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sim character:Brian looked after his wife Maud for 20 years before her death from Alzheimer’s disease six months ago. Brian is a retired Professor of History and taught at many Universities as well as active service in the army.

Brian and Maud had no children but both attended their local church and were very committed to their faith, trying to help out at the local food bank and supporting charities. Brian has an old sheep dog “Sammy” who he tries to walk every day, he also has a strong interest in music, local history and growing vegetables in his greenhouse. He has never smoked and now lives alone in a bungalow in the rural village of Cleverly.

Biological Needs: Brian had tuberculosis (TB) as a child and his family were very poor, this now appears to make him very likely to suffer lower respiratory tract infections. During his last hospital admission for pneumonia his Hb was found to be 9 and serum potassium high. His GP and community nurse have been visiting to monitor his progress but more recently he has been found to have cancer of the prostate and he now suffers continence problems. He suffered a myocardial infarction five years ago as a result of the stress of looking after his wife over many years and when he remembers, he now takes digoxin, warfarin and a diuretic as well as having treatment for a long standing vitamin B12 deficiency.

Psychological Needs: Since losing his wife six months ago Brian has lost all interest in life, his community nurse is concerned that he is not eating or looking after himself and sits for long periods in his chair asleep, making him more likely to develop a pressure ulcer. Brian has refused all help at home but worryingly the nurse has reported a strong smell of alcohol in his bungalow and at times Brian appears very agitated and confused, sometimes refusing visits from the nurse and GP. More recently the nurse has needed to visit twice a week to treat a small infected leg ulcer that was caused when he tripped over Sammy, keen to go for his walk. The nurse is also helping Brian to manage his continence problems and takes bloods to monitor his haemoglobin and electrolytes.

Question 1:

Identify one health condition from the SIM character Brian 

Chance and explain the pathophysiology of that condition, this 

may include mental, behavioural, physical and cognitive 

elements. You can consider the signs and symptoms typically 

associated with this condition and identify how this presents in 

Brian and affects his health

SCIENCE
HEALTH SCIENCE
NURSING

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