Question

Mrs. S

Mrs. S is a 56-year-old woman who has been working as a secretary at a dentist’s office for 30 years. She uses the computer to book and keep track of appointments. She is also in charge of the filing system and patient’s records. These cabinets are located on the floor, requiring her to bend down to reach them, often several times a day. Mrs. S has been diagnosed with carpal tunnel syndrome and has been receiving treatments for 6 months; however, she still reports symptoms and pain. Recently, she has begun to experience lower back pain.

Critical Thinking Questions

1.      What kind of suggestions can be made to rearrange/make changes to her office layout?

2.   What else can you suggest to Mrs. S to decrease symptoms?

Ms. Ellen

You are working as a nurse in a community health clinic in a town where about one-quarter of the residents are over age 65. Many of these older adults visit your clinic for primary care. Ms. Ellen is 72 years old. She has returned for the third time in as many months, complaining of urinary urgency and burning during urination. She also has noticed an unusual odor while urinating. She has been diagnosed and treated empirically based on these symptoms for a urinary tract infection during her two previous visits and reported feeling better after treatment. However, she is now back with the same symptoms and is asking for another course of antibiotics.

You are curious about her symptoms and review her record for additional information that may have been previously missed. You notice that 2 years ago, Ms. Ellen was treated for anxiety and learn that this was related to the death of her husband. You ask her how she is managing since his death, and she reveals that since meeting a new gentleman friend from the next neighborhood over, she has been much happier.

Critical Thinking Questions

1.      Based on the information you’ve learned from Ms. Ellen and her medical records, what questions do you ask her about her new relationship? How do you approach this conversation?

2. How might this information be related to Ms. Ellen’s recurring symptoms? How do you diagnose and treat her?

3.   What do you recommend to Ms. Ellen to prevent future visits to the clinic?

Answer 1

# 1. The suggestions that can be made to Mrs. S to rearrange the office layout are :-

- keeping all objects at a certain functional height

- keeping all objects that are required frequently nearby to sitting arrangement

- shift the files and objects kept down below the table up

- use a well comfortable table and chairs so that you don't have to stress

2. Other measures are :-

- taking rest in-between work by walking , doing eye exercise, neck exercises etc

- not to stretch and overexert

- maintaining wide base of support

- following body mechanics

- taking medication as per prescription

- doing physiotherapy and exercise regularly

#. 1) Based upon the informationi have learned ,I would ask her that how is her sexual relationship and how is she fulfilling her sexual needs

2) This might be related to Ms. Ellen's recurring symptoms because there are chances that they had sexual relationship and the other person had some sexual infection that has been transmitted. Diagnosis by taking culture and routine sample and treating with antibiotics and antivirals depending upon the causative agent

3. To prevent future visits I would advice her to have protected sexual relationships and have a regular medical check ups