M.S. has never had an osteoporosis screening. She confides that her mother and grandmother were diagnosed with osteoporosis when they were in their early sos.
M.S.'s diagnostic test revealed a bone density T-score of -2.7. How will this be interpreted?

H.K. is taken to surgery for open reduction and internal fixation (ORIF) of the tibia and fibula fractures. He returns with a full-leg fiberglass cast with windows over the areas of surgery.
Describe the assessment of a patient with a long leg cast involving trauma and surgery.

All serious medical conditions are ruled out, and J.C. is diagnosed with lumbar strain. The nurse practitioner (NP) orders a physical therapy consultation to develop a home stretching and back-strengthening exercise program and a dietary consultation for weight reduction. J.C. is given prescriptions for cyclobenzaprine (Flexeril) 10 mg tid x 3 days only, and celecoxib (Celebrex) 100 mg/day for 3 months. He receives the following instructions: heat applications to the lower back for 20 to 30 minutes four times a day (using moist heat from heat packs or hot towels), no twisting or unnecessary bending, and no lifting more than 1 0 pounds. J.C. is instructed to rest his back for 1 or 2 days, getting up only now and then to move around to relieve muscle spasms in his back and strengthen his back muscles. He is given a written excuse to stay off work for 5 days and, when he returns to work, specifying the limitation of lifting no more than 10 pounds for 3 months. He is instructed to contact his primary care provider if the pain gets worse.
Why do you think that cyclobenzaprine was prescribed instead of diazepam (Valium)?

Arterial Blood Gases
$pH$ 7.55
$Paco_2$ 24mm Hg
$HC0_3$ 24mEq/L
$Pao_2$ 56mm Hg
$Sao_2$ 86% (room air)
Vital Signs
BP 150/92mm Hg
Heart rate 110 beats/min
Respiratory rate 28 breaths/min
Temperature $99^{\circ}F$ ($37.2^{\circ}C$)
What is your interpretation of the ABGs, and what do you think the physician will order next, and why?

X-ray films confirm the diagnosis of intertrochanteric femoral fracture. Knowing that M.C. is going to be admitted, you draw admission labs and call for the orthopedic consultation.
What laboratory and diagnostic studies will be ordered to evaluate M.C.'s condition, and what critical information will each give you?

S.P. is taken to surgery for a total hip replacement. Because of the intracapsular location of the fracture, the surgeon chooses to perform an arthroplasty rather than internal fixation. The postoperative orders include the following
Why is the antibiotic to be stopped before the anesthesia end time?