Nursing

CASE:
Mr. Perkins, age 81, reports for an annual physical examination. He says he is doing well. His only known problem is osteoarthritis. He also requests a flu shot. He takes no medications other than Tylenol for arthritis pain. When he walks into the exam room, you notice that he is using a straight cane in his right hand. When you ask about the cane, he says he began using the cane because the pain in his right hip had increased significantly over the past 6 months.

Review this week’s Learning Resources, considering how assessment tools are used to evaluate patients.

DIRECTION :
Post an explanation of your evaluation plan for the patient in the case study provided and explain which type of assessment tool you might use for the patient. Explain whether the assessment tool was validated for use with this patient’s specific patient population and whether this poses issues. Include additional factors that might present issues when performing assessments, such as language, education, prosthetics, etc. Also explain the immunization requirements related to health promotion and disease prevention for the patient.

ANSWER

Osteoarthritis

Osteoarthritis is the most widespread chronic joint condition which is affecting millions of individuals globally. This condition happens when the protective cartilage that cushions the ends of the bones wears down over time. Although the complication can affect any joint, the ailment primarily affects joints of a person’s spine, hip, and knees. This condition can be controlled even though the damage of joints cannot be changed. A cover of rigid but smooth and slippery tissue called cartilage protects the bones’ surface and assists the bones in moving freely against each other in any healthy joint. When a joint is affected by osteoarthritis, a section of the cartilage thins, and the surface becomes rougher. This means the joint does not move freely as required.

Evaluation Plan

The patient should have his balance, gait, and risk of falls examined and treated appropriately in the provided case study. The existing balance and gait complications can best be detected through monitoring the patient’s performance balance and walking conditions (Papi, Murtagh, & McGregor, 2016). Testing can be done immediately a patient gets into the room, where the visual examination of gait and balance can be evaluated instantly. An evaluation of equipment to be used in treating the gait can be done at this time too. Other assessment tools include various tests that can be done in the evaluation room, including the ability to keep a side by side, semi-tandem, and full-tandem stance for 15 seconds. To examine quadriceps muscles, the doctor can observe if the patient can stand up without any help. The gait can be estimated through how slow or fast the patient can walk 10feet and back.

Validation of the Tool

The patient is using a cane to assist him in walking due to the pain in his right hip. However, the issue arising is that he is not using this equipment correctly, resulting in more complications. A cane is appropriately used when it is held on the patient’s right side. In this case study, he should use the cane in his left hand, on his left side, for the right hip pain. Education and language are common factors likely to hinder efficient and practical examination of ailments. When a person has poor communication skills or language barriers, it is difficult for the doctor to evaluate or do a proper analysis. Education also plays a fundamental role in disease evaluation. Performing assessment requires a patient to be well educated and have an idea of the type of ailment they are suffering from and probable treatments.

Immunization Requirements

Health promotion and disease prevention are significant arising themes in geriatric medicine and health care generally. Even though efforts have been driven towards younger people, there is growing proof that this approach is practical and feasible for those aged 65 and over (French et al., 2015). Disease prevention and health promotion strategies are effective strategies to deal with what has increasingly become a hallmark of current times. It is significant for the patient to enact behaviors that enhance bodily functioning and improves his ability to adapt to the changing environment. The patient still needs education on how to correctly use assistive devices, including his cane, together with an orthopedic evaluation due to his worsening symptoms within the past six months. The patients should also be examined to possibly have effective pain medication included in his regimen and be subjected to several motion exercises. Intense x-ray examinations should also be done along with frequent routine labs.

References

French, S. D., Bennell, K. L., Nicolson, P. J., Hodges, P. W., Dobson, F. L., & Hinman, R. S. (2015). What do people with knee or hip osteoarthritis need to know? An international consensus list of essential statements for osteoarthritis. Arthritis care & research, 67(6), 809-816.

Papi, E., Murtagh, G. M., & McGregor, A. H. (2016). Wearable technologies in osteoarthritis: a qualitative study of clinicians’ preferences. BMJ open, 6(1).