Reference no: EM133229044

Case: Ulie is a 45-year old mother and lives on a cropping farm located 50km west of Westtown. The property is run as a family business with her husband and his brother. Julie has three children; Sam aged 14, Katie aged 12 and James aged 8, the two older children attend boarding school in Sydney and return home during holidays. James is at home and attends the local primary school. Both Julie's boys have type one diabetes that she manages.

Julie has lived with her diabetes for 37 years and has many co-morbidity due to both her diabetes and celiac disease that she developed as a teenager. Julie has stage 3 chronic kidney disease, poor eyesight and osteoporosis.

She currently sees her endocrinologist in North Sydney every three months at the outpatient clinic, this takes her six-hour drive by car to the appointment in the city, a journey she takes with her husband. Her nephrologist is based at a regional hospital about two hours' drive from home. Julie engages with a Diabetes Educator via phone and face to face monthly. She attends a community chronic disease self-management program at the local church hall run by the community registered nurses once a week in town and does her weekly groceries.

Julie has expressed to the diabetes educator that she needs more assistance with managing her own condition. She is concerned her sons who have T1DM may end up with the same comorbidities that she has having an autoimmune chronic condition.

Question 1: In relation to Julie's case study, list FIVE functions and activities essential for Julie to maintain her health, manage her ADLs and IDLs (consider locality and access to essential services).

Question 2: Select TWO of these functions and activities and discuss how they (positively or negatively) influence complexity for Julie.

Question 3: Discuss the nursing management considerations for both four factors you have selected (be sure to consider geographical and social context).