Question

A 21 year old patient comes to the clinic after getting into a physical altercation at a bar the night before. He claims that he kicked and punch the other person. His right hard is swollen, red, and tender to the touch. What should the nurse practitioner do next?

a. Order x-ray of hand
b. Refer to ED
c. Refer to orthopedics
d. Suggest NSAIDS and ice

Answer 1

The nurse practitioner should initially order an x-ray of the hand to assess for fractures or other serious injuries. Subsequent steps, including pain management and possible referral to ED or orthopedics, will depend on the x-ray results.

Step-by-step explanation:

A 21-year-old patient presenting with a swollen, red, and tender hand after a physical altercation should be evaluated for potential fractures or soft tissue injuries. The appropriate initial step for the nurse practitioner would be to order an x-ray of the hand to determine the extent of the injury. It's important to assess for fractures, especially the 'boxer's fracture' which commonly affects the 5th metacarpal and could be the result of punching. Depending on the outcome of the x-ray, a referral to the emergency department (ED) or orthopedics may be necessary, as they can provide more specialized care if the injury is severe. While NSAIDs and ice may help reduce swelling and pain, these should only be used after ensuring that there are no contraindications, such as a fracture that requires immediate attention or surgery.

Increased redness, swelling, and pain after an injury can indicate an inflammatory response, a sign that the body is reacting to tissue damage or infection. It is vital to monitor these symptoms as they can help determine the severity of the injury and the need for further treatment.