Indrani Singh Severe Explained for Students (Easy Guide)
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Original Question
Mrs Indrani Singh is 72 yo. She has severe osteoarthritis in her right hip and is waiting for a hip replacement in the public health system. She has been living with significant pain for the past 18 months. Her medical history includes a stroke affecting the medial aspect of the right parietal lobe. She has presented to the clinic for review. She is accompanied by her daughter. She is assessed. Collect cues: Patient and family report: • unintentional weight loss – 10 kg in the last 3 months • constipation • cannot sleep lying down, sleeps upright in a chair and is tired from lack of sleep • finding it hard to “go on” and daughter reports that she has lost interest in many things • daughter reports that Mrs Singh has used all her opioid medication 2 weeks before the next script is due Medications: currently takes non-steroidal anti-inflammatory and paracetamol combination; opioid at night to relieve pain to assist sleeping Mobility assessment: walks with a limp, using a frame for assistance Pain assessment: P – movement and lying flat Q – ranges from a dull ache to sharp stabbing pain in the hip joint R – radiates through her buttocks and up her back; can sometimes extend down her leg S – ranges from 3 – 8/10 T – the pain never goes away. What is the Alterations in nervous system
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