StudentShare
Contact Us
Sign In / Sign Up for FREE
Search
Go to advanced search...
Free

Right Thumb Pain Child Treatment - Case Study Example

Comments (0) Cite this document
Summary
An author of the present writing seeks to examine a case study for medical treatment of a particular patient.  The patient was well until few hours ago when he was bitten by a stray dog while playing with other children in the neighbourhood…
Download full paperFile format: .doc, available for editing
GRAB THE BEST PAPER91.1% of users find it useful
Right Thumb Pain Child Treatment
Read TextPreview

Extract of sample "Right Thumb Pain Child Treatment"

Five Cases Studies with Minor Injuries Patient A. 4 years old male Patient comes accompanied by the motherand an older brother 7. The mother gives consent for examination and treatment (Greaves and Johnson 2002, p.74). Patient scheduled for examination and planning of care. The patient is alert and oriented, he however appears to be in pain. He has no problem walking and eating.
P/C: Pain on the right thumb with an open wound (Talan et al. 1999, p. 88).
HPC: The patient was well until few hours ago when he was bitten by a stray dog while playing with other children in the neighbourhood. Has been having consistent thumping pain on the bite site with swelling of the entire hand.
Weight: 19.6kg
PMH: There is no reported history of major illness since childhood.
Medications: The child is not on any medication.
Allergies: There is no known history of allergies to food or drugs reported.
Immunisations: the child is up to date for his age.
SH: Lives with the parents, both employed and 4 siblings. Both parents are elementary school teachers in a nearby school and come home daily.
The last born in the family; Known by the social worker.
Attending day care with other children. At home, he is left under the care of a house-help who is employed to take care of an ailing grandparent living with the family.
Playful and loves pets, has two pet cats at home. He likes playing with other children and sometimes takes his two pets with him to play.
O/E: The child is in pain, with an open wound on the dorsal side of the right thumb. The bite is 2 cm long and canine marks are also visible on the frontal side of the thumb. The hand is inflamed from the carpal tunnel distally (Benson et al. 2006, p. 471). The patient however guards the whole hand and does not agree to be touched. Only the mother can touch.
HEAD AND NECK: No abnormality detected.
Hands: Both hands are strong, with normal range of motion and symmetry. The right hand is inflamed from wrist joint downwards and the patient guards the entire hand and reports pain.
No other abnormal observation on assessment.
Right Wrist and thumb: NAD
Rt. Thumb: superficial wound on anterior aspect of proximal phalanx about 0.5cm in diameter. 1cm in depth (Dealey 2005, p.57).
No bleeding noted, slight swelling around the bite wound, no erythema, no atrophy, no sign of infection, no bruising.
ROM: Active:
Flexion- full range; with minimal pain on anterior aspect of distal phalanx
Extension- full range; pain free movement
Abduction- full range; pain free movement
Adduction- full range; with minimal pain on anterior aspect of distal phalanx
Medial Rotation- full range; with minimal pain on anterior aspect of distal phalanx
Passive:
Flexion- full range; with minimal pain on anterior aspect of distal phalanx
Extension- full range; pain free movement
Abduction- full range; pain free movement
Adduction- full range; with minimal pain on anterior aspect of distal phalanx
Medial Rotation-FROM with minimal pain on anterior aspect
Resistive:
Flexion-with minimal pain on anterior aspect of distal phalanx
Extension- pain free movement Abduction- pain free movement
Adduction-pain free movement
Medial Rotation-with minimal pain on anterior aspect of distal phalanx
OBS: From the Pain score chart, the patient reports a pain score of 8-10 (Davies et al. 2011, p.8). Pulse rate 108 bpm. Blood pressure 116/83 mmHg. Respirations 22 breaths per minute.
Plan: Vital signs observation. Anti-inflammatory analgesics injection stat.
Treatment: Analgesics Ibuprofen 200mg PO BD for one week. Antiseptic wound cleaning and dressing daily. Elevation of affected arm (Greaves and Johnson 2002, p.43). Rabies Vaccine.
Follow-up: Re-visit the clinic after 2 weeks.
Advice: Help the child to keep off stray animals and keep an eye on the child when at home.
Keep the wound clean and always dry. Avoid any contamination.
The child to stay at home, under observation for one week.
Abbreviations
PC- Presenting Complain
HPC- History of Presenting Complain
Kg- Kilogram
PMH- Past Medical History
Meds- Medication
Nil- Nothing
SH- Social History
O/E- On Examination
NAD- No Abnormality Detected
ROM:- Range of Motion.
References
Angus, D.C. & van der Poll, T., 2013. Severe Sepsis and Septic Shock. New England Journal of Medicine, 369, pp.840–851. Available at: Benson, L.S. et al., 2006. Dog and cat bites to the hand: Treatment and cost assessment. Journal of Hand Surgery, 31, pp.468–473.
Dawood, M. (2012) The Emergency Practitioner’s Handbook: for all front line health professionals. London: Radcliffe Publishers
Davies , F. Bruce, C.E. and Taylor-Robinson, K.J. (2011) A Pratical Handbook: Emergency Care of Minor Trauma in Children. Uk: Hodder Arnold an Hachette Uk Company
Greaves, I. & Johnson, G. (2002) Practical Emergency Medicine. London: Arnold Publisher.
Talan, D.A. et al., 1999. Bacteriologic analysis of infected dog and cat bites. Emergency Medicine Animal Bite Infection Study Group. The New England journal of medicine, 340, pp.85–92.
Patient B.
Age: 51 years old male.
Patient comes alone and gives own health and personal history. The patient also sign the consent form on his own and consents to examination and any necessary care. The patient comes walking with a level of difficulty. The patient is not sick-looking, communicates with ease and freely.
PC: The patient complains of a swollen and painful ankle (Kaufman 2008, p. 2396).
HPC: The patient has been running after a cow that had broken out of the shed when his left foot got stuck in a trench and he fell spraining his left ankle.
Attending the department for examination and care.
PMH: patient admitted once at the age of 16 years with appendicitis (Dealey 2012, p. 199). Appendectomy done.
No major illness since childhood.
Weight: 76kg
Medications: The patient has been on analgesics broad-spectrum antibiotics regimen that ended three days ago; provided at the clinic. No other medication currently.
Allergies: The client has a specific protein food allergies, cannot eat eggs. There is no known drug allergies.
Immunisation: Tetanus injection immediately after the cut (one week ago) scheduled for a repeat (booster) in three weeks’ time (Greaves and Johnson 2002, p.38).
SH: the patient is married, living with the wife and two children. He is a farmer while his wife owns a grocery shop. Does not smoke but occasionally takes alcohol.
His hobbies include reading, listening to music and tending the flowers.
O/E: Stable general outlook. Not sick-looking.
NAD on examination of the head, Neck, back, chest. Hands.
Left foot: The ankle joint is swollen. The patient reports painful joint and cannot walk well.
ROM:
ROM: Active:
Flexion- Cannot flex the ankle due to pain on anterior aspect
Extension- full range; with minimal pain on movement
Abduction- painful
Adduction- painful
Medial Rotation- painful
Passive:
Flexion- full range; with pain on anterior aspect the ankle
Extension- full range; painful
Abduction- full range; painful
Adduction- full range; painful
Medial Rotation- painful
Resistive:
Flexion-with intense pain on anterior aspect of ankle
Extension- painful
Abduction- painful
Adduction- painful
Medial Rotation- painful
Impression: Ankle sprain
Plan: Analgesics Diclofenac %50mg PO given, Range of motion exerceise.
Treatment: Analgesics. Weekly visit for physiotherapy.
Advised: Rest the foot for one work. Maintain active range of motion to ensure maintenance of functionality (Lippincot 2008, p. 20).
To take precaution whilst working because the ankle healing may be affected by strenuous exercise take at least one week before going back to work if possible.
Abbreviations
PC- Presenting Complain
HPC- History of Presenting Complain
Kg- Kilogram
PMH- Past Medical History
SH- Social History
O/E- On Examination
NAD- No Abnormality Detected
ROM:- Range of Motion
References
Angus, D.C. & van der Poll, T., 2013. Severe Sepsis and Septic Shock. New England Journal of Medicine, 369, pp.840–851. Available at: Benson, L.S. et al., 2006. Dog and cat bites to the hand: Treatment and cost assessment. Journal of Hand Surgery, 31, pp.468–473.
Dawood, M. (2012) The Emergency Practitioner’s Handbook: for all front line health professionals. London: Radcliffe Publishers
Davies , F. Bruce, C.E. and Taylor-Robinson, K.J. (2011) A Pratical Handbook: Emergency Care of Minor Trauma in Children. Uk: Hodder Arnold an Hachette Uk Company
Greaves, I. & Johnson, G. (2002) Practical Emergency Medicine. London: Arnold Publisher.
Kaufman, J.L., 2008. Management of acute cutaneous wounds. The New England journal of medicine, 359, pp.2395–2396; author reply 2396.
Patient. C.
Age: 38 years. Female
The patient was brought to the unit on a stretcher after being involved in a motorcycle accident. The patient was in pain but alert and fully oriented. Bleeding had been arrested and the affected area bound with a white clean cloth by the well-wishers. The patient signed the consent for examination and care and gave her own history (Greaves and Johnson 2002, p.74).
PC: Painful shoulder joint.
HPC: the patient was well until an hour ago when she was riding her motorcycle home from work. She was involved in an accident and landed on the lateral side of the right shoulder. She did not lose consciousness felt intense pain after the collision with the ground.
PMH: Normal childhood and youth. No major illness.
Weight: 71kg.
Medication: Reportedly given anti-inflammatory analgesics (Diclofenac 50mg tab) by a friend on the way here. Has not been on any other medication recently.
Allergies: The patient is reactive to sulphur and sulphur-containing compounds. There is no known food allergy.
Immunisation: Up to date for her age
SH: The patient is a mother of two boys, the youngest being 7 years old. She is single and lives with the two boys and a younger sister. She is a business woman and travels to and from work daily on her motorcycle. She does not smoke or take alcohol.
O/E: Looks stable and well oriented. She is however in pain but can walk in her own without support (Davies et al. 2011, p.6). She gives her own history,
Head and Neck: NAD
Trunk: NAD
Hands: slight bruising on the right palm. Patient was wearing riding gloves during the accident.
Right shoulder:
Anterior Aspect:
Minimal swelling over the SC Joint, Clavicle, AC Joint and
Trapezius muscle, slight bruising with no obvious deformity, no visible wound.
Bony tenderness noted over the SC Joint, Clavicle, AC Joint.
No bony tenderness over the Acromion Process, coracoid process, non - tender on deltoid muscle, pectoralis major and biceps muscle
Nerves: Regimental Badge Sign Tested-full sensation noted on deltoid muscle- Axillary, Brachial Plexus, Median, Ulnar and Radial nerve-sensation intact and compare to the left arm.
Posterior Aspect:
No bruising or obvious deformity, no erythema or wound, skin intact compare to left shoulder.
Slight Tenderness over the trapezius muscle, non-tender over the scapula, acromion process, Supraspinatus muscle, Infraspinatus muscle and Latissimus Muscle.
Active Movement:
Retraction-reduced and painful over the shoulder
Protraction-reduced and painful over the shoulder
Elevation-reduced and painful over the shoulder
Depression- Full range; pain free movement
Abduction-reduced and painful on shoulder
Adduction-reduced and painful on shoulder
Internal Rotation-reduced and painful on shoulder
External Rotation-reduced and painful on shoulder
Right Elbow:NAD
-Brachial and Radial pulse –present and strong compared to left arm
-no altered sensation/well perfused-capillary refill Read More
Cite this document
  • APA
  • MLA
  • CHICAGO
(“Right Thumb Pain Child Treatment Case Study Example | Topics and Well Written Essays - 2500 words”, n.d.)
Retrieved de https://studentshare.org/medical-science/1666370-minor-injuries-one-child
(Right Thumb Pain Child Treatment Case Study Example | Topics and Well Written Essays - 2500 Words)
https://studentshare.org/medical-science/1666370-minor-injuries-one-child.
“Right Thumb Pain Child Treatment Case Study Example | Topics and Well Written Essays - 2500 Words”, n.d. https://studentshare.org/medical-science/1666370-minor-injuries-one-child.
  • Cited: 0 times
Comments (0)
Click to create a comment or rate a document

CHECK THESE SAMPLES OF Right Thumb Pain Child Treatment

Pain

..., 2011). In terms of length of time that pain is experienced, pain may be considered acute or chronic. Acute pain may be related to trauma or injuring agents like biological, physical, and psychological agents. It may be sudden or slow in onset and be mild or severe in intensity with duration of less than 6 months. The patient may verbally report pain sensation and manifest with observed symptoms of pain, including protective gestures to avoid pain, changes in muscle tone, restlessness, moaning, crying, and irritability (Nurse Blog, 2009). Chronic pain is known to represent the disease itself. It may be environmental or psychological; may persist over a long period of time and be resistant to medical treatments (Medicine.net, 2011...
1 Pages(250 words)Essay

Under Treatment of Pain in the Elderly

...?Under Treatment of Pain in the Elderly Older adults are more likely to suffer from pain and most often they are undertreated because they hesitate in sharing their problems with their family or doctors. Also, in the elderly, the cause of pain is often not explicit because pain might be occurring due to damage in nerves, tissues or some internal organs. People assume that the feeling of pain in the elderly is part of a natural process of aging since growing age tends to bring with it more diseases and health related problems. This assumption leads to under treatment of pain in the elderly. Pain is not to be regarded as something normal because it always points to the occurrence of some illness no matter what the age. Roy and Thomas (1986...
4 Pages(1000 words)Essay

Family Conditions And Child Treatment

...?Family Conditions And Child Treatment Influence Juvenile Delinquency Juvenile delinquency is a perpetual problem in United s and other parts ofthe world. According to Afrey (2007, p.2), 2.18 million juvenile arrests were made in 2007 alone. There are basically 2 types of offenses and they are criminal law violation for an adult and status offenses like running away and truancy. 95 percent of the juvenile offenses are of criminal type (Afrey, p.2) and are dangerous not only to the adolescent but also to others. Several factors play a major role in the development of delinquent behavior in individuals. Of these, the environment in which the child is reared has been considered to be significant in the development of criminal behavior...
9 Pages(2250 words)Research Paper

Exception to the Right to Refuse Treatment

...?Running head: EXCEPTION TO THE RIGHT TO REFUSE TREATMENT Exception to the right to refuse treatment (school) Exception to the Right to RefuseTreatment Introduction Every person has an inherent moral right to refuse treatment. These are moral rights which help ensure that a patient’s right to self-determination and autonomy are respected by the health care givers and the medical professionals. They help ensure that despite the patient’s illness and incapacity, they would still have control over their bodies and over the procedures and interventions which are to be carried out in their behalf. This right is however not without its exceptions. These exceptions include the patient’s minority, mental incapacity, and in some instances in cases...
8 Pages(2000 words)Essay

Pain treatment and resolution

... be seemingly derived from an agent with no pharmacological activity. These nocebo effects can be invoked through the generation of negative expectancy to a phony treatment, subjective pain rankings increased by a significant factor on nocebo sites of the arm in comparison with control sites. fMRI investigations confirmed a variety of brain regions involved in an hyperalgesic nocebo effect. Functional Magnetic Resonance Imaging can be used to measure, and map out these brain regions specifically, and these fMRI studies have demonstrated brain activity corresponding to an increased pain reaction. Signaling increases can be found in the bilateral dorsal ACC, insula, superior temporal gyrus; left frontal and parietal operculum, medial frontal...
5 Pages(1250 words)Research Paper

Right to Refuse Treatment

...THE RIGHT TO REFUSE TREATMENT Introduction The right to refuse treatment is now well established for some kinds of patients, especially in cases ofpsychiatric treatment. Different states have adopted various procedures of addressing the right to refuse treatment and for the overriding of this refusal. Oregons administrative procedure for override depends on an evaluation by an independent examining psychiatrist. Every state has laws governing the right to refuse medical treatment and advance directives about this right. It is essential for nurses to ensure that they are familiar with the legislations of their state. There is a complex relationship between the right to refuse treatment and the right to treatment. The Right to refuse...
6 Pages(1500 words)Research Paper

Pain and different treatment modalities

...Pain and Different Treatment Modalities Research Summary Pain is defined as a multidimensional and a complex feeling affected by physical, psychological, emotional, and cultural factors. Pain can be categorized as nociceptive, neuropathic or a combination of both. It has been the top most reason why people is seeking medical intervention. Nine (9) out of Ten (10) pain sufferers in the United States were under treated and according to the research that 58% to 91% of hospitalized patients have experienced moderate to severe pain even if after receiving pain relievers. The American Pain Society (APS) has identified the top most reason why patients in the hospital have unrelieved pain is just because healthcare providers have failed...
3 Pages(750 words)Essay

Child Abuse Prevention and Treatment

...Child Abuse Over the recent years, cases of child abuse have been on the rise. The Child Abuse Prevention and Treatment Act defines child abuse as “at a minimum, any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm.” It further states that under normal circumstances, a child is anybody below the age of 18, or as has been specified by the state child protection laws. . There is a misplaced perception among the masses that child abuse is only sexual in nature. But emotional neglect of the child’s needs and desires by parents or guardians also constitutes...
6 Pages(1500 words)Research Paper

Pain

the site, intensity, and direction of the cause of the pain, allowing physicians and nurses to more adequately assess the disease process, and take the steps necessary to relieve the patient’s pain. Geriatric patients undergo pain, and which may pose particular challenges in nursing care. The physical, psychological, and social impact of geriatric pain will be highlighted in this study, and the particular issues of pain assessment and management will be explained as related to nursing care. 
There is no single definition of pain, as pain can manifest itself in many ways to different patients. Pain may occur in varying levels of severity, and in various parts of the physical anatomy. Many times, pain may also have mental co...
8 Pages(2000 words)Essay

Right Testicular Pain

...Nursing: Right Testicular Pain Number Introduction A 16-year-old male patient is presented with an acute onset of right testicular pain. He is nauseated, but is not vomiting and with an oral temperature of 101. The patient denies recent trauma or illness. On physical examination, a descended testicle that is red, swollen, and tender to palpation is noted. Interestingly, the cremasteric reflex is also absent. Determining This Patient’s Diagnoses From the foregoing, it will be important to consider the need for differential diagnosis. Differential diagnosis of testicular pain is meant for broad-based purposes and variegated factors such as testicular torsion, epididymitis and torsion of the testicular appendage, among a host of other...
4 Pages(1000 words)Case Study
sponsored ads
We use cookies to create the best experience for you. Keep on browsing if you are OK with that, or find out how to manage cookies.

Let us find you another Case Study on topic Right Thumb Pain Child Treatment for FREE!

Contact Us