1 Casey is a 17-year-old high school student admitted to the ER with a

1 Casey is a 17-year-old high school student admitted to the ER with a compound fracture of the left leg obtained falling at the local skateboard park while practicing for a national competition. He has never been hospitalized before. His mother has been notified and is on her way. The EMTs gave him morphine and he reports his pain level as “okay.”

What part of the interview and examination can be done prior to his mother’s arrival?
As you enter the room for the first time, what should you observe as part of the general survey?
As you complete his history, what areas are especially important?
What are the important developmental considerations for Casey?

2 Jean is a 68-year-old female admitted for a hip replacement. In her interview you learn that she has had increasingly severe pain over the last 3 years until it has become unbearable enough to prohibit her usual activities. She likes to walk two miles per day with her golden retriever, plays golf, and is in a bowling league, all of which she has had to quit in the last 3 months due to the pain. She is on no medications except for aspirin and ibuprofen, which do not stop her pain even at maximum dose. Her husband died 5 years ago and her adult children live on the other side of the country.

What further questions would you ask including about her medications? What are your concerns about the medication she currently takes?
What concerns do you have about her social support system?
What special considerations would you consider when planning for post-operative pain control?
What physical assessment techniques should you do?

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