When the APRN builds a clinical picture based on patient his…

When the APRN builds a clinical picture based on patient history, physical examination, and clinical suspicion, the decision to obtain additional radiographs is often warranted. When obtaining radiographs, why is it important to obtain additional views of the joint above and below the suspected fracture? 

A patient presents with a complaint of pain and discomfort i…

A patient presents with a complaint of pain and discomfort in the right foot. She denies known trauma or injury. She describes the pain as an initial aching sensation after daily walking of her dog.  She reports the pain started 4 weeks ago after initiation of the physical activity. Furthermore, the patient states the pain progresses in severity while walking her dog and continues until she finishes her walks. As the APRN, you suspect the patient has a 

A 31 year old male patient presents with right elbow pain. H…

A 31 year old male patient presents with right elbow pain. He denies injury or trauma. The patient has worked on an assembly line at the nearby factory for 13 years. He reports he does repetitive work daily packing boxes and loading them onto a truck. On exam, patient presents with pain that radiates from the medial portion of the right forearm and extends into the ring and pinky fingers of the right hand. When prompted, patient reports the pain is made worse with flexion of the elbow. Based on the HPI and patient presentation, what is your presumed diagnosis. 

A 65 year old patient presents to the ER with a one month hi…

A 65 year old patient presents to the ER with a one month history of left foot pain. Patient reports he has been dealing with a non-healing wound on the bottom of his left foot for over “awhile”.  States he was seen at an Urgent Care setting while on vacation and treated with a one week regimen of  “an antibiotic”. His wife is present with him and is concerned because “he just doesn’t seem to be himself”.  While assessing the patient, you note the patient is ill appearing and with mild acute distress due to discomfort.  Based on the image and information below, what is your initial diagnosis, work-up and plan of care? In addition, please include your top two differential diagnosis.  VS: Temp: 101.4; HR 101; RR: 20; Sp02: 95% RA Current Medications: Simvistatin, Metformin, Coumadin, HCTZ PMH: DM type II, HTN, A-Fib, Hyperlipidemia