Nursing Case Study Of Carpal Shock

S: TM completed total of 4 ESI visits for her right elbow Strain. TM reports ESI’s heat treatment is helping her with symptom’s management. TM reports her pain 5/10. Her pain starts at her elbow and radiates to her forearm, and reports weakness in her grip strength in her right hand. TM also reports her right elbow pain radiates up to her right shoulder (?) TM denies her right arm pain wakes her up at night.

S: Aerotek TM reported his Left wrist pain on 9/6/2016. According to the TM, the pain started the day after the several attempted blood draw from his left AC on 8/30/2016 for his TB. On 8/31/2016 his left arm was edematous, and he had pain to his left arm. Within next few days, left arm edema and left forearm resolved but his left wrist pain remained. TM denies any previous injury to the location, or current work process may have contributed to his left wrist pain. The pain is related to his AC puncture for his TB labs, since he never had any issues prior to this event.

DOI: 01/23/2016. This is a case of a 42-year-old female separation baker who sustained a work-related injury when one of the metal rack slipped off injuring her right arm. As per office notes dated 7/20/16, the patient complains of right shoulder pain, right wrist and hand pain as well as right elbow pain. The right shoulder pain is described as constant moderate pain in nature. It is described also by burning and weakness. The right wrist and hand pain is constant moderate to severe that is sharp and numb. The right elbow pain is constant moderate that is described as sharp and tingling. Objective findings revealed 2 + spasm and tenderness to the right rotator cuff muscles. Spuraspinatus test was positive on the right. The elbow revealed 2+spasm

Carpal tunnel syndrome (CTS) is a common complaint in patients seen by the Family Nurse Practitioner (FNP). Patients that complain of numbness, tingling or pain to the first three fingers and part of the ring finger of the hand are describing CTS. The patient may also complain of weakness to the affected hand. In patients that have experiences these symptoms chronically, there may also be muscle wasting to the thenar eminence near the base of the thumb (Dunphy, Winland-Brown, Porter, & Thomas, 2015). The typical patient that has symptoms of CTS is a pregnant or middle aged female as women are more likely than men to for CTS. Typically, the symptoms worsen at night and the patient may be wakened from sleep by wrist or

The patient has a Carpal Tunnel Syndrome if there is pain in palm, thumb, index and middle fingers, sometimes pain in wrist, forearm and upper arm.

Due to a schedule conflict my co-worker Chris Callahan attended the appointment with Mr. Price and Dr. Werner on 6/15/16. Mr. Price said that he has difficulty gripping with the right hand. He also reports numbness and tingling to the first three fingers. He stated this has been consistent since the injury. Dr. Werner reviewed the EMG report. Grip test showed that his right hand is weaker than the left. Dr. Werner did tapping and repositioning of the hands and wrist which resulted in numbness to the first four fingers of the right hand. Tapping to the elbow also caused the fifth finger to go numb. Ms. Callahan asked for clarification on the cause of the Carpal Tunnel (CTS) diagnosis. Dr. Werner stated that changes in the right shoulder

DOI: 6/16/2016. Patient is a 40-year-old female psychiatric assistant who sustained injury while she was breaking a fight between two patient and in the process, she injured her left shoulder. Per OMNI entry, she was initially diagnosed with strain of the left shoulder.

A 50 year old male presented to the Out-patient department with a two month history of worsening pain in the right upper limb, extending to the middle finger. This pain was not improving with analgesia prescribed by his general practitioner. He also complained of weakness in the affected limb for the preceding two weeks. He denied any lower limb symptoms, had no difficulty with micturition or defecation and no gait disturbance. His examination was significant for grade four weakness in right elbow extension and an absent tricep jerk on the ipsilateral side. A clinical diagnosis of a C7 radiculopathy was made. Magnetic

The status of this case is that we are awaiting the applicant to undergo an EMG of the upper extremity as recommended by the Panel Qualified Medical Evaluator, Dr. Stephan Choi, in his evaluation report dated December 14, 2016. Please recall, Dr. Choi requested an EMG of the right upper extremity so he can rule out possible carpal tunnel release. He opined if the EMG of the right upper extremity were to come back normal, the applicant would be deemed permanent and stationary.

Patient is a 57-year-old male fuel tank driver who sustained cumulative trauma on 2/7/2004 due to repetitive movement caused by delivering fuel. As per QME dated 1/25/14, the patient has numbness in the fingers and the patient is diagnoses that he has carpal tunnel syndrome. The left wrist had undergone carpal tunnel surgery; however, he gets numbness from the wrist up into his forearm and numbness in the fingertips. It was also noted that on 12/5/13, the patient complains of shoulder pain bilaterally at 7/10. It is constant and goes into noth arms, along with weakness with numbness in the hands, decreased ability to perform activities of daily living, and impared grip. The pain in the bilateral shoulders is constant and aching with intermittent

DOI: 12/21/2012. Patient is a 51-year-old female government collections supervisor who complained of right hand numbness and tingling to the left hand. Pere OMNI entry, she was initially diagnosed with cervical spine stenosis, bilateral spinal enthesopathy, right cervical radiculitis and right carpal tunnel syndrome. Patient was deemed maximum medical improvement on 12/17/13 with 0% permanent disability. Future medical care includes doctor visits, PT, injections and surgery.

01/26/16 Progress Report noted that the patient presented with left shoulder pain. The pain was gradual in onset and is constant. The pain is characterized as burning, sharp, shooting, and throbbing. It radiates to the neck. She described her pain as moderate to severe. Her condition is associated with numbness in her left fingertips and weakness in her upper extremities. Any activity, movement and reaching aggravate the pain. Stretching and hot showers relieve the pain. The level of sleep has been decreased due to difficulty falling asleep. The quality of sleep is poor. She has difficulty performing her ADLs. Current medications: Meloxicam, Naproxen, and Spironolactone. Review of Systems was positive for weakness and nausea. The patient also has anxiety and depression. She has had psychiatric, psychological, or social work evaluations or treatments for problems. The physical exam of the cervical spine revealed that the ROM is restricted. There were spasms and tenderness of the paravertebral muscles bilaterally. There was also spinous process tenderness noted on C6 and C7. Tenderness is noted at the paracervical muscles and trapezius. Spurling’s maneuver produces no pain in the neck muscles or radicular symptoms in the arm. Adson’s test is negative. No signs of meningism. Cervical facet loading is negative on both sides. The exam of the right shoulder was

DOI: 05/11/2015. Patient is a 56-year-old female indirect credit card officer who sustained a work-related injury to her right hand due to repetitive motion. The patient is subsequently diagnosed with right hand carpal tunnel syndrome; and carpometacarpal degenerative joint disease.

Based on the progress report dated 02/ 24/16, the patient presents for follow-up of his chronic forearm pain. He had been

The second main complaint to be addressed on the first day of treatment is the right forearm pain. As the client mentioned in the case history, experiences pins and needles pain in the right forearm and hand due to repetitive lifting and on upper limb tension testing a radial nerve and median nerve bias was diagnosed. Therefore, the lateral elbow could be due to nerve entrapment. Nerves move in relation to their surrounding connective tissues (Butler, 1989). These trapped peripheral nerves usually have an increased sensitivity to mechanical loading (Nee, 2006). However, testing of the dermatome revealed tingling on the right C6 and myotome testing indicated weakness of the triceps. This means a possible compression at C6 nerve root rather than entrapment of the peripheral nerves (Wainner, 2000).