Chapter 44, Problem 1CS

(1)

Summary Introduction

To determine:

What instructions are important for the patient at this time?

Case summary:

A 49-year-old writer has developed severe pain in her right wrist and has been unable to make her publisher's deadlines because of the pain she is having. After magnetic resonance imaging and a physical examination, she is diagnosed with tendinitis and started on diclofenac (Voltaren) extended release, 75 mg twice a day. She is also given a wrist brace and instructed to resume work slowly once she is feeling better.

(2)

Summary Introduction

To determine:

After 1 week of therapy, the patient calls the office and says, "There has been no change! My wrist still hurts. I need to get better quickly!" What is the nurse's best response?

Case summary:

A 49-year-old writer has developed severe pain in her right wrist and has been unable to make her publisher's deadlines because of the pain she is having. After magnetic resonance imaging and a physical examination, she is diagnosed with tendinitis and started on diclofenac (Voltaren) extended release, 75 mg twice a day. She is also given a wrist brace and instructed to resume work slowly once she is feeling better.

(3)

Summary Introduction

To determine:

At her 1-month checkup, the writer is happy that her wrist has stopped hurting and that she has been able to resume her writing part-time. She mentions, however, that she has felt very tired recently and has had increased abdominal discomfort. She also tells the nurse that her bowel movements have been darker and asks if that could be an adverse effect of the medicine. Explain what is possibly happening, and what steps will be taken next.

Case summary:

A 49-year-old writer has developed severe pain in her right wrist and has been unable to make her publisher's deadlines because of the pain she is having. After magnetic resonance imaging and a physical examination, she is diagnosed with tendinitis and started on diclofenac (Voltaren) extended release, 75 mg twice a day. She is also given a wrist brace and instructed to resume work slowly once she is feeling better.