...condition misdiagnosed due to its presentation of similar diagnoses. The purpose of this case report is to demonstrate the physical therapist’s capability to differentially diagnose SpA with a thorough examination and evaluation of the clinical findings. Case Description: The patient is a 48-year-old Caucasian male who presents with pain and a progressive loss of mobility bilaterally in the neck and shoulders over the past two years in addition to a ten-year history of chronic low back and neck pain. The outcome measure utilized was the neck disability index (NDI). The physical therapist evaluated the patient for physical therapy, differentially diagnosed...
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...-1- SUMMARY Ultimately, my client was parked at a residential area when he was struck at high velocity by your insured. The police report revealed your insured neglected to merge with approaching traffic. My client racked up over $20,000 in medical bills with a forecast of $23,000 in future medical expenses. The pain specialist estimated Maximum Medical Improvement at twelve months. -2- BACKGROUND This accident took place on January 4, 2018 at a residential location in Greensville on the corner of Brimstone Avenue and Boulder Street. Browsing social media, my client was viciously struck from his left by your insured travelling at 25 mph, thrusting my client’s car rightward forcing him to knock down a mailbox.[ Please see attached car accident photo exhibits (Exhibit A, photo 4); Also see police report (Exhibit F)...
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...University of Phoenix The article, “You Just Have to Make the Pain Go Away”-Children’s Experiences of Pain Management (2008) outlines a participatory case study undertaken in four pediatric units in a university hospital. Researchers collected data until theoretic saturation was reached. As a qualitative research, data techniques employed recorded interviewing and data analysis. The authors indicate that data collection techniques were triangulated in an inductive content analysis. Throughout the study, certain categories were identified from the data collected and coded – these categories were outlined in the tables at the end of the article and can be reviewed on the pain management nursing website. The results abled the researchers to inductively generate hypotheses which result in a grounded theory: “owing to the subjective nature of the pain experience, children’s self-reports should be the most reliable source of the methods used in the management of their pain” (Kortesluoma, Nikkonen, & Serlo, 2008, p. 147-148). There is a scarcity of research on children’s perception of pain and their expectation of pain management when in a hospital setting. Previous studies focused on methods used by health care providers and parents in alleviating children’s pain. This study’s purpose is to “describe the interventions young children use themselves and their expectations of other’s help, when managing the pain experienced during hospitalization” (Kortesluoma, et al., 2008...
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...progression of the disease. Cancer patients are chronic sufferers and require effective physiological and psychological management of the complications. Pain is a common complication of end stage cancer patients who are undergoing either curative or palliative treatment. It can range from mild, moderate and severe depending on the progress of the disease. When it comes to palliative or end stage cancer (terminal illness), severe chronic pain management becomes even difficult for the family and health care providers. In fact, in such cases pain becomes primary and chief complaint of people for referrals....
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...Marie Oliver of York Risk Services Group Insurance Company referred this file for medical case management. Instructions were given to meet with Mr. Jones and assist with coordination of appropriate and related medical care, and identify needs to facilitate recovery. Ms. Oliver would like me to obtain prior medical records from Mr. Jones primary care physician Dr. Wetzel. INTERVIEW SETTING On 2/15/18 I met Mr. Jones at the office of Dr. Vakhariya. Mr. Jones was driven to the appointment by his mother. He is dressed neatly. Mr. Jones is willing to discuss his prior and current medical history. He is alert and oriented. MEDICAL FACTORS AS RELATED TO INJURY Mr. Jones said that while working on a conveyer belt on 2/1/18 he slipped on an...
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...Running head: CANCER PAIN MANAGEMENT 1 Cancer Pain Management Lavon R. Williams University of South Alabama Running head: CANCER PAIN MANAGEMENT Cancer Pain Management Cancer is rapidly becoming a chronic illness, and an estimated that 10 million individuals in the United States are survivors of cancer (Sun, Borneman, Piper, Koczywas, & Ferrell, 2008). According to 2008, cancer statistics from the American Cancer Society, about 2 565,650 people die in the United States from cancer every year. Approximately 1.6 million new cases of cancer are expected to be diagnosed in the United States this year (American Cancer Society, 2012). This is why the health care needs of cancer patients are unique, and many are at risk for developing late or long-term side effects and pain from their primary treatments. These long-term effects may also hinder optimal physical, psychological, and cognitive functioning for patients (Sun et al., 2008). Pain is experienced by 30% to 50% of cancer patients receiving treatment and by 70% to 90% of patients with metastatic or advanced disease. In almost every cancer-related case pain is inadequately managed due to a lack of patient and professional knowledge of optimum management (Sun et al., 2008). This paper will discuss how nurses can help provide adequate pain management in advanced cancer patients. Patient and family needs Support for the patient and family may include education and information, coping skills, counseling and psychotherapy...
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...Maxcis Insurance Company referred this file for medical case management. Instructions were given to meet with Craig Westenburg and assist with coordination of appropriate and related medical care, and identify needs to facilitate recovery. INTERVIEW SETTING On 3/3/17 I met Mr. Westenburg at the office of orthopedic surgeon Dr. Cherwin. Mr. Westenburg arrived alone. He is alert and oriented and willing to work with a nurse case manager. MEDICAL FACTORS Mr. Westenburg said he was cleaning off cars in the auto dealership lot when he slipped between two cars. He hit his right shoulder. Mr. Westenburg reported the injury and was sent for examination. Mr. Westenburg was sent for an MRI and referred to orthopedic surgery Dr. Cherwin....
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...Pediatric Case: Brittany Long Opening Questions How did the simulated experience of Brittany Long’s case make you feel? I felt comfortable with the stimulated experience of Brittany long’s case. Discuss the actions you felt went well in this scenario. The actions that I felt went well in the scenario was how the patient’s pains was addressed by giving her a pain medication and fluids. Scenario Analysis Questions What is the relationship between fluid and oxygen therapy in the treatment of sickle cell anemia? The fluid help to prevent dehydration. Fluid is important in the treatment of sickle cell anemia to be able to prevent further vaso-occlusive crises and to provide relief of pain. Oxygen helps only if the patient is hypoxia. What complications...
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...Tina Castle of Maxcis Insurance Company referred this file for medical case management. Instructions were given to meet with Darrell Morgan and assist with coordination of appropriate and related medical care, and identify needs to facilitate recovery. INTERVIEW SETTING On 717/17 I met Mr. Morgan at the office of Dr. Kohn. Mr. Morgan arrived alone. He is willing to provide prior and current medical history and work with a nurse case manager. MEDICAL FACTORS Mr. Morgan reports that while working he was throwing a tailgate into the dumpster the left arm was hit in the bicep when it bounced back. He had immediate deformity to the arm. He was seen at an urgent care clinic and sent to orthopedic Dr. Kohn for repair of a torn bicep tendon. The...
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...Running head: PAIN CASE STUDY Case Study: Pain Amit Dhir, Omeid Heidari, Sean Mayer, Ololade Ikuomola & Adam Boyce NR110.542 Physiological/Pathophysiological Basis for Advanced Nursing Practice I 09/29/2015 Johns Hopkins University School of Nursing On our honor, we pledge that we have neither given nor received any unauthorized assistance on this assignment. 1 Running head: PAIN CASE STUDY CASE STUDY Pain Use this document in documenting your response to the Patient Case Questions. CHIEF COMPLAINT “My back is killing me. The pain is mostly sharp and stabbing, and sometimes it’s a dull ache. You’ve got to do something. Those Tramadol pills aren’t cutting it and they’ve bound me up.” “I am not sleeping because of the pain.” MEDICAL HISTORY P.M. is a retired, 81yearold male being seen for a routine health maintenance visit. He has a history of lower back pain, morbid obesity, hypertension, hypothyroid, occipital lobe stroke, bilateral total knee arthroplasty, GERD and sleep apnea. Now reporting pain in feet. He has been a smoker for the past 64 years, reporting 12 ppd. He is accompanied by his wife of 62 years. CURRENT MEDICATIONS Tramadol 50100 mg p.o. Q 12 hrs prn back pain Atenolol 25 mg p.o. Q a.m. Levothyroxine sodium 125 mcg p.o. Q a.m. Clopidogrel 75 mg p.p. Q a.m. Ibuprofen 600 mg ii p.o. prn knee pain Aspirin 650 mg p.o. prn “when I can’t get to sleep” ...
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...Shields Mrs. Knutsen ENC1101-83 16 April 2014 Chronic Pain: Curable or Not Abstract Chronic Pain is an interesting problem in society today. The exact cause of Chronic Pain is not the same in every patient. In fact most patients present with different symptoms and associated pathologies, such as the strong link with depression. Treatment of Chronic Pain is often performed a single practitioner whether that be a Medical Doctor, Chiropractor, Nutritionist, or an alternative health care professional. Chronic Pain is often extremely complex, because of this treatment needs to be multidimensional. Effective care of Chronic Pain requires the collective cooperation of health care professionals Chronic pain is an increasing problem affecting society today. Chronic pain is a complex condition that affects 42 million-50 million Americans, according to the American Pain Foundation. A recent market research report indicates that more than 1.5 billion people worldwide suffer from chronic pain and that approximately 3- 4.5% of the global population suffers from neuropathic pain, Despite decades of research, chronic pain remains poorly understood and notoriously hard to control. A survey by the American Academy of Pain Medicine found that even comprehensive treatment with painkilling prescription drugs helps, on average, only about 58% of people with chronic pain. The frequency of pain has a great impact on business, with a recent report by the Institute of Medicine (Medicine) ...
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...Everyone will have to deal with the death of a family member or friend, as well as his or her own mortality. The certainty of the end of life can be very stressful and overwhelming. Many aspects of caregiving, treatment, and pain management are all part of the journey towards the end of one’s life. Many people are unclear about pain and symptom management during the end of life. Some believe that if you choose to medicate for pain then they are hastening or responsible for the death of their loved one. Others believe that all measures should be taken to help prolong their loved one’s life. No all deaths are the same. Some people pass away peacefully, while others will have difficulty transitioning through the end of life stages and have difficulty with pain. Individual beliefs, religions and cultures are also a large piece of what we must consider in order to plan the appropriate care for the dying patient. Unfortunately, in many instances, patients usually have not had discussions regarding end of life preferences with their doctors, caregivers, and family members. This sometimes leads to decisions being made at the end of life that are not the treatment preferences of the dying person. Hospice is a philosophy that allows nature to take its course, with focus on the greatest quality of life until the end of life. The goal is to provide physical, emotional, and spiritual comfort to the patient as well as provide support to the caregivers. Educating caregivers and...
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...unning head: CASE STUDY GRID 1 Case Study Grid “Case History of Debbie” Janet Ibrahim NUR/403 September 21, 2015 Dr. Sherrily Mulleneaux Case Study Grid “Case History of Debbie” Five factors that demonstrate nursing needs: 1. Nutritional maintenance 2. Post-operative pain and nausea 3. Lacks knowledge about the importance of self-breast exams 4. Concerned about her and family’s future (2 daughters) 5. Emotional abuse from spouse Nursing Diagnosis 1: Pain (Acute) Rationale: Common among cancer patients. This is proved by various testimonies of Class V cervical cancer patients. Acute pain results from the activity of cancer cells and is related to the body’s surgical interruption. Desired Outcome 1 Desired Outcome 2 Nursing Intervention 1 Assess the client for pain presence routinely. Monitor the clients pain on a scale of 0-10 every shift or as needed. Client will use a self-report tool to identify current pain intensity level and establish a comfort –function goal within a few hours after surgery. . Client will be able to describe and use pharmacological and nonpharmacological methods that can be used to help to achieve their comfort- function goals prior to discharge. Nursing Intervention 2 Provide rest periods to facilitate comfort, sleep, and relaxation Pain level will decrease over the next 30 days. As the patients pain level decreases, so will their fatigue over the course...
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...Path physiology Of Pain Within this essay I plan to discuss: one current view of path physiology of pain, two ages appropriate pain tools for babies and toddlers and will also be exploring the nursing management of acute pain experience in babies and toddlers, including a strategy for ensuring the safe delivery of care. There have been a range of theories put forward in attempt to explain the path physiology of pain, one of these is the gate control theory (Fraser.L 1996) which states that a stimuli that enters the spinal cord can be manipulated through a process of opening and closing gates, which in turn determines if impulses proceed or not. The Gate control theory provides the most plausible explanation for the process involved in the perception of pain. As there are many factors to a person’s perception of pain. When the nerve impulses from the nociceptors (a free ending nerve which is present in almost all types of tissues which act to sense and transmit pain) reaches a critical level, the T cells in the substantia gelatinosa (which regulates impulses) is triggered, therefore the gate opens. This then in turn allows the transmission of impulses to proceed to the thalamus and cerebral cortex where the perception of pain is defined (Wall and Melzack 1989). However there are scenarios when the gate remains closed even though there are impulses from the nociceptors. For example if a child...
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...Brandy Eberly of Mackinaw Administrators Insurance Company referred this file for medical case management. Instructions were given to meet with Dale Stolicker and assist with coordination of appropriate and related medical care, and identify needs to facilitate recovery. INTERVIEW SETTING On 6/20/17 I met Mr. Stolicker at the office of Dr. Taha. Mr. Stolicker is alert and oriented. He is willing to provide current and prior medical information. He is open to working with a nurse case manager. Mr. Stolicker’s wife drove him to his appointment. He is able to maneuver using his wheeled scooter. MEDICAL FACTORS Mr. Stolicker said he was working out in the field. He walked over to an area being worked on when a piece of metal that was over...
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