Theresa is a bright, active 17-year-old and a model patient. Her
cystic fibrosis hasn’t slowed her down one bit. She makes
high grades in school, is involved in student council and yearbook,
and loves to play volleyball on the all-girls team.
Theresa comes from a well-educated family. Her mom is a pharmacist
at the local pharmacy and her dad teaches biology at the high school
in the neighboring town. Since both her parents work, Theresa
manages her own daily treatment regimen. She and her parents
have done a wonderful job at treatment, and Theresa hasn't been
in the hospital for any problems in 10 years—a great record
for a young person with cystic fibrosis. Her
parents and the Cystic Fibrosis Center team feel that Theresa does
an excellent job adhering to medications and this shows what a responsible
young woman Theresa is.
Theresa's treatments are certainly no walk in the park. She
has daily respiratory therapy to help keep her lungs clear, and she
takes loads of medications, including inhaled medications for her
lungs, a hi-potency multivitamin/mineral supplement with extra vitamins
A, E, D and K, enzymes to aid digestion, pills that help reduce stomach
acid and enhance enzyme action, and two medications to keep her bowel
movements regular. She also takes three eight-ounce cans of a nutritional
supplement to maintain her weight. She takes several courses of antibiotics
throughout the year.
Theresa has come to clinic for an unscheduled visit complaining about
an irritating, shallow cough. She decided not to mention the
constipation she has had for the last two weeks. Little does
she know that she will be admitted to the hospital for concerns that
she had no idea were important.
Things to consider about this case
There are several issues to consider about this case. You will explore
these issues more fully in the learning activities.
- The effect of Theresa's daily schedule on her adherence.
- Theresa's level of responsibility for her care given her developmental
- How her relationship with the Cystic Fibrosis Center team affects