NR305 Week 7 Discussion, Assessment Techniques

NR 305 Health Assessment Discussion Topic Week 7 Assessment of the Musculoskeletal System and Pain First, I would stabilize Fred and provide immediate treatment if necessary. Check his vital signs, postural blood pressure, apical HR and finger stick glucose. By looking at his medical history and his current condition, lab tests like CBC, urinalysis, pulse oximetry, electrolytes and EKG should be performed. Risk factors related to medical conditions or medication use maybe reflected in abnormal values, so keeping close check on labs is key. Also, check to see if he took his current medications today and what time. I would suspect that Fred has a fracture after his fall. While in the ER, since his pain was not relieved with Morphine, I would talk with the doctor if he can possibly order another pain medication to control his discomfort or just up the dosage. Finding out exactly where his pain is located and give him an ice pack if desired. When assessing Fred, it will be a through head to toe exam and will focus on the musculoskeletal system. We would focus on his right side since he landed on that side when he fell and examine his face, knee and right leg. If a fracture is suspected in his right leg, we would immobilize it in the position found. “Fracture cause sharp pain that increases with movement” (Jarvis, 2016). Performing an x-ray to figure out what type of fracture he has is important. This will help determine if he has a fracture in his face or leg. The concerns that I have with Fred and his potential need for surgery would be risks of blood clots or bleeding out. He has a risk for bleeding due to the use of Aspirin and Plavix daily which are blood thinners. And you must be cautious with people who use these types of medication and the planning of surgery. Making sure to stabilize coexisting medical problems and minimizing respiratory and cardiovascular functions is important before surgery. Mortality after hip or leg fracture ranges from 14-36%, with cardiovascular disease being the most common cause, followed by infection and pulmonary embolism (Sandhu, Sanders, & Geraci, 2013). Since Fred has potential risk factor of bleeding, most likely the doctor will order clotting factor labs PT, aPTT, and TT. We would make sure he is NPO in case of surgery. Preoperative elements that require correction before any type of surgery would be dehydration, hypovolemia, anemia, hypoxia, electrolyte imbalance and arrhythmias. References Jarvis, C. (2016). Physical examination & health assessment. (7th ed.) Philadelphia, PA: Saunders. p. 586 Sandhu, A., Sanders, S., & Geraci, S. A. (2013). Prognostic value of cardiac troponins in elderly patients with hip fracture--a systematic review. Osteoporosis International: A Journal Established As Result Of Cooperation Between The European Foundation For Osteoporosis And The National Osteoporosis Foundation Of The USA, 24(4), . doi:10.1007/s