Mrs. Johnson has returned for another visit.

Mrs. Johnson has returned for another visit. She reports that she has recovered from her sinus infection and feels much better. However, today, she states that she is having increasing right shoulder pain over the past couple of weeks. She explains that her shoulders have “always bothered” her because she worked in a factory moving boxes for years. She states that she uses naproxen, “prescription strength,” and that usually does the trick when her pain flares up, but she is out and would like a refill. In a patient Mrs. Johnson’s age, what conditions or disorders could cause shoulder pain as she describes? Identify three and explain your rationale. 2-Explain how a medication like naproxen may interrupt the pathophysiology of one of those conditions and help reduce pain. In other words, how does the use of that medication return Mrs. Johnson to a more homeostatic state? On exam, you note that her right shoulder is tender to palpate, and she has limited range of motion. She smells of BenGay but, otherwise, she seems healthy. There still have not been any medical records available for review. The area is edematous, and when asked, she does agree that her arm seems swollen. She denies any falls but remembers that she lost her balance and fell backward into her recliner a few days ago “kind of hard” but she caught herself when she grabbed for the coffee table. Otherwise, she does not recall any injuries. You decide to send Mrs. Johnson for an x-ray and she is in the waiting room until you get the results back. The following radiograph (image 1) is what is sent to you via teleradiology. 3-The x-ray indicates a pathological fracture of her humerus. What is a pathological fracture? 4-What can cause a pathological fracture? Be specific. 5- Assuming you had access to Mrs. Johnson’s medical records, what history or risk factors would you be looking for that could predispose her to an injury of this sort. 6- Identify three interventions that can promote healing of a pathological fracture. Explain how these interventions will help return Mrs. Johnson to a more homeostatic state. SCIENCE HEALTH SCIENCE NURSING NURSING 606

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