV

13.  Raymond is a 30-year-old man, he is newly diagnosed HIV positive.
At present, he is asymptomatic and is currently being treated with
Nucleoside/nucleotide reverse transcriptase inhibitors NRTs as well
as attending the HIV specialist clinic for regular blood checks.
 He is employed as bar staff in a busy city night club. Raymond met
his partner Paul in the club 3 years ago, they have had an exclusive
relationship during that time. Although initially very shocked and
frightened, Raymond is trying to come to terms with his diagnosis
and plan for the future.
 Raymond does not feel ready to tell his family about his diagnosis,
he is not sure how he could do this. He is worried they may not
understand and reject him. He is also concerned that Paul may be
at risk of contracting HIV from him.
 Raymond understands the need to live a healthy lifestyle,
however due to the nature of his work, he enjoys a smoke and
several alcoholic drinks after his shift to help him unwind.
 Raymond is also concerned that if becomes unwell or needs to
attend hospital appointments he may lose his employment.
Health Profile

14. GeorgeGrey
Age81
ARetiredBarber
Parkinson Disease

15.  George is 81 and has lived with his daughter Helen and son in
law since the death of his wife 3 years ago.
 George misses his wife as they had a very active social life and
enjoyed going on bus tour holidays several times a year .
 Just recently George was diagnosed as having Parkinson
Disease and must take his medication on time to avoid
stiffness.
 His main problems are stiffness which is causing poor mobility
and a slight tremor in both hands as well as a very poor sleep
pattern.
 This has meant the George can’t get out and about like he
used to and is dependent on taking his medication which he
says can make him feel worse sometimes.
Health Profile

16. PhilipGallagher
Age75
OccupationRetired
FactoryWorker

Chronic Wound: Venous Leg Ulcer

17.  Philip is a retired factory worker which during his 45 years of
working, demanded that he was on his feet for most of the
day. When he was 56 he suffered an injury at work, fracturing
his left ankle, which later compromised his mobility. As a
result, his ankle swells when standing, even for short periods
and aches most of the time which requires him to take pain
killers at night to help him get to sleep.
 Philip has been diagnosed with Peripheral Vascular Disease
and has chronic venous hypertension which has resulted in a
venous ulcer on his left leg just above his ankle.
 Philip is currently overweight BMI of 28 and wants to loose
weight as he feels this will help his mobility and ease the pain
he gets from his ankle. As a result, he is trying to cut down on
his carbohydrate intake which he loves so is finding this
difficult to do. Philip is a non smoker and enjoys going to the
local pub for a pint or two with his brother.
Philip’s Left Leg Status
http://legulcercharity.org/swollen-
ankles-and-venous-leg-ulcers/

19. MaryGallagher
Age58
Unemployed
Stress and Depression

20. HealthProfile
 Mary Gallagher BMI states that she is clinically obese (she is 5
feet and 2 inches tall and weighs 13 stones and 2 pounds).
 Mary successfully gave up smoking 3 years ago and believes her
weight gain is due to this. Although is fighting the cravings to
start again.
 Mary said that watching her mum-in-law Gladys gradually loss
her memory is a major worry that makes her feel helpless. She
worries about Jack’s who has COPD, that he won’t be able to
work.
 Mary worries about Sarah that she will fall into the wrong crowd
and not do well at school to get onto the career ladder.
 Last year Mary was diagnosed with clinical depression and is
being treated with an anti- depressant (an SSRI).
 Mary is currently unemployed and feels that this and her lack of
success to find work, is adding to her depression
Health Profile

21. JackGallagher
Age59
Occupation:Lorry
Driver
COPD

22.  Jack Gallagher, is employed as a long distance lorry driver (his work takes
him away from home at least 3 nights each week).
 Jack is loosing weight and is being monitored at the local health center in
order to promote healthy eating and exercise. As well as monitor his
respiratory function.
 Jack is also a very heavy smoker he confesses to smoking 20 a day. He has
tried several times to give up (using Nicotine replacement therapy) without
success, he would really like to try again in order to support Mary.
 Jack was diagnosed as having COPD last year, which is being managed by
medication. Although Jack is noting that he is unable to do the things he
used to such as go for a brisk walk with the dog, without becoming
breathless. And that he feels exhausted, even after eating a meal and notes
that he needs to take his inhalers often to control his breathlessness.
 Jack has confessed to the GP that he worries about his health because of
the breathlessness. As a result, he is loosing confidence to do things and is
worried that he will die suddenly.
Health Profile

23. GladysGallagher
Age78
RetiredSchool
DinnerLady
Dementia

24. HealthProfile
 Gladys Gallagher Jack’s mother, is 78 years old and has lived
with the family since her husband died 4 years ago.
 Gladys has become increasingly forgetful over the past year,
and and had been displaying erratic behaviour for the past
three months.
 As Gladys has been wandering the house during the night
stating that she is late for work. As well as talking about her
husband as though he is alive and living at home. She also
refers to her family as when they were children.
 Initially this was thought to be related to her bereavement, but
the situation has worsened recently and has prompted further
investigation by her General Practitioner, who believes that she
has ‘brain softening’ and is displaying dementia possibly a
Alzheimer's Dementia
Health Profile

25. SarahGallagher
Age17
6th FormSchool
Risky Health Behaviour

26.  Since the age of 15, Sarah has been drinking with her friends at
the beach and has been brought home by the police on several
occasions. 6 months ago, she spend a night in the local A&E
department after drinking too much and passing out.
 Following this event, Sarah confessed to her best friend that
she had unprotected sex.
 Mary worries about the long term effect of her daughter’s
lifestyle and is worried that she is taking illegal substances as
she found evidence that Sarah maybe smoking cannabis.
 She feels that Sarah has no idea just how dangerous the things
she is doing to her health and wants her to stop and do well at
school.
 Sarah confesses that she that is only doing what is normal for a
teenager today as all her friends do it and they are healthy.
Health Profile

27. ZackGallagher
Age20
FullTime
Undergraduate
Student
Asthma

28. HealthProfile
 Zack Gallagher, Jack and Mary’s 20 year old son, has suffered
from asthma since the age of 4.
 Zack’s asthma is fairly well controlled on his inhaled
medication and his parents have always been careful not to
smoke around him.
 Recently, he has experimented with smoking cigarettes and
has found that this has exacerbated his asthma. Mary his mum
is worried that this new habit will cause him to have frequent
asthma attacks which in turn will effect his studies and his
health .
 Mary describes her son as a nervous kid who is keen to please
people but is worried that he could get in with the wrong
crowd and not do well at university as he is a bright pupil who
if he does the work will do well.
Health Profile

29. Sustaining
Health
 Long Term Conditions cannot be cured but can be treated
 Long Term Conditions can cause unseen disabilities
 Long Term Conditions demand extra energy through effort
from the body to get through the day
 Long Term Conditions can cause fatigue and depression
 Long Term Conditions puts strain on the immune system
 Long Term Conditions can cause other illness and disease
 Long term Conditions are not the cause of death
Points to Note
Reflect on your chosen Gallagher and consider all of the above in
the context of their long term condition to help determine how the
role of the nurse can help sustain their health.

30. References
Further
Reading
 Nicol, J. (2015) Nursing adults with long term conditions. Available at: http://capitadiscovery.co.uk/edgehill/items/254260
(Accessed: 2 January 2017).
 Presho, M. (2008) Managing long term conditions: A social model for community practice. Available at:
http://capitadiscovery.co.uk/edgehill/items/79855 (Accessed: 2 January 2017).
 Lorig, K. (2014) Self-management of long term health conditions: A handbook for people with chronic disease. Available at:
http://capitadiscovery.co.uk/edgehill/items/81771 (Accessed: 2 January 2017).
 Thornton, L. 2013, Whole person caring: an interprofessional model for healing and wellness, 1st edn, Sigma Theta Tau
International, Indianapolis, Indiana.
 McKenna, H.P., Pajnkihar, M. & Murphy, F. 2014, Fundamentals of Nursing Models, Theories and Practice, Second;2nd; edn,
Wiley Blackwell, Chichester, West Sussex.
 Kim, H.S. 2015, The essence of nursing practice: philosophy and perspective, Springer Publishing Company, New York, New
York.
 McKenna, H.P., Pankhihar, M. & Murphy, F. 2014, Fundamentals of Nursing Models, Theories and Practice, 2nd edn, Wiley
Blackwell, Chichester, England.
 Orem, D.E. 2001, Nursing: concepts of practice, 6th edn, Mosby, St. Louis, Mo;London;.
 Rogers, K.M.A., Scott, W.N. & ebrary, I. 2011;2013;, Nurses! Test yourself in anatomy and physiology, McGraw-Hill/Open
University Press, Berkshire, England.
 Peate, I. & Nair, M. 2017, Fundamentals of Anatomy and Physiology for Nursing and Healthcare Students, 2nd edn, Wiley
Blackwell, Chichester, West Sussex.
 Waugh, A., Grant, A., Chambers, G., Ross, J.S. & Wilson, K.J.W. 2014, Ross and Wilson Anatomy & Physiology in Health and
Illness, 12th edn, Churchill Livingstone, Edinburgh.
 Journals
 Orem, D.E., Renpenning, K.M., Taylor, S.G. & ebrary, I. 2003, Self-care theory in nursing: selected papers of Dorothea Orem,
Springer Pub, New York.