NURS 6512 Week 8 Discussion Assessing Muscoskeletal Pain<\/p>\n
The body is constantly sending signals about its health. One In this Discussion, you will consider case studies that Note: By Day 1 of this week, your Instructor will have A 42-year-old male reports pain in his lower back for the spine<\/p>\n A 46-year-old female reports pain in both of her ankles, but ankle<\/p>\n A 15-year-old male reports dull pain in both knees. additional history do you need? What categories can you use to differentiate knee<\/p>\n With regard to the case study you were assigned:<\/p>\n Review this week\u2019s Learning Resources, and consider the Consider what history would be necessary to collect from the Consider what physical exams and diagnostic tests would be Identify at least five possible conditions that may be Note: Before you submit your initial post, replace the Post an episodic\/focused note about the patient in the case Note: For this Discussion, you are required to complete your Read a selection of your colleagues\u2019 responses.<\/p>\n Respond to at least two of your colleagues on 2 different S.<\/u><\/strong><\/p>\n HPI<\/strong>: The patient is a 42-year-old Caucasian man who has been experiencing lower back pain since struggling to lift a large object at work a month ago. The pain is described as “sharp and scorching” and radiates down his leg’s left side. Sleep deprivation and difficulty working are among the symptoms described by the patient. With exercise, bending over, and straining, the pain worsens. The level of discomfort is an eight on a ten-point scale. Rest and ibuprofen 600mg orally every four hours to relieve pain, which is assessed at a four out of 10 for intensity.<\/p>\n Location:<\/strong> low back<\/p>\n Onset<\/strong>: one month \u00a0ago<\/p>\n Character<\/strong>: the pain is sharp and scorching and radiates down his leg’s left side.<\/p>\n Associated signs and symptoms:<\/strong> sleep deprivation<\/p>\n Timing<\/strong>: after straining, bending, or exercise<\/p>\n Exacerbating\/ relieving factors:<\/strong> exacerbated with bending or straining, relieved by taking pain medication.<\/p>\n Severity:<\/strong> 4\/10 pain scale<\/p>\n Current Medications<\/strong>: ibuprofen 200mg prn pain, Losartan 50mg orally daily, and rosuvastatin 20mg orally daily.<\/p>\n Allergies: <\/strong>\u00a0No Known Food or Drug Allergies, allergic to latex or pollen.<\/p>\n PMH<\/strong>:\u00a0 The patient denies having ever had arthritis or osteoporosis in her past. The patient has a history of hypertension and hyperlipidemia that is controlled with medication, seasonal allergies, and cholecystectomy on August 17th, 2018. Pt denies having undergone any other procedures or hospitalization. Tdap (06\/12\/2021) and flu and pneumonia vaccines (10\/07\/2021) are all current on the patient’s medical record.<\/p>\n Soc Hx<\/strong>: the patient enjoys spending time with friends and playing slow-pitch softball. He also used to play baseball while in college. The patient is married with two teenage children who live in a remote region, attend church regularly, and volunteer their time. The patient denies using illicit drugs or cigarettes.<\/p>\n Fam Hx<\/strong>: Father 64 with hypertension and hyperlipidemia; mother 60 with hypothyroidism; wife 34; son 14, healthy; daughter 12, healthy; mother 60 with hypertension and hypothyroidism; father 64; mother 60; wife 34; son 14, healthy; daughter 12, healthy.<\/p>\n ROS<\/strong>:<\/p>\n GENERAL: fatigue, weakness, denies having fever.<\/p>\n HEENT: patient denies changes in vision or blurry vision and denies cough, congestion, or hearing loss.<\/p>\n SKIN: \u00a0reports no itching or rash<\/p>\n CARDIOVASCULAR: \u00a0no dizziness, chest pain, or edema.<\/p>\n RESPIRATORY: denies cough, wheezing, or sputum<\/p>\n GASTROINTESTINAL: \u00a0No nausea, vomiting, or diarrhea<\/p>\n GENITOURINARY: \u00a0patient denies polyuria, dysuria, frequency, or urgency.<\/p>\n NEUROLOGICAL: \u00a0patient denies dizziness, headache, syncope, or hx of fainting<\/p>\n MUSCULOSKELETAL: \u00a0Lower back pain that radiates down the patient’s left leg is creating aberrant gait patterns and restricted range of motion in the patient. The patient denies having ever had arthritis, gout, or a fall.<\/p>\n HEMATOLOGIC: \u00a0No anemia, bleeding, or bruising.<\/p>\n LYMPHATICS: \u00a0No enlarged nodes. No history of splenectomy.<\/p>\n PSYCHIATRIC: \u00a0No history of depression or anxiety.<\/p>\n ENDOCRINOLOGIC: \u00a0No reports of sweating, cold, or heat intolerance. No polyuria or polydipsia.<\/p>\n ALLERGIES: \u00a0No history of asthma, hives, eczema, or rhinitis.<\/p>\n O.<\/u><\/strong><\/p>\n V\/S: \u00a0V\/ S: B\/P 130\/80, P 87, RR 19, T 98.4 F, O2 97%, Wt 202lbs, Ht 71\u201d<\/p>\n GENERAL: The patient is sitting straight on the test table with a small grimace, and some grumbling can be heard. NAD, which is neatly groomed and appropriately attired, gives the impression that he is older than he appears. The patient is attentive and gives thoughtful responses.<\/p>\n HEENT: the mouth has no ulcers, no scars, ears are in the correct orientation.<\/p>\n CHEST: no chest pains, no wheezes, normal breath sounds.<\/p>\n MUSKULOSKELETAL: Muscle tone and strength are excellent, except for the left leg, which is weak due to pain. Pain in the lower back left hip, and a lack of mobility causes the left leg. Scoliosis is not present, and the spine is straight and symmetrical with no masses or nodules palpable and no soreness observed. The back is symmetrical.<\/p>\n x-ray: To eliminate the possibility of a broken bone, a tumor, or bony protrusion, an X-ray is performed (Jenkins et al., 2018). Low Back Pain (Acute) claimed that quick x-ray use was not evidence-based practice, and AHRQ suggests waiting six weeks if pain continues to perform x-rays (Fujimoto et al., 2109).<\/p>\n A<\/u><\/strong>.<\/u><\/p>\n \u00a0<\/strong><\/p>\n Batti\u00e9, M. C., Joshi, A. B., & Gibbons, L. E. (2019). Degenerative disc disease. Spine, 44(21), 1523-1529. https:\/\/doi.org\/10.1097\/brs.0000000000003103<\/a><\/p>\n Fujimoto, K., Inage, K., Eguchi, Y., Orita, S., Toyoguchi, T., Yamauchi, K., Suzuki, M., Kubota, G., Sainoh, T., Sato, J., Shiga, Y., Abe, K., Kanamoto, H., Inoue, M., Kinoshita, H., Norimoto, M., Umimura, T., Koda, M., Furuya, T., \u2026 Ohtori, S. (2019). Dual-energy X-ray Absorptiometry and Bioelectrical impedance analysis are beneficial tools for measuring the trunk muscle mass of patients with low back pain. Spine Surgery and Related Research, 3(4), 335-341. https:\/\/doi.org\/10.22603\/ssrr.2018-0040<\/a><\/p>\n Jenkins, H. J., Downie, A. S., Maher, C. G., Moloney, N. A., Magnussen, J. S., & Hancock, M. J. (2018). Imaging for low back pain: Is clinical use consistent with guidelines? A systematic review and meta-analysis. The Spine Journal, 18(12), 2266-2277. https:\/\/doi.org\/10.1016\/j.spinee.2018.05.004<\/a><\/p>\n Kim, J., Van Rijn, R. M., Van Tulder, M. W., Koes, B. W., De Boer, M. R., Ginai, A. Z., Ostelo, R. W., Van der Windt, D. A., & Verhagen, A. P. (2018). Diagnostic accuracy of diagnostic imaging for lumbar disc herniation in adults with low back pain or sciatica is unknown; a systematic review. Chiropractic & Manual Therapies, 26(1). https:\/\/doi.org\/10.1186\/s12998-018-0207-x<\/a><\/p>\n
\nof the most easily recognized signals is pain. Musculoskeletal conditions
\ncomprise one of the leading causes of severe long-term pain in patients. The
\nmusculoskeletal system is an elaborate system of interconnected levers that
\nprovide the body with support and mobility. Because of the interconnectedness
\nof the musculoskeletal system, identifying the causes of pain can be
\nchallenging. Accurately interpreting the cause of musculoskeletal pain requires
\nan assessment process informed by patient history<\/a> and physical exams.<\/p>\n
\ndescribe abnormal findings in patients seen in a clinical setting.<\/p>\n
\nassigned you to one of the following specific case studies for this Discussion.
\nAlso, your Discussion post should be in the Episodic\/Focused SOAP Note format,
\nrather than the traditional narrative style Discussion posting format. Refer to
\nChapter 2 of the Sullivan text and the Episodic\/Focused SOAP Template in the
\nWeek 5 Learning Resources for guidance. Remember that all Episodic\/Focused SOAP
\nnotes have specific data included in every patient case.<\/p>\nCase 1: Back Pain<\/h3>\n
\npast month. The pain sometimes radiates to his left leg. In determining the
\ncause of the back pain, based on your knowledge of anatomy, what nerve roots
\nmight be involved? How would you test for each of them? What other symptoms
\nneed to be explored? What are your differential diagnoses for acute low back
\npain? Consider the possible origins using the Agency for Healthcare Research
\nand Quality (AHRQ) guidelines as a framework. What physical examination will
\nyou perform? What special maneuvers will you perform?<\/p>\nCase 2: Ankle Pain<\/a><\/h3>\n
\nshe is more concerned about her right ankle. She was playing soccer over the
\nweekend and heard a \u201cpop.\u201d She is able to bear weight, but it is
\nuncomfortable. In determining the cause of the ankle pain, based on your
\nknowledge of anatomy, what foot structures are likely involved? What other
\nsymptoms need to be explored? What are your differential diagnoses for ankle
\npain? What physical examination will you perform? What special maneuvers will
\nyou perform? Should you apply the Ottowa ankle rules to determine if you need
\nadditional testing?<\/p>\nCase 3: Knee Pain<\/h3>\n
\nSometimes one or both knees click, and the patient describes a catching
\nsensation under the patella. In determining the causes of the knee pain, what<\/p>\n![\"NURS](\"https:\/\/nursingassignmentcrackers.com\/wp-content\/uploads\/2023\/02\/NURS-6512-Week-8-Discussion-Assessing-Muscoskeletal-Pain-300x118.png\")
\nknee pain? What are your specific differential diagnoses for knee pain? What
\nphysical examination will you perform? What anatomic structures are you
\nassessing as part of the physical examination? What special maneuvers will you
\nperform?<\/p>\nTo prepare:<\/h3>\n
\ninsights they provide about the case study.<\/p>\n
\npatient in the case study you were assigned.<\/p>\n
\nappropriate to gather more information about the patient\u2019s condition. How would
\nthe results be used to make a diagnosis?<\/p>\n
\nconsidered in a differential diagnosis for the patient.<\/p>\n
\nsubject line (\u201cDiscussion \u2013 Week 8\u201d) with \u201cReview of Case Study
\n___.\u201d Fill in the blank with the number of the case study you were
\nassigned.<\/p>\nBy Day 3<\/h3>\n
\nstudy to which you were assigned using the episodic\/focused note template
\nprovided in week 5 resources. Provide evidence from the literature to support
\ndiagnostic tests that would be appropriate for each case. List five different
\npossible conditions for the patient\u2019s differential diagnosis and justify why
\nyou selected each.<\/p>\n
\ninitial post before you will be able to view and respond to your colleagues\u2019
\npostings. Begin by clicking on the \u201cPost to Discussion Question\u201d link
\nand then select \u201cCreate Thread\u201d to complete your initial post.
\nRemember, once you click on Submit, you cannot delete or edit your own posts,
\nand you cannot post anonymously. Please check your post carefully before
\nclicking on Submit!<\/p>\nBy Day 6<\/h3>\n
\ndays who were assigned different case studies than you. Analyze the possible
\nconditions from your colleagues\u2019 differential diagnoses. Determine which of the
\nconditions you would reject and why. Identify the most likely condition, and
\njustify your reasoning.<\/p>\nClick here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERSNURS 6512 Week 8 Discussion: Assessing Muscoskeletal Pain<\/strong><\/a><\/span><\/em><\/h3>\n
CC<\/strong>: Low back pain for one month<\/h3>\n
Physical exam<\/strong><\/h3>\n
Diagnostic results<\/strong>:<\/h3>\n
Differential Diagnoses <\/strong><\/h3>\n
\n
NURS 6512 Week 8 Discussion: Assessing Muscoskeletal Pain References<\/strong><\/h3>\n