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Infections in the hospital setting
Infections in the hospital setting
Infections in the hospital setting
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SUBJECTIVE Patient comes in with a complaint of chronic right lower extremity pain due to a surgery that he had back in 2011. He apparently does have hardware in the proximal tibial area and apparently, this has been chronically infected. He is supposed to have this hardware removed by his orthopedic surgeon but he got incarcerated prior to having that done. He is also following with infectious disease. He states he has had an infection in there for at least 2-3 years and currently is on Bactrim suppression therapy. He also has some acne on his face that he would like to try Cleocin for which has worked well in the past. Otherwise, his pain has been his biggest issue. He understands that we cannot prescribe narcotics but he states that
Education of the patient will begin. Depending on the size of the abscess and how extensive the procedure was the patient may need a relative or friend to drive them back home. Not only would the patient need a ride back home, they may need to be watched for 24 hours. As part of pain management pain medication may be given to the patient to decrease pain. Antibiotics may be given to fight or prevent infection caused by the bacteria. The patient will also need to list all medications that they are taking so there will not be any contraindications with the medications that the patient is given. Advise the patient that more than one follow-up appointment will be necessary in order to properly treat the wound. Before the end of the appointment, the medical assistant should give the patient written instructions along with an emergency number and the number to the practice incase the patient has any questions or concerns. Advise the patient to return to the practice if they experience any fever, chills, or the abscess returns. If red streaks appear around the wound tell the patient to call the emergency department immediately. After the the procedure and patient education has been completed, make sure all the step of the procedure has been documented in the patient’s record and all follow-up procedures have been
Chronic pain is a long term condition, which means it cannot be cured, but the symptoms may be controlled by therapies and medications (Saxon and Lillyman, 2011). When pain is considered chronic, it lasts longer than the expected healing period and there may not be a clear cause (Kraaimaat and Evers, 2003).
Musculoskeletal pain affects the bones, muscles, ligaments, tendons and nerves, its commonly but not always it is caused by physical injury, which can be widespread or localised in just one body part. Joint and muscle pain is the probably the number one symptom that prompts people to seek the help of health professionals like osteopaths.
Sports Medicine is a medical field that specializes with physical fitness, treatment and prevention of injuries related to sports and exercise. It was introduced around the early Greek and Roman era when the first modern Olympic Games took place. The Greek felt they could do something to help heal and prevent injuries that the athletes were receiving. Now in sports medicine, certain injuries can only be assessed and treated by specific physicians. These physicians can include physical therapists, athletic trainers, and strength and conditioning coaches. Although sports physicians are most commonly seen by athletes after they are hurt so they can be treated, there are some physicians that are seen before an injury occurs so that they can learn how to prevent injuries.
J.P., a 58 year old female, presents to the Emergency Room on March 18th. She has a past medical history of cervical cancer, atheroembolism of the left lower extremity, fistula of the vagina, peripheral vascular disease, neuropathy, glaucoma, GERD, depression, hypertension, chronic kidney disease, and sickle cell anemia. She complains of right lower extremity pain accompanied by fatigue, a decreased appetite, increased work of breathing, burning on urination, and decreased urine output for three days.
Pain is often overlooked and disregarded as an unimportant health issue by health care providers. However, according to the National Institutes of Health, pain affects more Americans than diabetes, heart disease, and cancer combined. It is the most common reason people seek health care, the leading cause of disability, and a major contributor to health care cost (National Institutes of Health [NIH], 2013). By managing pain, patient outcomes improve and health cost decreases because the patient is more likely to participate in activities such as mobilization and deep-breathing exercises, leading to fewer complications and earlier discharge. Organizations such as the American Society for Pain Management Nursing, the American Pain Society, and
In The Body in Pain, Elaine Scarry argues, “Physical pain has no voice, but when it at last finds a voice, it begins to tell a story” (3). Scarry’s argument highlights two important notions – the difficulties of elucidating unimaginable pain, and its ability to unravel through narration, both of which are exemplified in Elizabeth Bishop’s poem, “The Fish”. Centered on an anonymous speaker’s three-fold experience of catching, analyzing and unexpectedly releasing a fish back into the ocean, Bishop’s poem skillfully evokes the titled fish’s suffering by taking on the subject of pain visually. She moves from observing the fish’s external features to its physiological features, and ultimately to its soul. Although the speaker initially sees the
Mr. GB is a 78 year old white male admitted to Bay Pines VAMC on 6/18/96. for " atypical chest pain and hemoptysis". V/S BP 114/51, P 84, R 24, T 97.4. He seems alert and oriented x 3 and cheerful. Bowel sounds present x 4. Pt. has a red area on his coccyx. Silvadene treatments have been started. Pt. Has a fungal lung infection with a pleural suction drainage tube inserted in his chest . Pt is extremely thin with poor skin turgor with a diagnosis of cachexia ( wasting) secondary to malnutrition and infection. Patient is no known allergies to drugs but is allergic to aerosol sprays disinfectants and dust.. Advanced directives on chart. Code status DNR. Primary physician Dr. R, Thoracic surgeon Dr. L. Psychology Dr.W. There is PT, OT Dietary and Infectious Disease consults when necessary. He lives with his wife who he has been married to for 56 years. His son and his daughter come to visit him. He does not smoke. He wears dentures but did not bring them. He dose not use a hearing aid but he does have a hearing deficit.
Exploring the precision of assessing pain by using available tools in the hospitals chosen for the study by comparing them with the (COPT).
S: TM works in GA Trim 1. According to TM his both elbows and forearm area stared to have trouble gripping and picking up wires since late February. Also he was experiencing numbness and tingling sensation I his left hand. For the past several days his elbow pains were gradually getting worse that’s when he decided to come to the HMMA medical clinic; TM reports Tenderness at origin of wrist extensors, denies any difficulty with ROM.
Musculoskeletal pain generally arises due to an injury, infection or overuse/exertion. This is generally marked by muscle tenderness, weakness, limited range, stiffness and decreased nerve conduction velocity.²Here, we wanted to analyse the musculoskeletal pain among school and university female teachers. They have various works ranging from giving lectures, checking assignments to tedious computer work. These all are the reasons for the increase neck, shoulder and back pain. Teachers in colleges have to give long hours of lectures in standing whereas teachers in high school have more stress and work load as they have to cover large syllabuses including competitive exams. Awoman has to manage the whole house taking care of elderly as well as her children. And being a teacher definitely increases the wholesome workload. Whereas men on the other hand, are not at all active in the household chores, which thereby proves the difference in the workload among the two genders.Also women, undergoes various hormonal changes in the body and many a times musculoskeletal pain is one the symptoms.
This is his first admission to the ward after having his second episode of the same pain. The first episode was 10 days prior to his admission. The first episode was relieved after taking pain killer at the clinic.
Current subjective complaints (from claimant) and objective observations: Mr. Anderson continues to walk using 2 canes, his legs shake when he is walking; he has frequent tremors of his legs while sitting and reports with any movement he has severe back spasms. He said the best his pain ever gets is a 7 and with any activity it is a 10+. He said he has swelling to the low back, and radiation of pain down both legs. The trial of the spinal cord stimulator decreased his pain with the current medications by 50%, but he still rated it at an 8. He feels that with his pain medications and the spinal cord stimulator his pain would be 80% better.
IASP’s definition of pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage” (H. Merskey and N. Bogduk 1994). Pain however is much broader and can be further classified by its duration or pathophysiology. Most commonly pain can be classified as acute or chronic. Acute pain is a essential warning sign that helps the host protect itself from a potentially dangerous environment. The unset of acute pain is sudden and it usually accompanied by tissue damage and inflammation. The duration of acute pain is anything that last less than 3 months and subsides when the injury is healed.
Nociceptors are cutaneous and subcutaneous receptors specialized for the detection of noxious stimuli (Latremoliere & Woolf, 2009). Nociception is considered a protective process designed to help prevent injury by producing a withdrawal reflex from the stimulus and by generating an unpleasant sensation resulting in behavioral strategies to avoid further contact with the stimuli (Latremoliere & Woolf, 2009). Pain can be divided into nociceptive pain or neuropathic pain since each type of pain has a different mechanism. Nociceptive pain results from direct activation of pain nerve fibers from inflammatory, mechanical or chemical mediators, whereas neuropathic pain generally refers to pain that is initiated or sustained by a primary lesion or