of the Ham and Sloane course|Essay guru

Posted: January 28th, 2023

As we learned earlier this semester there is no longer access to the Hartford case studies without paying a fee.

Here is the information for your first case study.  Please construct your responses and upload them into the Case Study 1 drop box.

Complete the case study questions including what the appropriate interventions hat should be done to address her symptoms.

The assignment will be due by 11:59 pm on Sunday at the end of week 3.

Opal Smith (Part 1) – retrieved from page 235 of the Ham and Sloane course text.

Opal Smith, an 80-year-old woman, comes to your office as a new patient. She has hypertension, type 2 diabetes (diet-controlled), osteoarthritis, and mild hearing loss. Mrs. Smith’s main reported symptoms are bilateral mild knee pain and some sense of unsteadiness on walking. She denies dizziness, postural symptoms, or falls in the past year. She takes lisinopril 10 mg daily, a multivitamin, calcium with vitamin D, acetaminophen as needed for pain, and diphenhydramine as needed for occasional insomnia. She has lived alone since her husband died 3 years ago. She still drives and has several friends with whom she visits. One of her friends suffered a fall several months ago and fractured a hip, from which she is still recovering. Mrs. Smith is somewhat worried about her own unsteadiness and risk for falls.

On exam, her blood pressure is 136/78 mmHg, pulse 72, weight 150 lbs (68 kg), and height 5 ft 5 in. She is mildly hard of hearing but communicates well. She has some mild crepitus on motion of her knees; her gait is slowed with short steps and is somewhat wide based. The rest of her examination is unremarkable, as are all routine laboratory tests. At the end of her examination, Mrs. Smith asks you for fall prevention recommendations.

·       1. What are Mrs. Smith’s major risk factors for falls?

·       2. What interventions would you recommend to minimize her risk?

Instructions: Please prepare and submit a paper 3-4 pages in length (not including APA format) answering the questions or responding to the prompts presented.

SOLUTION

Mrs. Smith’s main reported symptoms are bilateral mild knee pain and some sense of unsteadiness on walking. She has a history of hypertension, type 2 diabetes (diet-controlled), osteoarthritis, and mild hearing loss. She denies any recent episodes of dizziness, postural symptoms, or falls. Based on this information, it would be appropriate to conduct a thorough physical examination, including an assessment of her gait and lower extremity strength, to determine the cause of her knee pain and unsteadiness. Depending on the results of the examination, further testing such as x-rays or MRI may be ordered. Treatments options may include physical therapy, medication, or possibly surgery. A referral to a rheumatologist or orthopedic specialist may be considered if needed.