NURS 6512 Week 8 Discussion: Assessing Muscoskeletal Pain Essay

The body is constantly sending signals about its health. One of the most easily recognized signals is pain. Musculoskeletal conditions comprise one of the leading causes of severe long-term pain in patients. The musculoskeletal system is an elaborate system of interconnected levers that provide the body with support and mobility. Because of the interconnectedness of the musculoskeletal system, identifying the causes of pain can be challenging. Accurately interpreting the cause of musculoskeletal pain requires an assessment process informed by patient history and physical exams. NURS 6512 Week 8 Discussion: Assessing Muscoskeletal Pain Essay

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In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.

Case 1: Back Pain

A 42-year-old male reports pain in his lower back for the past month. The pain sometimes radiates to his left leg. In determining the cause of the back pain, based on your knowledge of anatomy, what nerve roots might be involved? How would you test for each of them? What other symptoms need to be explored? What are your differential diagnoses for acute low back pain? Consider the possible origins using the Agency for Healthcare Research and Quality (AHRQ) guidelines as a framework. What physical examination will you perform? What special maneuvers will you perform?

Note: Please view the Week 8 Discussion area to view the image for Case Study 1. NURS 6512 Week 8 Discussion: Assessing Muscoskeletal Pain Essay

Case 2: Ankle Pain

A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What other symptoms need to be explored? What are your differential diagnoses for ankle pain? What physical examination will you perform? What special maneuvers will you perform? Should you apply the Ottowa ankle rules to determine if you need additional testing?

Note: Please view the Week 8 Discussion area to view the image for Case Study 2.

Case 3: Knee Pain

A 15-year-old male reports dull pain in both knees. Sometimes one or both knees click, and the patient describes a catching sensation under the patella.In determining the causes of the knee pain, what additional history do you need? What categories can you use to differentiate knee pain? What are your specific differential diagnoses for knee pain? What physical examination will you perform? What anatomic structures are you assessing as part of the physical examination? What special maneuvers will you perform?

Note: Please view the Week 8 Discussion area to view the image for Case Study 3.

To prepare:

With regard to the case study you were assigned:

Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study you were assigned.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

Note: Before you submit your initial post, replace the subject line (“Discussion – Week 8”) with “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned. NURS 6512 Week 8 Discussion: Assessing Muscoskeletal Pain Essay

By Day 3

Post a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. Include how the patient X-ray helped you to refine the differential diagnosis.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.

NURS 6512 Week 8 Quiz

Question 1

A 7-year-old boy is brought into your office with a chief complaint of possible fracture in his left third finger. He jammed it while playing basketball 2 days ago. The mother states that she really does not think it is broken because he can move it. What is your best response?

Question 2

A patient presenting for the first time with typical low back pain should receive which of the following diagnostic tests?

Question 3

Classic carpal tunnel syndrome would result in:

Question 4

A tingling sensation radiating from the wrist to the hand on striking the median nerve is a positive _____ sign.

Question 5

A red, hot swollen joint in a 40-year-old man should lead you to suspect:

Question 6

The usual number of vertebrae is:

Question 7

In differentiating osteoarthritis from rheumatoid arthritis (RA), the osteoarthritis patient typically exhibits:

Question 8

The physical assessment technique most frequently used to assess joint symmetry is:

Question 9

During a football game, a player was struck on the lateral side of the left leg while his feet were firmly planted. He is complaining of left knee pain. To examine the left knee you should initially perform the _____ test. NURS 6512 Week 8 Discussion: Assessing Muscoskeletal Pain Essay

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Question 10

Light skin and thin body habitus are risk factors for:

Question 11

Risk factors for sports-related injuries include:

Question 12

An adult with bowed tibias and a shortened thorax may have:

Question 13

Ligaments are stronger than bone until:

Question 14

An increase in muscle tone is known as:

Question 15

A goniometer is used to assess:

Question 16

When the patient flexes forward at the waist, what spinal observation would lead you to suspect scoliosis?

Question 17

The dowager hump is:

Question 18

You note that a child has a positive Gower sign. You know that this indicates generalized:

Question 19

The elasticity of pelvic ligaments and softening of cartilage in a pregnant woman are due to:

Question 20

Injuries to long bones and joints are more likely to result in fractures than in sprains until: