Research Articles Base: Case Based Essay

Case Based Essay Hip Replacement Surgery

This is a case-based Essay(1500 words) (use an academic language as a physiotherapist)   Introduction: Summarise the case. definition- the important thing(reason)eg. decrease the pain , increase normal hip function. Look at physical processes OA + Structures of THR involved in the case The Anatomy in this case has to be short it is not very important. What we can do to help her. <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal"> The essay should discuss the structures in terms of  PATHOLOGY (bone, muscle, ligaments etc.)  </li> </ul> ·        Describe the main physical processes and the structures involved in this case ·        Identify the key biopsychosocial  factors that may influence the patient’s experience of this problem. eg. Biopsychological(how these effect management): Social History: Husband who has Parkinson’s disease, flat 1st floor, cats, daughter + grandchildren Management – Social Services, MDT ·        Discuss how consideration of these factors that may influence the management and outcome (what is necessary for a good outcome eg. Rest, posture) of the case ·        Include a full reference a list    2) Annotated Reference ·        Select five reference from your reference list that were key to your essay ·        For each of those five, provide a 200 word summary (in total 1000 words of annotated reference) Case 1500 words+ reference 1000words = 2500 words     Hip joint replacement   PERSONAL BACKGROUND Mrs Vera Chatsworth is a newly retired 65 year old female. She lives with her husband who has Parkinson’s disease which limits his mobility and requires the use of a wheelchair outside which needs to be pushed. They live in a 1st floor flat, which has no lift. Their daughter, Tracy, lives 5 miles away and is currently able to visit daily to help with shopping and caring for her father. Tracy is married with 2 children, which means that she will not be able to help out as much when the school holidays end in two weeks. Mrs Chatsworth is worried that she is going to be a burden on here daughter and that she would like to do as much as possible for herself, while she still can. The elderly couple have two cats called Jasper and Shamus; they love their cats and claim that they keep them company on the days when they can’t get out and about. Mrs Chatsworth has been unable walk any distance (more than 10 minutes) for past year and before the operation the pain was preventing her sleeping. HISTORY OF PRESENT CONDITION Successful total right hip joint replacement 6/52 ago; Posterolateral approach. Good post-op recovery in spite of the large post-op haematoma. She was discharged home in 10 days. At discharge there remained a significant loss of ipsilateral knee ROM that was possibly due to the soft tissue swelling in the thigh. She is independently mobile PWB on elbow crutches, but has been referred for physiotherapy due to lack of full ROM in ipsilateral knee PAST MEDICAL HISTORY High blood pressure Osteoarthritic changes in hips, knees and shoulders. For the past 5 years she has had severe right hip pain. Very painful and stiff in the mornings, usually eases slowly with light activity and warm baths. Worsens after walking 10 -15 minutes. Cannot sit in low chairs or climb stairs easily. Now she is sleeping well and pain is significantly reduced but her right hip and knee are still both very stiff and she is reluctant to trust her right leg for FWB.   MEDICATION Atenalol Analgesia as needed   OBJECTIVE ASSESSMENT Observation: Healed wound with residual thigh and knee joint swelling   Gait: PWB with elbow crutches with a slightly flexed knee.   Strength She has no apparent loss of strength on her left side although you notice that she does not have much muscle definition or bulk in her right or left quadriceps and a marked reduction of her right gluteal muscle bulk compared to her left.  All active hip movements in standing are pain free on the left, but repeated or manually resisted movements of her right hip are uncomfortable. This is not a sharp pain, but more a dull ache in the hip and thigh which fades quickly with rest. Resisted knee extension in sitting also causes a dull ache but resisted knee flexion at end of range is not a problem.   Hip                  Active ROM              Passive ROM                                               R         L                      R                     L                                  Flex                 80°      100°                90° stiff           110°                            Ext                   -10°     -10°                 -10° OK          -10°                             Abd                 40°      40°                  40°                  40°                              Add                 Limited by post operative care guidelines Int Rot             Limited by post operative care guidelines   Knee              Active ROM              Passive ROM                                               R         L                      R                     L                                  Flex                 80° *   130°                90° *               130°                            Ext                   -15°     0°                    -5° stiff            0°                                  * = pain at end of range       Credit:ivythesis.typepad.com

Case Based Essay Hip Replacement Surgery

This is a case-based Essay(1500 words) (use an academic language as a physiotherapist) Introduction: Summarise the case. ...

Case Based Essay Hip Replacement Surgery

Case Based Essay Hip Replacement Surgery

This is a case-based Essay(1500 words) (use an academic language as a physiotherapist) Introduction: Summarise the case. ...

Case Scenario

Case Scenario                 Paul, a 5 year-old rescued street child was admitted in the charity ward of the hospital you are working to. He is suffering from severe malnutrition and some wounds in his legs and arms are left untreated. Upon attending to the patient, you learned that he is from the nearby city with no parents alive. His relatives are not interested of taking care of him. Immediately, you asked his name. As a five year-old kid, he is somewhat shy to answer several of your questions. But to the vital information that you need are given by his short, soft and hesitant responses.             After the preliminary recording of personal data and whereabouts, you immediately order a colleague to check on the medical files of the child in the hospital records shelves or in the nearby hospitals whom he is possibly admitted before. The colleague found out that Paul was born in your hospital as on March 18, 2000. According to the facts listed on the records, his mother passed away upon giving birth. He belongs to a poor family when his parents are still living.             1.         Physical milestones               – As a street kid, Paul is too skinny and short. He definitely falls below the average weight and height of a normal five years old child. For some normal kids of his age, they are expected to be active and curious. They are generally playful and full of energy. It is believed that the first five years of a child is the most crucial and considered the formative years (‘). In the same article, a healthy child is in a perfect state not only in body but in mind. A child learns how to play independently, dress and undress (2001), talk, run, stand on one leg even as early as the age of 3 (1990). In relation to height and weight, a 5 year old child has the average of 109.0 cm and 18.2 kg. With the case of Paul, he is under the average height and weigh acceptable to his age.   2.         Gross motor skills               “Gross motor skills are larger movements involving the arm, leg, or feet muscles or the entire body — things like crawling, running, and jumping are gross motor skills” (2005).             – Paul is not as active as a normal five years old child. He can run but easily gets exhausted. When tired, he barely moves his arms and limbs due to his malnourished condition. Accordingly, he just sits on street or park benches and waits for alms from by-passers. During meals, he often eats leftovers from rubbish.   3.         Fine motor skills   According to (2005), “Fine motor skills are those smaller actions like picking things up between the thumb and finger or using the toes to wriggle into sand or the lips and tongue to taste and feel objects.”             – Though Paul is physically weak, he is still capable of thinking and speaking in his age. He can comprehend to questions from the people who interview him. He can move his hands in coordination with his eyes. He has a develop senses.   4.         Language   Language as well as motor development is now at a level to give expression to imagination at the age of 4 to 5 (1999).  - Basing it to his age, Paul can speak well. However, he is shy and hesitant. He can pronounce works as a normal kid of his age but his soft shy voice is the only problem.   5.         Social development for the particular age group               Paul is shy. Hence, he lacks self-confidence and self-esteem. His emotional health is poor. He is aloof to people and seems worried. Since he is a street child and no relatives taking care of him, his sense of security is low. This makes him troubled and uncomfortable. Referral may be the action of choice when a health professional believes that a patient has a personal problem and needs counseling. When the problem appears to be primarily related to something beyond the current treatment situation, or when it seems to be complex, the health professional may feel inadequate to deal with it (1999). Nursing Suggestions             In developing gross motor skills, consider the long-term implications for development for its control, as well as fine motor coordination and eye-hand coordination basing it from the data taken in the environment of the patient.             Most importantly, healthy food should be given to Paul to make him as fit as a normal 5 years old kid. His wounds should be treated to alleviate the risk of infection. Exercise, sleep, and proper care and attention must be given to him. Further, as a street child, the responsibility of the nurses and/or doctors is to look for an institution that will cater to the needs of the child.             In social development, “Emotional relations established very early in life set the pattern of relations in later life” (‘). Paul must develop his emotional health because it is the basis of the child’s development of a sense of security, confidence and the ability to cope well with other people and with the world at large.             Meanwhile, it is vital to bear in mind that progression through the stages is a function of chronologic age, physical and emotional maturation, and the social environment. Different cultural contexts place different demands and expectations on individuals. Those presented here reflect a post-industrial society, and would not necessarily apply to a tribal society or that of a developing country. Thus, change occurs in the individual in several different areas simultaneously at each psychosocial stage throughout life.       Credit:ivythesis.typepad.com

Case Scenario

Case Scenario Paul, a 5 year-old rescued street child was admitted in the charity ward of the hospital you are working t...

Case Scenario

Case Scenario

Case Scenario Paul, a 5 year-old rescued street child was admitted in the charity ward of the hospital you are working t...

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