NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL
Sample Answer for NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL Included After Question
NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL
DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL
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BY DAY 7 OF WEEK 8
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A Sample Answer For the Assignment: NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL
Title: NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL
Integrating Evidence-Based Practices in Complex Pain Management: A Case Study Analysis
Introduction
Complex Regional Pain Syndrome (CRPS), a challenging neurological condition, demands a nuanced and evidence-based approach to alleviate suffering and enhance patients’ quality of life. This in-depth analysis delves into the intricate case of a 43-year-old white male diagnosed with CRPS in his right hip. Through a series of carefully considered decisions, this patient’s journey sheds light on the complexities of managing CRPS while balancing medication side effects and therapeutic outcomes.
Patient Summary
The patient’s ordeal commenced seven years ago, following a fall at work resulting in significant right hip injury. Despite extensive diagnostic tests, he faced skepticism from healthcare professionals, leading to delays in appropriate treatment. The decisions taken included initiating amitriptyline at 25 mg, titrating to 125 mg at bedtime, and later reducing the dosage to 100 mg daily. These decisions were geared towards mitigating pain, enhancing functionality, and minimizing side effects such as grogginess and weight gain.
Evidence-Based Support for Decisions
The initiation of amitriptyline aligns with studies demonstrating its efficacy in managing neuropathic pain, particularly CRPS (Neyama et al., 2020). Amitriptyline, a tricyclic antidepressant, modulates pain perception through multiple pathways, making it a cornerstone in neuropathic pain management (Solomon et al., 2022). The decision to maintain the dose despite minor weight gain is substantiated by research indicating that the benefits of pain control often outweigh modest side effects (Naguib et al., 2021). Additionally, the avoidance of Qsymia was prudent, considering its potential cardiac risks and the patient’s BMI falling below the recommended threshold for its use (Lei et al., 2021).
In addition to pharmaceutical interventions, exploring alternative therapies such as neuromodulation techniques has gained significant attention. A comprehensive study by Sivanesan, & Goebel (2021) delves into the effectiveness of spinal cord stimulation and peripheral nerve stimulation in managing Complex Regional Pain Syndrome, providing valuable insights into diverse treatment modalities.
Goals and Outcomes
The overarching goal was to reduce the patient’s pain levels to an acceptable threshold (around 3 on the scale) and restore his ability to perform daily activities without crutches. The outcomes were remarkably positive; the patient’s pain diminished from a debilitating 9 to a manageable 4. This reduction facilitated enhanced mobility and daily functioning, marking a significant improvement in his overall well-being. Despite minor weight gain, the patient’s improved quality of life underscored the success of the interventions.
Discrepancies Between Expectations and Results
In this case, the outcomes closely mirrored the expectations. The patient experienced a substantial reduction in pain, improved functionality, and minimal side effects, including manageable weight gain. The decisions made successfully struck a delicate balance between therapeutic benefits and potential drawbacks, ensuring the patient’s optimal quality of life. The minor weight gain, while a concern, was overshadowed by the vast improvements in pain control and functionality, aligning with the patient’s stated preferences.
Conclusion
CRPS management necessitates a holistic and individualized approach, integrating evidence-based practices, patient preferences, and vigilant monitoring of outcomes. This case study underscores the pivotal role of healthcare providers in navigating the complexities of CRPS treatment. By employing a comprehensive understanding of available therapies and their potential effects, clinicians can significantly enhance the lives of individuals afflicted with this debilitating condition.
References
Lei, X., Ruan, J., Lai, C., Sun, Z., Yang, X., Lei, X.-G., & Ruan, J.-Q. (2021). Efficacy and Safety of Phentermine/Topiramate in Adults with Overweight or Obesity: A Systematic Review and Meta-Analysis. Obesity (19307381), 29(6), 985–994. https://doi.org/10.1002/oby.23152
Naguib, I. A., Ali, N. A., Elroby, F. A., & Elghobashy, M. R. (2021). Green HPLC-DAD and HPTLC Methods for Quantitative Determination of Binary Mixture of Pregabalin and Amitriptyline Used for Neuropathic Pain Management. Journal of Chromatographic Science, 59(6), 536–547. https://doi.org/10.1093/chromsci/bmab031
Neyama, H., Dozono, N., Uchida, H., & Ueda, H. (2020). Mirtazapine, an α 2 Antagonist-Type Antidepressant, Reverses Pain and Lack of Morphine Analgesia in Fibromyalgia-Like Mouse Models. The Journal of Pharmacology and Experimental Therapeutics, 375(1), 1–9. https://doi.org/10.1124/jpet.120.265942
Sivanesan, E., & Goebel, A. (2021). Complex regional pain syndrome: developing diagnostic tools and treatments from sympathetic nervous system, neuroimmune and neuromodulation discoveries in neuropathic pain. Regional Anesthesia & Pain Medicine, 46(3), 193–195. https://doi.org/10.1136/rapm-2020-101644
Solomon Tesfaye, Gordon Sloan, Jennifer Petrie, David White, Mike Bradburn, Tracey Young, Satyan Rajbhandari, Sanjeev Sharma, Gerry Rayman, Ravikanth Gouni, Uazman Alam, Steven A Julious, Cindy Cooper, Amanda Loban, Katie Sutherland, Rachel Glover, Simon Waterhouse, Emily Turton, Michelle Horspool, … Dinesh Selvarajah. (2022). Optimal pharmacotherapy pathway in adults with diabetic peripheral neuropathic pain: the OPTION-DM RCT. Health Technology Assessment, 26(39). https://doi.org/10.3310/RXUO6757
Rubric
| NURS_6521_Week8_Assignment_Rubric | ||||||
| Criteria | Ratings | Pts | ||||
| This criterion is linked to a Learning OutcomeBriefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented. Be specific. |
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20 pts | ||||
| This criterion is linked to a Learning OutcomeBased on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources. |
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25 pts | ||||
| This criterion is linked to a Learning OutcomeWhat were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources. |
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20 pts | ||||
| This criterion is linked to a Learning OutcomeExplain any difference between what you expected to achieve with each of the decisions and the results of the decisions in the exercise. Describe whether they were different. Be specific and provide examples. |
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20 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. |
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5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
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5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. |
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5 pts | ||||