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24 Nov 2018

Compare and contrast how pain is interpreted by children and adults. Describe the appropriate pain scales and assessments made to determine the presence of pain. Refer to the three articles in the required reading to discuss if nurses assess and treat pain approrpriately/adequately.

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Nestor RutherfordLv2

26 Nov 2018

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Related questions

What bones, muscles, ligaments, and/or tendons do you think are affected? Why? Note: Since you are a physician, be sure to use the correct anatomical name(s) for muscles and bones (e.g. use "gluteus maximus" instead of "butt muscle").

Which type of diagnostic imaging will you use to determine if your prediction is correct? Why? Is there a known treatment for problem? If so, what would you prescribe?

Keep in mind that there may be multiple correct answers for each case study, as pain may be caused by a variety of factors. You are only required to describe one possible scenario and how you would proceed as a physician. Feel free to use any available resources to help you diagnose and treat your patients as accurately as possible.

Case Studies

Case Study #1 Age: 75 Sex: Female Report: The patient was admitted to the emergency room with complaints of severe right hip pain after falling down the stairs. The upper leg and hip area are swollen and bruised, and the patient is unable to put weight on the right leg. In addition, the patient has a family history of osteoporosis.

Case Study #2

Age: 23 Sex: Male Report: The patient was taken to the emergency room via ambulance after falling at a ski jump competition. The patient is describing severe pain in the back of the left knee with significant swelling. Onlookers reported hearing a faint popping sound when the patient fell.

Case Study #3

Age: 34 Sex: Male Report: The patient, a soccer player in the 2014 FIFA World Cup, is complaining of sharp pain in the back of the left thigh. The area is slightly swollen and tender to the touch, and the patient reports weakness in the left leg. Case Study #4 Age: 42 Sex: Female Report: The patient, a cyclist, fell off of her bike after hitting a pothole in the road. She extended her right arm to break the fall, then immediately had a sharp, persistent pain in her shoulder. Her arm and shoulder are sagging, and she is unable to lift her arm.

ivorycheetah911

PLEASE ANSWER ALL THESE QUESTIONS I REALLY NEED THEM.

8- Older women experience bone loss, which makes them more susceptible to hip fracture. How should an environment change after a hip-fracture repair?

A. Sleep only on one side

B. Raise the toilet seat

C. Don't allow use of stair

D. Use a shower

9- A vigorous recent widower visited his primary care team and stated that he was lonely. Which recommendation should the team make for this patient?

A. Finding a new relationship

B. Moving in with his children

C. Taking a sleep pill

D. Taking an antidepressant

10- How often is tetanus vaccination recommended for older adult?

A.every 15 years

B. Every 10 years

C. Yearly

D. Every 5 years

11- Which lighting feature in most nursing homes compromises elder adult's ability to function?

A. Indirect lighting

B. Glare

C. Sunlight

D. Even lighting

12- A spiritual African American elder has terminal HIV. Based on knowledge of spiritual beliefs common in African American communities, why might this patient require careful assessment and monitoring for pain?

A. The patient may understate pain levels because of a belief that the illness is God's plan.

B. The patient may overstate pain levels so that God will be more likely to hear the patient's suffering.

C. The patient may overstate pain levels so that more drugs can be obtained for religious rituals.

D. The patient may understate pain levels because of faith in the doctor's ability to treat the patient.

13- A home-care nurse visits an elder living with dementia whose spouse is providing care. The nurse notices a restraint sitting in the.... What is the most important thing the nurse should do?

A. Find out why the spouse needs to use the restraints

B. Help the spouse plan care without using restraints

C. Report the spouse's abuse to adult protective services

D. Lecture the spouse about the risks of restraints.

14. Which assessment tool can be used to determine activities of daily living ( ADL) independence in older adult?

A. Mini-mental state examination (MMSE)

B. Mini-cog assessment

C. The Karz index

D. Confusion assessment method for the ICU ( CAM ICU)

15. Which nonpharmacologic interventions should nurses counsel patients on when they complain of occasional heartburn, constipation, and low energy?

A. Distribution of fatty meals throughout the day.

B. Two tablespoons of liquid antacid 30 minuts after each meal

C. A hot cup of coffee or tea at each meal

D. Adequate consumption of whole grains, fruits, and vegetables

A 67-year-old retired male went to his doctor, complaining initially of leg pain that started in his lower back, which then radiated down across the side of his thigh and over the front of his knee. Subsequently, he developed pain that radiated from his back to his front at two different levels: at the chest through the level of his nipples and also at the umbilicus.

His physician performed a history and physical, followed by laboratory tests. He discovered a hard nodule on his prostate and an elevation in several of the blood tests. His PSA (prostate specific antigen), an enzyme secreted by normal prostate tissue (0-4 ng/ml) was 450. Alkaline phosphatase was also elevated at 157 U/L, an indication of bone involvement.

A bone scan was ordered to visualize the bone involvement. (This test uses a calcium analogue attached to a radioactive tag. A special scanner can pick up images of this radioactivity and create an anatomical picture of the skeletal system. The radiation shows up as black spots on the film.)

Usually prostate cancer's growth is initially influenced by the presence of testosterone. If testosterone is removed by castration, the cancer will often shrink for some period of time before the remaining fraction of testosterone-independent cancer cells grow.

This gentleman was not interested in castration and asked if there was another way to treat this. He was treated was a single shot of a drug which is slowly released into the body over a three month time period. Within that time the patient noticed marked relief in his pain.

1. What is the diagnosis of this gentleman?

2. Why would the scan show bone abnormalities?

3. Which endocrine organs are responsible for serum calcium levels?

4. Describe the feedback loop between the anterior pituitary and the production of testosterone in the testes.

5. Describe a mechanism by which a drug could act on the anterior pituitary to lower the testosterone level in the human body.