Tuesday, April 22, 2008

I reluctantly decided against the hike yesterday. During our morning walk, it was overcast and windy, and the forecast was for rain. It's a 70-mile round trip, and if it had rained, it might have been cancelled anyway. I definitely intend to go on the Oog's Hat hike next Monday and am sure there'll be another Atsion sooner or later.
Leslie joined Susan and me for our morning walk and we enjoyed having her. She and I will go to the "Losers' Club," as I can't help calling it, tonight. It's a support group for those who have suffered losses in some way.
While Pat was at the bay, I went to Acme, then drove to the dollar store in Manahawkin to pick up a few things. Aside from the ever-present housework, that was it for the day.
I'm picking Julie L. up for lunch today, and am looking forward to it.
Hey, nursies: I just noticed a kind of bump on my right thumb; seems to be inside, on the joint bone itself. It's hard and isn't sore. What do you suppose that could be?

6 comments:

iloveac said...

No idea.....possibly it's a 'bump'....LOL. Not allowed to do a medical dx without a license. Nurses now make nursing diagnosis. Yours might go like this.

'Raised area at base of right thumb related to unknown cause'. Our nursing goals would be directed to the 'related to' part of the statement. In your case we'd try to get an adequate history. And you thought we just gave needles.
The Care Plan would go like this:
1.) Patient will provide information clarifying etiology as evidenced by recall of any recent trauma to the thumb.
2.) Patient will state duration of induration.

Next my nursing intervention might go like this:

1.) Advise patient to view pictures in NYT of the hand and be more specific as to which anatomical area is affected.
2.) Advise patient to show 'bump' to MD at next office visit if one is scheduled.

Nurse would docment her observations using the SOAP method. Subjective, objective, assessment , plan.

As an aside nurse would tell her/himself it might be a lipoma....fatty lump...usually on soft tissue however...or it might be a small bone spur. There also may be a foreign body embedded in the area. Nurse would keep in mind that those statements are the differential diagnoses and as such are part of a Medical diagnosis.

Student nurses have to write out the entire scenario described above. It's called the Nursing Process and the term was unknown til 1967. Betty and I learned a much less formalized method for providing nursing care to patients.

If I could get my webcam working you could hold it up and show me.

Actually it developed because you did not respond to comment #5 on Mimi's Musings posted yesterday.

Mimi said...

I am IMPRESSED! I never knew you had to go to such precise lengths in nursing. Actually, I'm not sure it would show up on a web cam; I can't even see it well, but I can feel it. (Maybe I could send you the thumb itself...) I don't think it's a foreign object because it doesn't hurt even if I press on it and there's no opening in the skin. Nursie Pat, is it possibly arthritis (I humbly ask)?
As for that comment 5, so sorry; I didn't go back and look at yesterday's entry after my last comment.
However, our courtship was so long ago, I don't even remember it--NOT! Part of it was actually somewhat of a cause celebre, not to say scandal, in Ventnor at the time. Someday, I'll tell you about it.

iloveac said...

There is something called 'Heberden's nodes' or something like that. The presence of such nodes helps the MD make a diagnosis. Not all kinds of arthritis manifest nodes.
If it's a node I think it would be on the top of your finger....I was thinking it was at the bottom...i.e. underside.
Go to those fabulous photos you sent from the NYT and look at the hand....where is your bump?

You did share some of the courtship with me...but you surely could tell us about the wedding planning. # of bridesmaids etc....who were they? Are you still in touch with any of them? Where were the rehearsal dinner and wedding receptions held? Who gave you away? I assume it was your brother Jim. Imagine women had to be 'given away'.......from one patriarch to another......

Mimi said...

Betty was my maid of honor; the bridesmaids were my older sister, Gene, and my friend, Joan Welsh--both gone now. Pat's best man was his brother, Bill (he and Bill are the only ones left of the Molloy sibs.) The ushers were his broth-in-law, Buddy Wilker (now gone), and Bob "Muff" McGinty. My brother, Jim, "gave me away." (Pat's been trying to give me back ever since.)
It was a quiet wedding and we didn't have a rehearsal dinner. The reception was at the Hotel Morton; can't remember what street in A.C.

iloveac said...

I think it was on Virginia Ave.

I saw your picture on your dresser when I visited in August. You were a beautiful bride.

Anonymous said...

Hum, now my two cents. Not a nurse responder though.
Could be a small ganglion cyst or arthritic bone spur.

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