Mr. Rogers is a 51-year old male. During his pre-operative examination, he tells the nurse, “I have an ache in my right foot”. He offers an explanation, suggesting, “I must have stepped on something or twisted my ankle. Maybe I got bitten by a bug when I was outside yesterday”. The nurse notes that the patient’s ankle is reddened, slightly swollen, and warm to the touch. However, his temperature is within normal limits. Mr. Roger’s ankle is x-rayed and there is no fracture noted. He has full range-of-motion of his right ankle. Mr. Rogers has a preexisting medical condition of gout. He is scheduled for outpatient surgery on his thyroid.

Based on the scenario described, Mr. Rogers should be evaluated and treated outside of the ambulatory care setting for his right foot ache. The fact that his ankle is slightly swollen and warm to the touch indicates that there is some inflammation in the area. This, combined with his preexisting medical condition of gout, suggests that there may be an underlying medical issue that needs to be addressed.

In addition, Mr. Rogers is scheduled for outpatient surgery on his thyroid. Surgery is a significant procedure that requires careful evaluation of the patient’s overall health status, including any preexisting medical conditions and any recent medical issues. It would be important to ensure that Mr. Rogers is in optimal health before undergoing surgery, and addressing his right foot ache may be part of this process.

Therefore, Mr. Rogers should be referred to his primary care physician or a specialist for further evaluation and treatment of his right foot ache before proceeding with surgery. Depending on the underlying cause of the pain and inflammation, he may require additional testing, medication, or other interventions to address the issue. Once his foot is fully evaluated and treated, his health status can be reassessed to determine if he is a suitable candidate for outpatient surgery.