Exercise Refferal Case Study for Rheumatoid Arthritis,...

Summary of clients details Name: Ms. Lewis Gender: Female Age: 66 Contact No: 01234 5678910 Next of Kin: Mrs Levenhulme Referral reason: Rheumatoid Arthritis, Depression elderly Medication: Acelofenac Nortriptyline Physiological Information Blood Pressure (seated): 122/82 mmHG Resting Heart Rate: 64 bpm Predicted VO2max: 24 ml/kg/min Present physical activity: Very low, essentially sedentary Patient’s statement regarding state of change: â€Å"I want to exercise, and I think I can do it, but I will need some support† (Preparation) Medical conditions Rhematoid Arthritis – Is an autoimmune disease which can cause chronic inflammation of body`s organs, joints, and the surrounding tissue of the joints. It can†¦show more content†¦When these chemicals are released from nerve cells they act to lighten mood. When they are reabsorbed into the nerve cells, they no longer have an effect on mood. Nortriptyline works by preventing this re-absorption of noradrenaline and serotonin back into the nerve cells. Therefore, it helps prolong the mood-lightening effect of any released noradrenaline and serotonin†. (http://www.tiscali.co.uk/lifestyle/healthfitness/health_advice/netdoctor/archive/100003239.html) Possible side effects: â€Å"dry mouth, sedation, blurred vision (disturbance of accommodation, increased intra-ocular pressure), constipation, nausea, difficulty with micturition; cardiovascular side-effects (such as ECG changes, arrhythmias, postural hypotension, tachycardia, syncope, particularly with high doses); sweating, tremor, rashes and hypersensitivity reactions (including urticaria, photosensitivity), behavioural disturbances (particularly children), hypomania or mania, confusion or delirium (particularly elderly), headache, interference with sexual function, blood sugar changes; increased appetite and weight gain (occasionally weight loss); endocrine side-effects such as testicular enlargement, gynaecomastia, galactorrhoea; also convulsions (see also Cautions), movement disorders and dyskinesias, dysarthria, paraesthesia, taste disturbances, tinnitus, fever, agranulocytosis, leucopenia, eosinophilia, purpura, thrombocytopenia, hyponatraemia