The patient for the care plan is a 68-year-old female of height 162.56 centimeters ailing from left middle finger tenosynovitis. She is allergic to NKFA foods and penicillin medication and always wears glasses. The finger tenosynovitis is also referred to as trigger finger, which is a condition that occurs during an inflammation that narrows the effective species within a sheath surrounding tendons in an affected finger.
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Three Nursing Diagnoses
From the data presented, doctors can diagnose the left middle finger by examining the hand to establish whether the client can feel pain when pressure is applied on the thumb side of his wrist. Besides, medical professionals can complete a Finkelstein test by bending the client’s thumb across the palm of their hand and effectively bending their fingers down over their thumb. Finally, the condition can be diagnosed using the Kanavel signs and confirming them with X-rays. The Kanavel cardinal signs of flexor sheath mainly include infection. I will ask the client to hold a finger in a slight flexion fusiform, the swelling of the same part that has been affected. It will mainly aim at the exact amount that has tender flexor sheath tendons and pain passively extending the affected region.
Evidence and Risk factors
Doctors can find critical evidence of the condition from the signs and symptoms displayed in the presented information. The signs and symptoms displayed from the results of the patient’s examination by the doctor can have some close risk factors that may lead to other conditions which may affect the patient. The critical pieces of evidence include dizziness and impaired balance associated with inadequate cardiovascular coordination. As a result, the patient is susceptible to higher blood pressure, which is hypertension. Besides, some cases of high cholesterol respiratory aspects might arise as per the bronchitis examination and gastrointestinal.
There is evidence of frequent UTI’s endocrine, hence vulnerable to acid reflux and genitourinary, which implies that the condition is associated with Diabetes Inspidus. She has an onset of ten years nutritional state that has no restrictions. Finally, the examined medical Hx from the patient displays that she may be affected by anxiety, musculoskeletal arthritis, and bilateral surgical health conditions, which are dangerous to their health conditions.
Outcomes for each Diagnosis
The client will no longer feel pain when pressure is applied to her finger and the thumb side. She will feel relaxed on her left middle finger and will effectively participate in activities that will make her finger exercise. Additionally, she will be able to hold objects with the support of her left middle finger, implying that it will not be as painful as when it was diagnosed. Secondly, the client will be in a position of bending her finger together with the thumb and across her palm using a single hand. It will be an outcome of the Finkelstein test, which is essential to the client. The test is mainly clamped to diagnose Quatrain’s tenosynovitis condition among individuals who have writs pains, just like the client under the study. After the diagnosis, the patient will experience reduced or no wrist pains hence essential in curbing the condition.
Finally, the client will not experience pain on the extension digit after a Kanavel cardinal sign test. The infection sheath will disappear as the tenderness will have reduced, and pain with a passive extension of the number will have subsided.
Nursing Interventions for each Outcome of the Three Diagnosis
|Ask the patient to effectively rest the middle finger joint for about 6-12 hours.||It is favorable mainly in the determination of the program’s efficacy and effectiveness. It prevents more pain that may affect the patient.|
|Wrap the injured left middle finger in an elastic bandage for some days if the finger’s arthrography was performed successfully.||The elastic bandage gets the finger fixed back in its required position, which helps in providing a faster recovery for the patient’s condition.|
|The doctor can apply ice on the mentioned finger joint to ensure that the tendons and ligaments successfully join. Besides, it also prevents excessive swelling.||The tendons and ligaments get effectively aligned as per the biology of an individual’s fingers. It brings back in its recommended position.|
|The patient can be given pain killers to reduce pain or analgesics such as palliative drugs.||The pain killers or analgesics help in relieving pain that the patient may undergo.|
|The patient can be asked to report some of the other signs and symptoms of infection besides the doctor in charge has diagnosed.||Reporting of further signs and symptoms effectively maintains the patient’s health as the doctor can quickly examine any other infection that may be affecting the patient.|
|Recommend or avail a firm sponge for resting the client’s left hand to stabilize the finger in a good position.||The soft and form sponge availed to the client mainly prevents the maintenance of proper body alignment, which might place some stress on the affected part. The elevations of the hand reduce the pressure on the patient’s hand, reducing inflation on the injured joints.|
Evaluations or Medications for the Condition
The medications recommended by the doctor for left middle finger tenosynovitis are as follows;
as little as 3 hours
- Aspirin 325 mg EC PO daily
- Cefazolin 2g IV PB 88h scheduled 0200 hrs. 1000hrs, 1800hrs infused over 10 minutes.
- Citalopram AKA Lexapro 20 mg tablet PO daily.
- Insulin apart ISF 0-20 units SQ taken four times in a day.
- Lisinopril AKA Zestinal 20 mg tablet PO
- Melatonin 10 mg PO daily. The individual should take the dose daily to ensure that its effectiveness is managed.
- Pantoprazole, also known as Protonix 40 mg tab PO taken daily
- Sodium chloride flush 2.5ml solution IV flashes three times a day.
- Sitagliptin is also known as Januvia 100 mg tab PO.
The medication suggested of the PRN includes
- Acetaminophen 650 mg tablet PO 86has needed if the client has a headache and an increasingly more excellent, more excellent temp of 101 degrees F and mild pain.
- Dextrose injection 12.5g IV push is needed if PRU if blood glucose is less than 70 mg per deciliter and the patient cannot take it orally.
- Hydralazine 10 mg IV push 84has systolic blood pressure goes more than 150.
- Ondansetron Zofran 4mg IV pushes 84has nausea and vomiting.
- Oxycodone immediate release 10mg tablet PO 86h in severe pain
- Oxycodone 5mg 96 h if lesser pain occurs from the condition.
- Sodium chloride flush 2.5 ml solution IV flushes 86h if tolerating fluids PIL flush after each use.
- Sodium chloride 2.5 ml IV flush three times as needed.
The healthcare professionals have ordered the mentioned medication to ensure that the patient is completely cured of the tenosynovitis on her left middle finger. The nursing implications associated with the directions are that Doctors can entirely cure the disease if the patient follows the doctor’s prescriptions. However, the side effects of the medications can be linked to permanent arthritis if the drugs are not followed and cancer if the patient does not allow the finger to get some direct sunlight and the prescribed medication. Finally, the contraindications of the condition may include chronic overuse of the patient’s wrists, repetitive movement of the finger, and pitching objects using the affected finger. The mentioned aspects may increase the dangers of the condition.