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NEUROLOGICAL AND MUSCULOSKELETAL DISORDERS MODULE 4 NURS 6501
Sample Answer for NEUROLOGICAL AND MUSCULOSKELETAL DISORDERS MODULE 4 NURS 6501 Included After Question
In this exercise, you will complete a 5-essay type question Knowledge Check to gauge your understanding of this module’s content.
Possible topics covered in this Knowledge Check include:
- Stroke
- Multiple sclerosis
- Transient Ischemic Attack
- Myasthenia gravis
- Headache
- Seizure disorders
- Head injury
- Spinal cord injury
- Inflammatory diseases of the musculoskeletal system
- Osteoporosis
- Osteopenia
- Bursitis
- Tendinitis
- Gout
- Lyme Disease
- Spondylosis
- Fractures
- Parkinson’s
- Alzheimer’s
Three basic bone-formations:
- Osteoblasts
- Osteocytes
- Osteoclasts
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 7 OF WEEK 7
Complete the Knowledge Check by Day 7 of Week 7.
A Sample Answer For the Assignment: NEUROLOGICAL AND MUSCULOSKELETAL DISORDERS MODULE 4 NURS 6501
Title: NEUROLOGICAL AND MUSCULOSKELETAL DISORDERS MODULE 4 NURS 6501
It is no coincidence that the neurological system and the musculoskeletal system share both anatomical, physiological, and functional connectivity. This structure-function relationship between the neuronal and muscular topology is responsible for influencing the disease process, the pathogenesis, presentation, diagnostic formulation, and treatment of both systems. Therefore, an understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment and helps in educating the affected patients. This paper provides an account of the interplay between the neurological and the musculoskeletal system, how the racial and ethnic variables impact the physiological functioning, and how these processes interact to affect the patient.
Pathophysiologic Processes That Would Account for The Patient Presenting These Symptoms
Conspicuously, the patient has a history of hypertension and smoking that form the basis of his clinical symptoms including left-sided weakness of both the upper and lower limbs and a mild left facial droop. These features suggest a stroke. Hypertension is a well-established cause of stroke through various mechanisms that include acceleration of the arteriosclerotic process in the cerebral arteries thus increasing the risk of stenosis, embolism, and consequently infarction. Furthermore, high intravascular pressure within the cerebral arteries leads to considerable damage to the endothelial lining and alteration of the smooth muscle function (Wajngarten & Silva, 2019). This endothelial damage and altered blood cell-endothelium interaction lead to the formation of local thrombi, ischemia, and cerebral infarction whereas smooth muscle cell degeneration leads to intracerebral hemorrhages.
Smoking on the other hand is associated with an increased risk of developing a stroke. According to Pan et al. (2019) smokers have an increased risk of overall stroke compared with nonsmokers, with a pooled odds ratio of 1.61 (95% CI: 1.34–1.93). Tobacco smoke contains a lot of chemicals that include nicotine, carbon monoxide, and cyanide among many others. These chemicals increase the risk of developing atherosclerosis, platelet aggregation, hypertension, low levels of high-density cholesterol, and high levels of low-density cholesterol. A complex and multifactorial interaction of the abovementioned factors leads to impaired vascular function resulting in both cardiovascular compromise and cerebral embolism and infarction.
Racial/Ethnic Variables That May Impact Physiological Functioning
Generally, evidence shows that a racial disparity exists in the presentation of this physiological process, affecting more blacks as compared to whites. According to a study by Howard et al. (2019), the black individuals aged between 45 and 64 years had a 3-fold increase of developing stroke as compared with the whites. Black individuals have a higher preponderance of stroke because of their high risk to develop metabolic conditions such as diabetes mellitus, hypertension, obesity, hypercholesterolemia, and smoking (Tong et al., 2021).
How These Processes Interact to Affect the Patient
Neurological and musculoskeletal processes work hand in hand. Every movement the body makes requires communication between the brain and the muscles. Consequently, a pathologic process affecting the neurological process can lead to musculoskeletal manifestations such as hemiplegia, muscle spasms, muscle atrophy, and muscle pain among others. For instance, chronic musculoskeletal pain is principally considered a nervous system disorder as a result of nervous system plasticity (George & Bishop, 2018). Similarly, several factors such as smoking, hypertension, aging, and racial variables impact these physiologic systems resulting in an inherent complexity of interactions that affect patient functioning.
Conclusion
Musculoskeletal and neurological systems are correlated. Nurses must assess both systems at a given point for effective diagnosis and treatment. It is also elemental to educate the patient concerning modifiable risk factors such as smoking and hypertension that result in occurrences that limit the functioning of the musculoskeletal and neurological systems.
References
George, S. Z., & Bishop, M. D. (2018). Chronic musculoskeletal pain is a nervous system disorder… now what? Physical Therapy, 98(4), 209–213. https://doi.org/10.1093/ptj/pzy002
Howard, V. J., Madsen, T. E., Kleindorfer, D. O., Judd, S. E., Rhodes, J. D., Soliman, E. Z., Kissela, B. M., Safford, M. M., Moy, C. S., McClure, L. A., Howard, G., & Cushman, M. (2019). Sex and race differences in the association of incident ischemic stroke with risk factors. JAMA Neurology, 76(2), 179–186. https://doi.org/10.1001/jamaneurol.2018.3862
Pan, B., Jin, X., Jun, L., Qiu, S., Zheng, Q., & Pan, M. (2019). The relationship between smoking and stroke: A meta-analysis: A meta-analysis. Medicine, 98(12), e14872. https://doi.org/10.1097/MD.0000000000014872
Tong, X., Schieb, L., George, M. G., Gillespie, C., Merritt, R. K., & Yang, Q. (2021). Racial/ethnic and geographic variations in long-term survival among Medicare beneficiaries after acute ischemic stroke. Preventing Chronic Disease, 18(200242), E15. https://doi.org/10.5888/pcd18.200242
Wajngarten, M., & Silva, G. S. (2019). Hypertension and stroke: Update on treatment. European Cardiology, 14(2), 111–115. https://doi.org/10.15420/ecr.2019.11.1
Question 1
4 out of 4 points
Scenario 1: GoutA 68-year-old obese male presents to the clinic with a 3-day history of fever with chills, and Lt. great toe pain that has gotten progressively worse. Patient states this is the first time that this has happened, and nothing has made it better and walking on his right foot makes it worse. He has tried acetaminophen, but it did not help. He took several ibuprofen tablets last night which did give him a bit of relief. HPI: hypertension treated with Lisinopril/HCTZ . SH: Denies smoking. Drinking: “a fair amount of red wine” every week. General appearance: Ill appearing male who sits with his right foot elevated. PE: remarkable for a temp of 100.2, pulse 106, respirations 20 and BP 158/92. Right great toe (first metatarsal phalangeal [MTP]) noticeably swollen and red. Unable to palpate to assess range of motion due to extreme pain. CBC and Complete metabolic profile revealed WBC 15,000 mm3 and uric acid 9.0 mg/dl. Diagnoses the patient with acute gout. Question:Explain the pathophysiology of gout. |
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Question 2
4 out of 4 points
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Scenario 1: Gout
A 68-year-old obese male presents to the clinic with a 3-day history of fever with chills, and Lt. great toe pain that has gotten progressively worse. Patient states this is the first time that this has happened, and nothing has made it better and walking on his right foot makes it worse. He has tried acetaminophen, but it did not help. He took several ibuprofen tablets last night which did give him a bit of relief.
HPI: hypertension treated with Lisinopril/HCTZ .
SH: Denies smoking. Drinking: “a fair amount of red wine” every week. General appearance: Ill appearing male who sits with his right foot elevated.
PE: remarkable for a temp of 100.2, pulse 106, respirations 20 and BP 158/92. Right great toe (first metatarsal phalangeal [MTP]) noticeably swollen and red. Unable to palpate to assess range of motion due to extreme pain. CBC and Complete metabolic profile revealed WBC 15,000 mm3 and uric acid 9.0 mg/dl.
Diagnoses the patient with acute gout. Question:Explain why a patient with gout is more likely to develop renal calculi. |
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Question 3
4 out of 4 points
Scenario 2: OsteoporosisA 78-year-old female was out walking her small dog when her dog suddenly tried to chase a rabbit and made her fall. She attempted to try and break her fall by putting her hand out and she landed on her outstretched hand. She immediately felt severe pain in her right wrist and noticed her wrist looked deformed. Her neighbor saw the fall and brought the woman to the local ER for evaluation. Radiographs revealed a Colles’ fracture (distal radius with dorsal displacement of fragments) as well as radiographic evidence of osteoporosis. A closed reduction of the fracture was successful, and she was placed in a posterior splint with ace bandage wrap and instructed to see an orthopedist for follow up. Question:Discuss what is osteoporosis and how does it develop pathologically? |
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A Sample Answer 2 For the Assignment: NEUROLOGICAL AND MUSCULOSKELETAL DISORDERS MODULE 4 NURS 6501
Title: NEUROLOGICAL AND MUSCULOSKELETAL DISORDERS MODULE 4 NURS 6501
The case study is about a 76-year-old male Iranian patient suspected of having Alzheimer’s disease. The conclusion is reports based on his eldest son, and during the test, there were no organic disease processes found. The behavioral changes began two years earlier, which involved changes in personality and apathy, accompanied by memory loss, which challenges in recognizing the appropriate words. During the speech, self-reported euthymic mood and clinical interview confabulation are often noticed. The patient often has an impairment and a lack of impulse control in his insight and judgment. There is no reported ideation of suicide, and because of Alzheimer’s disease, the patient is diagnosed with neurocognitive disorder.
Donepezil 5 mg at bedtime will be used as the first approach. The donepezil use has been studied for decades by patients who have Alzheimer’s disease. The medication is an inhibitor of acetylcholinesterase, which raises the brain’s acetylcholine levels also makes up for the reduced cholinergic neurons function (Čolović, Krstić, Lazarević-Pašti, Bondžić, & Vasić, 2013). An evaluation of randomized clinical trials analyzes the effect that donepezil has on Alzheimer’s patients utilizing randomized control trials. The results revealed that there is evidence that donepezil is effective in managing this condition in three main fields, including behavior, functional capacity, and cognition (Knowles, 2006, pp. 195–219). These are the key areas in which the patient affected as well as the aim was to reduce his quality of life effect. As demonstrated in the case, he had major personality changes that had a negative impact on his involvement in activities of interest.
The effects of Donepezil vary as complications may occur along with minimal clinical benefits. The patient-reported side effects documented in patients taking this medication, like appetite, loss of weight, nausea, vomiting, and diarrhea. (Kumar & Sharma., 2019).
The second decision was cognitive behavioral therapy use, that has been shown to have a beneficial effect in early-stage patients of Alzheimer’s disease. In isolated cases, evidence suggesting psychosocial treatments for dementia patients identified (Forstmeier, Maercker, Savaskan, & Roth, 2015). There is also limited empirical information on such approaches, though. Among patients who have neuropsychiatric symptoms, certain researchers have described behavioral treatments as necessary. This may also be used by the patient to promote behavior, especially directed at reducing apathy & enhancing the patient’s self-control. Mood improvement might have a positive effect on the quality of life as well as the patient’s ability to engage in activities that increase his cognitive status.
In this case, the third decision will involve family members in the therapeutic process, which will continue to improve behaviors that help the patient. The aim is to improve the patient’s support system and also daily interactions, though it has been shown to have a significant effect on the emotional and cognitive well-being of dementia patients.
References
Čolović, M. B., Krstić, D. Z., Lazarević-Pašti, T. D., Bondžić, A. M., & Vasić, a. V. (2013). Acetylcholinesterase inhibitors: pharmacology and toxicology. Curr Neuropharmacol, 11(3), 315–335. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3648782/
Forstmeier, S., Maercker, A., Savaskan, E., & Roth, a. T. (2015). Cognitive-behavioral treatment for mild Alzheimer’s patients and their caregivers (CBTAC): study protocol for a randomized controlled trial. Trials., 16. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650298/
Knowles, J. (2006). Donepezil in Alzheimer’s disease: an evidence-based review of its impact on clinical and economic outcomes. Core Evid., 1(3), 195–219. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321665/
Kumar, A., & Sharma., S. (2019). Donepezil. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513257/
Grading Rubric
Performance Category | 100% or highest level of performance
100% 16 points |
Very good or high level of performance
88% 14 points |
Acceptable level of performance
81% 13 points |
Inadequate demonstration of expectations
68% 11 points |
Deficient level of performance
56% 9 points
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Failing level
of performance 55% or less 0 points |
Total Points Possible= 50 | 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points |
Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic topics. |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three or more of the following elements
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16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points | |
Application of Course Knowledge
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in the all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three of the following elements
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10 Points | 9 Points | 6 Points | 0 Points | |||
Interactive Dialogue
Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic. |
Demonstrated all of the following:
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Demonstrated 3 of the following:
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Demonstrated 2 of the following:
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Demonstrated 1 or less of the following:
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Grammar, Syntax, APA
Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error. |
The following was present:
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The following was present:
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The following was present:
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The following was present:
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The following was present:
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The following was present:
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0 Points Deducted | 5 Points Lost | |||||
Participation
Requirements |
Demonstrated the following:
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Failed to demonstrate the following:
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Due Date Requirements | Demonstrated all of the following:
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Demonstrates one or less of the following.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |