Westcoast NURS663B 2021 October Week 7 Forum Latest

NURS663B Primary Care Adult and Geriatric Patient Theory

Week 7 Forum

Select one of the following case studies to address. In the subject line of your post, please identify which prompt you are responding to, for example,  #1 45-year-old woman, intermittent fevers.

Discuss what questions you would ask the patient, what physical exam elements you would include, what further testing you would want to have performed, differential and working diagnosis, treatment plan, including inclusion of complementary and OTC therapy, referrals, and other team members needed to complete patient care.

In your peer replies, please reply to at least one peer who chose a different case study.

Case Studies

1. Julie is a 26-year-old hockey coach who was violently hit into the end boards about two weeks ago and was removed from the ice on a stretcher. Her head CT was clear and neck X-rays were negative. She presents today for 8 out of 10 lower back pain that is not responsive to Motrin. She has no radicular symptoms and no other past medical history.

2. Mark is a 46-year-old firefighter on disability for the past year due to a 30" fall from a ladder in which he sustained a pelvic fracture, a left femur fracture, and several disc fractures to his spine. He has been on Norco, one pill every six hours for the past year, although sometimes he does not take the medication at all. Today, he presents to the clinic for escalating pain over the past  week, with no relief from Norco. His symptoms include numbness to both feet, numbness to his tailbone, and sharp pain throughout his lower back. He denies any new trauma.

3. Cleo is a 55-year-old who was diagnosed with fibromyalgia three years ago. She has been treating her muscle pain with stretching and has been taking Prozac for about two years, which has stabilized her sleep pattern and helped with pain. Her pain has worsened significantly in the past four to five months, interfering with her ADLs, exercise routine, and mood. Today, she has ten positive trigger points and a severe migraine for which she has already taken two doses of Imitrex without relief.  She is extremely teary and feeling hopeless. She tells you that she does not want to become one of those “fibromyalgia patients that everyone makes fun of.”