BSN, RN
Isolation:
Code Status:
Weight:
125 lbs
Height:
5'8"
Emily Lawrence
19 y/o
Female
Provider:
Dr. Rachel Martinez, MD
Allergies:
Latex (anaphylaxis), Adhesive tape (skin tears)
Emergency Contact:
Margaret Lawrence (Mother) | 555-XXX-5309
Insurance:
United Healthcare
Chief Complaint
"I dislocated my right shoulder reaching for a book on a high shelf. It usually goes back in easily, but this time it won't, and the pain is much worse than usual."
Medical History
- Ehlers-Danlos Syndrome (diagnosed age 12)
- Recurrent joint dislocations
- Chronic joint pain
- Postural Orthostatic Tachycardia Syndrome (POTS)
- Mitral valve prolapse
- Anxiety
Home Medications
- Midodrine 5mg PO TID for POTS
- Metoprolol 25mg PO BID for POTS
- Duloxetine 60mg PO daily for pain/anxiety
- Vitamin D3 5000 IU daily
- Vitamin C 500mg daily
What specific precautions should nurses take when caring for a patient with EDS during procedures and general care?
Specific nursing precautions for EDS patients:
Fragile Skin and Tissues: Use non-adhesive or paper tape to secure IVs and dressings to prevent skin tears.
Gentle Handling: Avoid excessive pressure or stretching during positioning or physical exams.
Venous Access: Use small-gauge needles and minimal attempts for IV placement due to fragile veins.
Supportive Positioning: Provide pillows or splints to prevent strain on hypermobile joints.
Monitor Closely for Complications: EDS patients are more prone to delayed wound healing and bruising, requiring vigilant monitoring.
Latex-Free Materials: Use latex-free equipment and gloves due to patient’s severe allergy.
Why is vascular imaging particularly important in this case, and what complications should the nurse monitor for?
Importance of Imaging: EDS patients have fragile connective tissues, including blood vessels, increasing the risk of vascular injury or compromise during dislocations. The CT angiogram ensures no vascular tears or compression are present.
Complications to Monitor:
Neurovascular Compromise: Decreased sensation, delayed capillary refill, or pallor in the affected limb.
Compartment Syndrome: Severe pain, swelling, or reduced circulation, requiring urgent intervention.
Aneurysms or Vessel Tears: Although rare, vascular complications are more likely in EDS patients.
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Emily Lawrence
19 y/o
Female
Provider:
Dr. Rachel Martinez, MD
Allergies:
Latex (anaphylaxis), Adhesive tape (skin tears)
Emergency Contact:
Margaret Lawrence (Mother) | 555-XXX-5309
Insurance:
United Healthcare
Chief Complaint
"I dislocated my right shoulder reaching for a book on a high shelf. It usually goes back in easily, but this time it won't, and the pain is much worse than usual."
Medical History
- Ehlers-Danlos Syndrome (diagnosed age 12)
- Recurrent joint dislocations
- Chronic joint pain
- Postural Orthostatic Tachycardia Syndrome (POTS)
- Mitral valve prolapse
- Anxiety
Home Medications
- Midodrine 5mg PO TID for POTS
- Metoprolol 25mg PO BID for POTS
- Duloxetine 60mg PO daily for pain/anxiety
- Vitamin D3 5000 IU daily
- Vitamin C 500mg daily
What are the early warning signs of compartment syndrome, and why are EDS patients potentially at higher risk?
Compartment syndrome signs and EDS risk factors:
Early Warning Signs:
Severe, unrelenting pain disproportionate to the injury.
Swelling and tightness in the affected area.
Decreased sensation, tingling, or numbness.
Delayed capillary refill or pallor.
Weakness or paralysis in the limb.
Higher Risk in EDS Patients: Fragile connective tissues and hypermobile joints can lead to greater soft tissue trauma during injuries, increasing the likelihood of swelling and vascular compression.
What nursing interventions should be prioritized while waiting for surgical intervention?
Priority nursing interventions:
Frequent Neurovascular Checks: Assess sensation, capillary refill, pulse, and temperature in the affected limb every hour.
Elevate the Limb: Maintain a neutral position to minimize swelling without further compromising circulation.
Pain Management: Administer prescribed medications to keep the patient comfortable.
Psychological Support: Provide reassurance to reduce anxiety, which can exacerbate symptoms.
Prepare for Surgery: Ensure consent is signed, maintain NPO status, and have necessary supplies ready for the surgical team.
Click Blur To Reveal Answer
Emily Lawrence
19 y/o
Female
Provider:
Dr. Rachel Martinez, MD
Allergies:
Latex (anaphylaxis), Adhesive tape (skin tears)
Emergency Contact:
Margaret Lawrence (Mother) | 555-XXX-5309
Insurance:
United Healthcare
Chief Complaint
"I dislocated my right shoulder reaching for a book on a high shelf. It usually goes back in easily, but this time it won't, and the pain is much worse than usual."
Medical History
- Ehlers-Danlos Syndrome (diagnosed age 12)
- Recurrent joint dislocations
- Chronic joint pain
- Postural Orthostatic Tachycardia Syndrome (POTS)
- Mitral valve prolapse
- Anxiety
Home Medications
- Midodrine 5mg PO TID for POTS
- Metoprolol 25mg PO BID for POTS
- Duloxetine 60mg PO daily for pain/anxiety
- Vitamin D3 5000 IU daily
- Vitamin C 500mg daily
What specific wound care considerations are important for an EDS patient, and why?
Wound care considerations for EDS:
Gentle Cleansing: Use mild antiseptics to avoid irritating fragile skin.
Non-Adhesive Dressings: Use non-stick or silicone-based dressings to prevent skin tears during dressing changes.
Close Monitoring for Infection: EDS patients are at higher risk for delayed wound healing, so watch for redness, warmth, swelling, or drainage.
Avoid Tension on Wounds: Secure dressings carefully to prevent pulling or stretching of the surrounding skin.
Moist Wound Environment: Use dressings that maintain moisture to support healing without risking maceration.
What elements should be included in the discharge teaching plan to prevent future complications?
Discharge teaching elements:
Wound Care Instructions: Educate the patient and family on how to change dressings, recognize signs of infection, and when to seek help.
Activity Modifications: Avoid activities that put stress on the shoulder or other joints, and use assistive devices if needed.
Physical Therapy Compliance: Encourage regular participation in therapy to strengthen muscles and stabilize joints.
Pain Management: Discuss safe use of prescribed pain medications and alternative methods like heat, ice, or gentle exercises.
Emergency Plan: Teach signs of neurovascular compromise, such as numbness, coldness, or severe pain, and the importance of seeking immediate medical attention.
Preventing Dislocations: Provide tips on joint protection, such as avoiding overextension, and encourage the use of braces or supports during activities.
Follow-Up Care: Ensure the patient understands the importance of attending follow-up appointments with orthopedics and physical therapy.
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