Answer :
The nurse's priority action when assessing a client with shoulder pain and no signs of inflammation is to perform a thorough history and physical examination to determine the cause of the pain.
To begin, the nurse should ask the client about the onset, duration, and intensity of the pain, as well as any activities or movements that exacerbate or alleviate the pain. It is also important to inquire about any recent injuries or trauma to the shoulder, as well as the client's occupational and recreational activities, which may contribute to overuse or repetitive strain injuries.
During the physical examination, the nurse should assess the shoulder's range of motion (ROM), strength, and stability. Special tests, such as the Neer test, Hawkins test, or the empty can test, can be performed to assess for impingement syndrome or rotator cuff tendinopathy. The nurse should also palpate the shoulder joint and surrounding structures to check for any tenderness or abnormalities.
If the pain is mechanical in nature and not associated with inflammation, the nurse should consider other potential causes such as muscular strain, tendonitis, bursitis, or referred pain from another source, such as the cervical spine. The nurse should also assess for any neurological deficits that may suggest a nerve impingement or other neurological involvement.
Based on the assessment, the nurse can then provide appropriate interventions, which may include pain management strategies, referral to physical therapy, or consultation with an orthopedic specialist for further evaluation. Education on activity modification, proper body mechanics, and ergonomic principles may also be provided to prevent further injury and promote healing.
In summary, the priority action for the nurse is to conduct a comprehensive assessment, including a detailed history and focused physical examination, to identify the underlying cause of the shoulder pain and develop an appropriate plan of care.
Stabilize the injury , keep checking vitals , MRI / X-ray . Check skin for cold and clammy temp.
