Sample Of Nursing Case Studies

Decent Essays
This is a 57-year-old female with a 4/26/1995 date of injury. She was assisting a coworker to transfer a resident to a shower chair and the resident began to fall.

DIAGNOSIS: Left above the knee amputation Pain joint knee Flexion contracture right knee Degenerative osteoarthritis right knee

01/28/16 DWC Form RFA for Opana IR, Lyrica, Cymbalta, and metaxalone

01/13/16 Progress Report by Dr. Minn documented a follow-up visit. The patient is doing about the same. She is resting and getting NGT feeding. She developed a rash on her body since last night. Current medications: ASPIRIN, BETA CAROTENE, COREG, DILAUDID, FERROUS SULFATE, LOVENOX, MIRTAZAPINE, MORPHINE SULFATE, MULTIVITAMIN, NAMENOA, OXYCONTIN, PAXIL, TYLENOL, VITAMIN C, VITAMIN D and
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Roget noted that the patient took her Dynasplint to PT, and the therapist will call the company for more information on proper use. She has missed PT appointments because her wife’s mother has been in the hospital and therefore, the wife is not available to transport her to the appointment. Current medications: Hydromorpbone (Opana)lR 10 mg, Lyrica 100 mg, Cymbalta 60 mg, Meta.xalone 800 mg). She has not been taking Trazodone, Soma, or Clonazeparn anymore. She gets the Lorazeparn from her PCP. She also had a trial of Nucynta lR in November 2013, but said it would interact with Cymbalta, therefore has not been taking it. Plan: Prosthetics, CBT, wheelchair, HEP, and remodeling the kitchen and bathroom fr=or handicap accessibility.

09/21/15 IPE Report noted to wean Oxymorphone, Lyrica and Metaxalone. No agreement had been reached to wean Oxymorphone and Metaxalone. However, agreement had been reached to continue Lyrica.

Treatment to date: Associate had multiple surgeries and complications post-surgery. Final result was amputation left mid-thigh due to osteomyelitis. Most recent treatment: Home health services, physical therapy, wheelchair repairs, medications, and splint.

The request is for All medications for the next 3 months. Opana IR 10mg 4 to 5 times per day.
Lyrica 100mg 1 pill three times a day.
Cymbalta 60mg 1 pill twice a day
Metaxalone 800mg 1 pill twice a

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