Skeletal System Case Study Overview: Mrs. Donovan, a 72-year-old woman, is admitted to the hospital complaining...
Fantastic news! We've Found the answer you've been seeking!
Question:
Transcribed Image Text:
Skeletal System Case Study Overview: Mrs. Donovan, a 72-year-old woman, is admitted to the hospital complaining of an extremely sore hip after a recent fall. Chief Complaint: right hip Notes: Mrs. Margaret Donovan, a 72-year-old white female, was brought to the emergency room by her son-in-law after falling in her bathtub. She was previously in good health, despite leading a relatively sedentary lifestyle and having a 30-year history of cigarette smoking. The only medication she currently takes is Inderal (propranolol) for mild hypertention (high blood pressure). She fell upon entering the bathtub when her right leg slipped out from under her; she landed on her right hip. There was no trauma to her head, nor does she complain of right or left wrist pain. However, she reports severe pain in the right hip and upper thigh, and was unable to get up after her fall. An injection of oxymorphone hydrochloride (Numorphan) helped relieve her pain and she was taken to the radiology department for an X-ray of her right leg and hip. Physical examination: The patient was alert, oriented to time, place, and date, and was responding appropriately to questions despite being in considerable pain. There were no signs of trauma to the head, neck, torso, arms, or left leg. The right thigh and hip were extremely tender and were immobilized by a leg splint. Heart and lung sounds were normal and abdominal sounds were reduced. She measures at 5'3" and weighs 102 pounds. Her temperature is 98.6, pulse is 84, and blood pressure 130/80. Her respiratory rate is 18. Mrs. Donovan's pain description indicates that the pain appears to originate in her sacral and lumbar regions and migrate upward toward the cervical region and throughout her pelvis. A black and blue contusion is visible on her upper right hip. Patient History: Last physical was eleven months ago. Her height was 5'4" and weight 108 pounds. Heart rate was 65 bpm and blood pressure was 120/90. Temperature was 98.2 and resting rate was 15 breaths/min. Radiology report: The X-ray of the right hip revealed a complete, comminuted, intertrochanteric (top part of the femur) fracture of the right hip. No other fractures were noted in the right leg. There were also long-term osteoporotic changes in the femur, tibia, and fibula. An open reduction surgery is recommended to immobilize the bones with internal pins. Questions 1. What is meant by a "complete, comminuted, intertrochanteric fracture of the right hip?" 2. Draw a picture of what you think Mrs. Donovan's fractured femur looks like. 3. The radiologist reports signs of osteoporosis. How is osteoporotic bone different from regular bone? 4. Why do bones become osteoporotic in some people? (What specifically is happening in the bones themselves?) Surgeons performed an open reduction of Mrs. Donovan's fracture, immobilizing the bones with internal pins. "Open reduction surgery" is a procedure in which the broken bones are re-aligned and long, thick pins are inserted lengthwise into the bone tissue. These pins are held in place by screws drilled in from the outside of the bone. 5. Describe the changes that a broken bone undergoes as it is healing. During her long recovery, Mrs. Donovan is advised by her physician to begin weight-bearing as soon as she can. To aid her in this regard, she begins light physical therapy three times per week. 6. How does weight-bearing influence the bone healing process? 7. In addition to the physical therapy benefits, why else might her physician want her to avoid prolonged bed-ridden activity? 8. What risk factors does Mrs. Donovan have for osteoporosis? 9. What bones are most vulnerable to osteoporosis and why? Following her recovery, Mrs. Donovan was placed on three medications: oral calcium supplements, oral estrogen, and oral alendronate sodium (Fosamax). (Fosamax is a drug which inhibits the activity of osteoclasts.) 10. Specifically describe how each of these medications works to treat Mrs. Donovan's condition. Skeletal System Case Study Overview: Mrs. Donovan, a 72-year-old woman, is admitted to the hospital complaining of an extremely sore hip after a recent fall. Chief Complaint: right hip Notes: Mrs. Margaret Donovan, a 72-year-old white female, was brought to the emergency room by her son-in-law after falling in her bathtub. She was previously in good health, despite leading a relatively sedentary lifestyle and having a 30-year history of cigarette smoking. The only medication she currently takes is Inderal (propranolol) for mild hypertention (high blood pressure). She fell upon entering the bathtub when her right leg slipped out from under her; she landed on her right hip. There was no trauma to her head, nor does she complain of right or left wrist pain. However, she reports severe pain in the right hip and upper thigh, and was unable to get up after her fall. An injection of oxymorphone hydrochloride (Numorphan) helped relieve her pain and she was taken to the radiology department for an X-ray of her right leg and hip. Physical examination: The patient was alert, oriented to time, place, and date, and was responding appropriately to questions despite being in considerable pain. There were no signs of trauma to the head, neck, torso, arms, or left leg. The right thigh and hip were extremely tender and were immobilized by a leg splint. Heart and lung sounds were normal and abdominal sounds were reduced. She measures at 5'3" and weighs 102 pounds. Her temperature is 98.6, pulse is 84, and blood pressure 130/80. Her respiratory rate is 18. Mrs. Donovan's pain description indicates that the pain appears to originate in her sacral and lumbar regions and migrate upward toward the cervical region and throughout her pelvis. A black and blue contusion is visible on her upper right hip. Patient History: Last physical was eleven months ago. Her height was 5'4" and weight 108 pounds. Heart rate was 65 bpm and blood pressure was 120/90. Temperature was 98.2 and resting rate was 15 breaths/min. Radiology report: The X-ray of the right hip revealed a complete, comminuted, intertrochanteric (top part of the femur) fracture of the right hip. No other fractures were noted in the right leg. There were also long-term osteoporotic changes in the femur, tibia, and fibula. An open reduction surgery is recommended to immobilize the bones with internal pins. Questions 1. What is meant by a "complete, comminuted, intertrochanteric fracture of the right hip?" 2. Draw a picture of what you think Mrs. Donovan's fractured femur looks like. 3. The radiologist reports signs of osteoporosis. How is osteoporotic bone different from regular bone? 4. Why do bones become osteoporotic in some people? (What specifically is happening in the bones themselves?) Surgeons performed an open reduction of Mrs. Donovan's fracture, immobilizing the bones with internal pins. "Open reduction surgery" is a procedure in which the broken bones are re-aligned and long, thick pins are inserted lengthwise into the bone tissue. These pins are held in place by screws drilled in from the outside of the bone. 5. Describe the changes that a broken bone undergoes as it is healing. During her long recovery, Mrs. Donovan is advised by her physician to begin weight-bearing as soon as she can. To aid her in this regard, she begins light physical therapy three times per week. 6. How does weight-bearing influence the bone healing process? 7. In addition to the physical therapy benefits, why else might her physician want her to avoid prolonged bed-ridden activity? 8. What risk factors does Mrs. Donovan have for osteoporosis? 9. What bones are most vulnerable to osteoporosis and why? Following her recovery, Mrs. Donovan was placed on three medications: oral calcium supplements, oral estrogen, and oral alendronate sodium (Fosamax). (Fosamax is a drug which inhibits the activity of osteoclasts.) 10. Specifically describe how each of these medications works to treat Mrs. Donovan's condition.
Expert Answer:
Answer rating: 100% (QA)
1 A complete comminuted intertrochanteric fracture of the right hip refers to a specific type of fra... View the full answer
Related Book For
Fundamentals of Case Management Practice Skills for the Human Services
ISBN: 978-1305094765
5th edition
Authors: Nancy Summers
Posted Date:
Students also viewed these accounting questions
-
A baby is admitted to the hospital with a history of diarrhea and watery feces occurring over the last three days. The baby has sunken fontanelles, indicating extreme dehydration. Tests indicate that...
-
Ms.G a 23-year old diabetic is admitted to the hospital with a cellutitis of her left lower leg. She had been applying heating pads to the leg for the last 48 hours, but the leg has become more...
-
A 2-month-old child is admitted to the ICU with fever, hypotension, tachycardia, and lethargy. The medical history is notable for a similar hospitalization at 2 weeks of age. Physical examination is...
-
Is informing the consumer about any toxic substances used in the manufacture of a product sufficient to produce an efficient level of toxic substance use for that product? Why or why not?
-
For her tax class, Yvonne is preparing a research paper discussing the tax aspects of child support payments. Explain to Yvonne how she can research the provisions on this topic.
-
Ann hires a nanny to watch her two children while she works at a local hospital. She pays the 19-year-old nanny $125 per week for 48 weeks during the current year. a. What is the employer's portion...
-
In stepwise regression, we specify that \(F_{\mathrm{IN}} \geq F_{\mathrm{OUT}}\left( ight.\) or \(t_{\mathrm{IN}} \geq t_{\mathrm{OUT}}\) ). Justify this choice of cutoff values.
-
Bart and Elizabeth Forrest, both age 47, are married and have no dependents. They have asked you to advise them whether they should file jointly or separately in 2016. They present you with the...
-
[111] The inverse of the matrix A = 6 7 8 8 using 6 7-8 adjoint method is :
-
In this exercise, you create a Triangle class and a program that uses the Triangle class to instantiate a Triangle object. a. If necessary, create a new project named Intermediate17 Project and save...
-
You are the manager of the train depot. One of your tasks is to efficiently order the train cars so that it is easy to attach and detach them. In this assignment, you will implement Train Cars...
-
Describe the use and development of GIS within the context of vulnerability assessment
-
What are the Insurance industry basis regulation? 2-In the United States, most insurance industry rules are made at the state level. State regulation of the insurance industry and the impact of this...
-
The story of Canada's trade relationship with China presents several challenges related to international trade law and the topics of the course. Some of the challenges include: Resolution of dispute:...
-
In December 2019, a novel coronavirus outbreak was first documented in Wuhan, China. This virus triggered crisis for the global economy and markets including Ghana. With an escalating number of...
-
Can paraphrase my sentences in my assignment? 1. Intellectual property protection : Legal safeguards for creative works including inventions, designs, logos, and brand names include intellectual...
-
A spaceship is traveling at a velocity of when its rockets fire, giving it an acceleration of V= Vo = (37.5 m/s) i a = (3.87 m/s) + (5.91 m/s) How fast, in meters per second, is the rocket moving...
-
A bubble-point liquid feed is to be distilled as shown in Figure. Use the Edmister group method to estimate the mole-fraction compositions of the distillate and bottoms. Assume initial overhead and...
-
Jim is doing an intake with a man who claims he is depressed. He tells Jim that ever since his wife left he has had trouble concentrating and waking up in the morning. He talks about how lonely it is...
-
Chris is a single father who is trying to work and raise three small children. His wife was killed 2 years ago in a traffic accident. After the initial shock and outpouring of support from friends...
-
I know you said this is temporary housing and all, but I never had a place like this place. I cant stand to think I have to move again sometime, and God knows where Ill go. FEELING: EMPATHIC...
-
What is the difference between leading zeros and trailing zeros? Which ones are considered significant digits?
-
Explain the difference between number of digits, number of decimal places, and number of significant digits in a numerical value. Illustrate your explanation using the number 0.03720 .
-
What is the simplest way to convert a quantity given in one unit to the same quantity given in a different unit?
Study smarter with the SolutionInn App