Answer 2 for NU 606 Week 4 Discussion 1: Case-Based Discussion

You provided a comprehensive description of pathophysiology and symptomatology associated with fractures and discussed the peculiarities of diagnosing and managing fractures and associated complications. Also, you reviewed complementary therapies, lifestyle modifications, and interventions used to promote bone health, muscle strength, recovery, and regaining limb function. I can use the information you shared to prevent and manage fractures in my patients.
In terms of prevention, it is necessary to know the categories of the patients at risk of falls and associated fractures. For example, objective “symptoms’ and “signs” indicating that the patient is at risk for falls and requires additional measures to prevent fall-associated lower limb fractures include old age, frailty, the presence of certain conditions (cataract, obesity, cancer, parkinsonism, alcoholism, epilepsy, dementia, rheumatoid arthritis, large joints osteoarthritis, and systemic osteoporosis,), and previous fractures (Grygorieva & Vlasenko, 2017). Possible subjective “signs” include inadequate physical activity and excessive physical load. Another objective sign that the patient is at greater risk for falls and related fractures is a pharmacotherapy with psychotropic drugs, antihypertensive drugs, and narcotic analgesics (Montali et al., 2015). Therefore, optimization of the aforementioned drug therapies in combination with the fracture prevention intervention discussed in your post can help to reduce the risk of falls and associated traumas.
When encountering patients with stress fractures, I should be aware of the peculiarities of the clinical presentation (signs and symptoms) and diagnostics associated with this type of fractures. For example, physical examination of stress fractures is unspecific since patients present with edema, pain, and increasing sensitivity at the lesion location after repetitive increase in or abrupt physical activity (Astur et al., 2016). Rest helps to reduce and alleviate the pain and continue physical activity, whereas aggressive movement leads to injury progression and increased pain. It is important to remember that X-ray may produce a false-negative result since the changes caused by stress fractures become clearly visible on radiography only two to four weeks after the start of the pain. Magnetic resonance imaging is the most specific and sensitive exam for diagnosing stress fractures (Astur et al., 2016). Finally, adequately management of a stress fracture involves identification of the risk factors, preventing overloading of affected site, pain management, and rehabilitation.

References

Astur, D.C., Zanatta, F., Arliani, G.G., Moraes, E.R., Pochini, A.C., & Ejnisman, B. (2016).
Stress fractures: Definition, diagnosis and treatment. Revista Brasileira de Ortopedia, 51(1), 3-10. doi: 10.1016/j.rboe.2015.12.008
Grygorieva, N., & Vlasenko, R. (2017). Epidemiology and risk factors of lower limb fractures
(literature review)”. Pain, Joints, Spine, 7(3), 127-138.
doi:10.22141/2224-1507.7.3.2017.116868