Case study(2.

0)

Patient info
Born:

February 26,1996 Height: 55 inches 165 lbs Starts high school (9th grade) in fall On basketball team Lives with mother, father and sister

Pt History
L.

Knee Menuscus repair 08/11 R. Knee Menuscus repair 12/10

The two most common causes of a meniscus tear are due to traumatic injury (often seen in athletes) and degenerative processes (seen in older patients who have more brittle cartilage). The most common mechanism of a traumatic meniscus tear occurs when the knee joint is bent and the knee is then twisted. It is not uncommon for the meniscus tear to occur along with injuries to the
anterior cruciate ligament (ACL) and the medial collateral ligament (MCL)-these

three problems occurring together are known as the unhappy triad," which is seen in sports such as football when the player is hit on the outside of the
knee.

Medication list

Ortho Tri-Cyclen (28) PO once per day This combination hormone medication is used to prevent pregnancy. It contains 2 hormones: a progestin and an estrogen. These hormones prevent pregnancy in 3 ways. One way is by preventing the release of an egg (ovulation). A second way is by changing the cervical mucus, making it more difficult for an egg to meet sperm (fertilization). A third way is by changing the womb lining, making it difficult for a fertilized egg to attach to the lining of the womb (implantation). A fertilized egg (embryo/unborn baby) needs to attach to the womb to receive blood and nutrients and continue to grow. If an embryo/unborn baby does not attach, it cannot survive.

Lexapro 5mg Po once per day Escitalopram is used to treat depression and generalized anxiety disorder (GAD; excessive worry and tension that disrupts daily life and lasts for 6 months or longer). Escitalopram is in a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance

Side effects and precautions

Changes in vaginal bleeding (e.g., continuous spotting, Sudden heavy bleeding, missed periods), Problem wearing contact lenses, Dark patches on the skin (melasma), Unwanted facial/body hair, Swelling of the ankles /feet, Weight changes (gain or loss). Pain/swelling/warmth in the groin/calf, tingling/weakness/numbness in the arms/legs, Headaches with other symptoms such as vision changes/lack of coordination, existing migraines becoming worse, sudden/very severe headaches), Slurred speech, Weakness on one side of the body, vision problems/changes.

nausea diarrhea constipation changes in sex drive or ability drowsiness increased sweating dizziness heartburn stomach pain excessive tiredness dry mouth increased appetite flu-like symptoms runny nose sneezing

Nursing Dx

Stress overload R/t Starting high school As evident by: Acute episodes of anxiety States: I dont know how I am going to do this I miss my friends

Disturbed body image R/t: Wearing knee braces As evident by: PT states: I look like a robot with these things. How will anyone like me?

Interventions

Encourage client to take time to be introspective in the search for peace and harmony. Provide a basis to build on for growth/change Proper coping mechanisms Relaxation techniques Teen help hotline

Acknowledge normalcy of emotional response to actual or perceived change in body structure or function. Encourage verbalization of positive or negative feelings about actual or perceived change.

Assessment

Clean appeareance, well fed Pink Oral mucosa Dry cough (seasonal allergies) Diarrhea, vomiting, stomach ache (during first 4 days of lexapro then resolved) Wears Knee braces during activities (Basketball) Denies using drugs or having sexual activity Pain in knees only when weather changes pt states. Has had trouble sleeping in past. Resolved once lexapro was added. States that she is less moody on the medication.

Prognosis
With

use of braces Prognosis is good