A review of her medical record indicates that she has had a functional decline with development of venous stasis ulcer to RLE. She suffers from dementia which is in the advanced stages. She also suffers from co-morbidities of anemia which is chronic, HTN which is stable and osteoporosis which is chronic.…
Mr. Leighe is charged with a hit and run, that caused a pedestrian to lose his life. Mr. Hall was riding his bike down the road, in front of Leighe, with his front and rear lights working properly, following all the rules. Leighe hit him with the front of his car, then drove away from the accident scene immediately. He had not only been drinking wine that evening, but also drove home, and hid his car at the back of his property. Leighe fled from the crime scene, had alcohol in his system, and hid the evidence. However, his driving record only consisted of two speeding tickets made more than 10 years ago. Leighe claims his car was frosted over making it visibly difficult to see and therefore had no intention of harming Mr. Hall. He also pleaded…
A patient is performing a Phase I (inpatient) cardiac rehabilitation exercise session. The physical therapist should terminate low-level activity if which of the following changes occurs? 1. The diastolic blood pressure increases to 120 mm Hg. 2. The respiratory rate increases to 20 breaths per minute. 3. The systolic blood pressure increases by 20 mm Hg. 4. The heart rate increases by 20 bpm. A patient is being evaluated for possible carpal tunnel syndrome, and a nerve conduction velocity test is performed. Which of the following findings would MOST strongly support the diagnosis? 1. Decreased latency at the elbow. 2. Decreased latency at the carpal tunnel. 3. Increased latency at the carpal tunnel. 4. Increased latency at the forearm. When examining a patient with a history of alcohol abuse, a physical therapist notes that the patient demonstrates fine resting tremors and hyperactive reflexes. The patient reports frequent right upper quadrant pain. Which of the following additional signs is MOST likely? 1. Jaundice 2. Hyperhidrosis 3. Hypotension 4. Nocturnal cough Which of the following examination findings would be expected in a patient who also had sustained ankle clonus? 1. An upgoing great toe when the sole of the foot is stroked 2. Weakness of ankle plantar flexors with one-repetition strength testing 3. Absence of sensation to sharp/dull testing over the posterior lower leg 4. Hyporeflexia when deep tendon reflexes are elicited in the lower leg Which of the following sensory testing locations corresponds to the C 7 nerve root? 1. Volar aspect of the little finger (5th digit) 2. Dorsal aspect of the middle finger (3rd digit) 3. Lateral aspect of the upper arm 4. Medial aspect of the upper arm A 3-month-old infant has poor midline head control. During evaluation, the physical therapist notes facial asymmetry and observes that the infant has limitation of cervical rotation to the left and cervical lateral flexion to the right.…
complains of pain and coldness of the right fingers. Which action should the nurse take?…
Mrs. Caretaker’s work history is 40 years steady. Her jobs have included much physical work. The patients that she cared for needed help with their daily activities. These activities include getting in and out of bed, getting on and off the toilet, and showering. Her long history of physical work could very well be a contributing factor to her musculoskeletal…
SITUATION: Lavon is a 30 year old, single African American who was diagnosed with sickle cell anemia when he was 4 years old. He works for a computer company and has been working 12 hour days to meet the deadline for a special project. Lavon is complaining of fatigue and decided to relax by playing golf on a warm Saturday morning. After the seventh hole he experienced dyspnea, tingling, and numbness in his legs. After the next hole, he experienced severe pain in his right ankle and knee. He was taken to the local medical center, where he was admitted. Lavon rates his pain at 8 on a scale of 1-10. The physician ordered oxygen, IV fluids, and a PCA pump with morphine sulfate.…
notices that the numbness and tingling not only persists, but has also spread up to her knees. Again, she ignores the abnormal sensation. By the end of a month’s time, the numbness spreads to the midline of her body. At this point, she becomes alarmed.…
Situation: It is early morning and the client, an 80-year-old woman, is getting out of bed. She has a mild headache over the right temple, is fatigued, and feels slightly weak. She calls for her husband to let him know she will be going back to bed for a while. When her husband comes in to check on her, he finds that she is having trouble saying words and has a slight left-sided facial droop. When he helps her up from the bedside, he notices weakness in her left hand and convinces her to go to the local emergency room.…
HISTORY OF PRESENT ILLNESS: This 40-year-old Latin female presents with complaints of low back and right leg pain. She said that she hurt her back in a motor vehicle accident three years ago and she has had a history of intermittent low back pain since that time. Last December she started a job where she had to lift boxes that weighed approximately 40 pounds. Around the first of January this year, she began to complain of back pain that gradually went into her right leg. The pain is primarily in the sacroiliac region and radiates into the buttock and lateral lower leg as far as the ankle. She has no numbness. Coughing and sneezing exacerbates her pain. She has to move around to get comfortable when lying down, but she is more comfortable lying down than in any other position. She is still working fulltime, but is not doing the heavy lifting at this time. She has been going to a Chiropractor for the last two months with no pain relief. She has taken Flexeril, Norflex, Tylenol with codeine and Darvocet. All of these have failed to improve her symptoms. She had a CT scan done recently and we are getting those results.…
Mary Smith has a prior injury that consisted of bone spurs in her feet. The bone spurs caused her hip and back pain. She wears orthotics on a daily basis. She has had surgery on both feet approximately two years before the auto accident. The surgery did not alleviate the problem. Mary Smith also has hypertension that she does take medication. Other than, the bone spurs and hypertension, Mary Smith was in great health. She attended water aerobics three times a week and bingo twice a week.…
My Uncle has calculated that he has suffered through 780,840 hours of constant pain since the onset of this disease. It is a difficult disease to understand and little is known about it. Generally it targets an area of the body that has received a minor injury and turns on pain receptors and swelling and doesn’t allow for them to be turned off. The pain can be heightened by physical or emotional stress. It can move to other areas of the body as further injuries occur. Moving or touching the area is almost intolerable. At this point my Uncle has lost the use of one hand and one leg making it impossible to work and making daily life difficult. My Uncle is addicted to painkillers. With constant use he has found them to be less effective in managing the pain. Recently, he has undergone numerous surgeries to install neurotransmitters in his spine. These wires send out electrical impulses that reach the brain faster than the pain and replace the pain with a tingling sensation. This has been somewhat effective, but has come with complications such as wires that move and…
According to the Quality of Life Index for Adults 1997, Mrs. G is experiencing some difficulty within the domain of physical health and pain. Mrs. G stated that she was unable to do some activities such as climbing more than one flight of stairs and walking several blocks. Mrs. G stated that her pain level is moderately…
She undergoes corrective surgery, but it fails to relieve her pain and resolve the problem.…
Eighteen months after diagnosis, D.W. seeks out her physician because of puffy hands and feet and…
Sannu has contracted Leprosy. As a sixteen year old teenager, it is hard to pin point when he was infected since Leprosy has a long incubation period. As a small boy traveling barefoot along trails in his village, Sannu’s body has already adapted to his living conditions. Sannu’s feet are tough and calloused. As Sannu ages, so does his Leprosy infection progress. The infection will cause neuropathy in his extremities which will lead to many injuries to his feet and hands. The wounds acquired will be infected for weeks or even months without treatment. The neuropathy caused by the Leprosy infection is characterized by causing a decrease in sensation in the extremities, muscle weakness, and numbness. Sannu’s feet that have been toughened by his environment and life style have been further injured due to lack of sensation and medical treatment. In an attempt to keep his feet clean to aide the healing of his infections, Sannu is more than likely maintaining a sedentary life style. This life style along with the progression of the Leprosy infection will weaken Sannu’s muscles.…