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. You are a nurse working in a primary care office. You assess a…

 

1. You are a nurse working in a primary care office. You assess a 79-year-old man who complains of back pain for the past “month or so.” The patient reports that the pain has been increasing and is no longer relieved with ibuprofen (Motrin). Vital signs are within normal limits. The patient weighs 118 lb, and you note that he is 2 in shorter than he was 5 years ago.

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a. What additional assessment information would you want to obtain from this patient? 

b. What appropriate diagnostic tests would you anticipate for this patient? 

c. What is your priority nursing diagnosis and plan of care for this patient?

 

 

 

2. You are a nurse working in the emergency department (ED) and caring for a 75-year-old woman who arrived via ambulance after falling at home. She tells you she slipped on a rug and hurt her wrist trying to brace herself from the fall. You notice an obvious deformity of her right wrist. Her current weight is 90 lb; she admits to smoking half a pack of cigarettes a day for the past 45 years, and drinks 1 alcoholic drink a day. She has a medical history of chronic obstructive pulmonary disease (COPD) and hypertension. X-ray confirms a fractured right distal radius.

 

a. What other health concerns should be evaluated for this patient? 

b. What is the evidence base that supports strategies for educating and planning care for this patient? In particular, what strategies can be implemented in order to educate this patient about fall prevention and maximize her musculoskeletal health? 

 

 

 

3. 70-year-old woman is 3 days postoperative after a left TKA. She is moderately overweight, has extensive varicose veins, and has a history of smoking. She has been reluctant to ambulate and complains that her intermittent compression devices are uncomfortable and she does not want to wear them. Her morning assessment reveals a red, swollen, and painful left calf. She is questioning what is going on and does not understand why she is at risk for VTE.

 

a. How would you respond to her? 

b. Describe the physical assessment that should be conducted for this patient. 

c. What are her risk factors for this disease process?

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