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NURS 6512 Week 8 Discussion: Assessing Musculoskeletal Pain

NURS 6512 Week 8 Discussion: Assessing Musculoskeletal Pain

Photo Credit: Getty Images/Fotosearch RF
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 provides 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.
In this Discussion, you will consider case studies that describe abnormal findings in
patients seen in a clinical setting.
To prepare:
 By Day 1 of this week, you will be assigned to one of the following specific case studies
for this Discussion. Please see the “Course Announcements” section of the classroom
for your assignment from your Instructor.
 Your Discussion post should be in the Episodic/Focused SOAP Note format rather than
the traditional narrative style Discussion posting format. Refer to Chapter 2 of the
Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning
Resources for guidance. Remember that all Episodic/Focused SOAP notes have
specific data included in every patient case.
 Review the following case studies:
Case 1: Back Pain
Photo Credit: University of Virginia. (n.d.). Lumbar Spine Anatomy [Photograph]. Retrieved from http://www.med-
ed.virginia.edu/courses/rad/ext/5lumbar/01anatomy.html. Used with permission of University of Virginia.
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?
Case 2: Ankle Pain
Photo Credit: University of Virginia. (n.d.). Lateral view of ankle showing Boehler's angle [Photograph]. Retrieved from http://www.med-
ed.virginia.edu/courses/rad/ext/8ankle/01anatomy.html. Used with permission of University of Virginia.
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

NURS 6512 Week 8 Discussion Assessing Musculoskeletal Pain

NURS 6512 Week 8 Discussion Assessing Musculoskeletal Pain

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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 Ottawa ankle rules to determine if you need
additional testing?
Case 3: Knee Pain
Photo Credit: University of Virginia. (n.d.). Normal Knee Anatomy [Photograph]. Retrieved from http://www.med-
ed.virginia.edu/courses/rad/ext/7knee/01anatomy.html. Used with permission of University of Virginia.

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?
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.
By Day 3 of Week 8
Post an episodic/focused note about the patient in the case study to which you were
assigned using the episodic/focused note template provided in the Week 5 resources.
Provide evidence from the literature to support diagnostic tests that would be
appropriate for each case. List five different possible conditions for the patient's
differential diagnosis, and justify why you selected each.
Note: For this Discussion, you are required to complete your initial post before you will
be able to view and respond to your colleagues’ postings. Begin by clicking on the "Post
to Discussion Question" link, and then select "Create Thread" to complete your initial
post. Remember, once you click on Submit, you cannot delete or edit your own posts,
and you cannot post anonymously. Please check your post carefully before clicking
on Submit!
Read a selection of your colleagues' responses.
By Day 6 of Week 8
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.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 8 Discussion Rubric
Post by Day 3 of Week 8 and Respond by Day 6 of Week 8

To Participate in this Discussion:
Week 8 Discussion

Name:  Discussion Rubric

  Excellent

90–100

Good

80–89

Fair

70–79

Poor

0–69

Main Posting:

Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

40 (40%) – 44 (44%)

Thoroughly responds to the Discussion question(s).

Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

No less than 75% of post has exceptional depth and breadth.

Supported by at least three current credible sources.

35 (35%) – 39 (39%)

Responds to most of the Discussion question(s).

Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of the post has exceptional depth and breadth.

Supported by at least three credible references.

31 (31%) – 34 (34%)

Responds to some of the Discussion question(s).

One to two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Cited with fewer than two credible references.

0 (0%) – 30 (30%)

Does not respond to the Discussion question(s).

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible references.

Main Posting:

Writing

6 (6%) – 6 (6%)

Written clearly and concisely.

Contains no grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

5 (5%) – 5 (5%)

Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

4 (4%) – 4 (4%)

Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

0 (0%) – 3 (3%)

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Posting:

Timely and full participation

9 (9%) – 10 (10%)

Meets requirements for timely, full, and active participation.

Posts main Discussion by due date.

8 (8%) – 8 (8%)

Meets requirements for full participation.

Posts main Discussion by due date.

7 (7%) – 7 (7%)

Posts main Discussion by due date.

0 (0%) – 6 (6%)

Does not meet requirements for full participation.

Does not post main Discussion by due date.

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

7 (7%) – 7 (7%)

Response is on topic and may have some depth.

0 (0%) – 6 (6%)

Response may not be on topic and lacks depth.

First Response:

Writing

6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in standard, edited English.

4 (4%) – 4 (4%)

Response posed in the Discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

First Response:

Timely and full participation

5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

3 (3%) – 3 (3%)

Posts by due date.

0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.
9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

7 (7%) – 7 (7%)

Response is on topic and may have some depth.

0 (0%) – 6 (6%)

Response may not be on topic and lacks depth.

Second Response:
Writing
6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in standard, edited English.

4 (4%) – 4 (4%)

Response posed in the Discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

Second Response:
Timely and full participation
5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

3 (3%) – 3 (3%)

Posts by due date.

0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Total Points: 100

Name:  Discussion Rubric

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