What are the considerations that must be taken into account for patients with musculoskeletal conditions? how should you respond to patients who are in pain when they come into the office? think about patients with musculoskeletal conditions who have been prescribed pain medications. what are some considerations with this and describe how narcotic dependence can be prevented.

Ahealthy 26-year-old woman sustained a significant crush injury to her right upper extremity while on the job at a local construction site. she was brought to the emergency department and subsequently underwent pinning and reconstructive surgery and received perioperative broad-spectrum antibiotics. her blood pressure remained normal throughout her hospital course. on the second hospital day, a medical consultant noted a marked increase in her creatinine, from 0.8 to 1.9 mg/dl. her urine output dropped to 20 ml/h. serum creatine kinase was ordered and reported as 3400 units/l. questions what are the primary causes of this patient’s acute kidney injury? how should her kidney injury be categorized (as prerenal, intrarenal, or postrenal)? how should she be treated?