NUR643 Health Assessment Of Musculoskeletal System Paper

NUR643 Health Assessment Of Musculoskeletal System Paper

Topic 4 DQ1

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Conducting a focused musculoskeletal system and extremities requires the understanding of history, drug history, family, and psychosocial profile. All of these will help in formulating differentials and clinical diagnoses. The details are discussed hereafter.

Past History

Have you had trauma or fractures in the past? Understanding the history of past fractures or accidents will be essential in ruling out any recurring symptoms and help identify any musculoskeletal deformities that may have resulted from the initial injury. Furthermore, extensive injuries and fractures contribute to many amputations and disabilities.

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Are you suffering from any autoimmune condition? The presence of autoimmune disorders such as systemic lupus erythematosus, diabetes mellitus, Grave`s disease, and rheumatoid arthritis, among others, present musculoskeletal symptoms that affect patients (Mishra & Sarkar, 2021)NUR643 Health Assessment Of Musculoskeletal System Paper. Therefore, they must be ruled out during history and examination.

Are there any birth deformities? Several congenital conditions, including spina bifida, Duchene muscular dystrophy, and arthrogryposis, affect various parts of the musculoskeletal system. Therefore, they should be identified as they determine the treatment modalities.

Drug History

Have you been using steroids? Prolonged use of steroids causes bone loss and osteoporosis and increases the risk of fractures (Gómez-Galán et al., 2021). Stopping steroids can alleviate worsening bone loss and reverse patient symptoms.

Have you been on chemotherapy or exposed to radiation? The use of chemotherapy causes extensive side effects on the bones and other body systems. On bones, it suppresses bone development and causes bone suppression (Mishra & Sarkar, 2021)NUR643 Health Assessment Of Musculoskeletal System Paper. Bones become weak and are at increased risk for breaking. Alternatively, bone metastasis from primary cancer can further weaken bones.

Family History

Do you have a family history of congenital bone conditions? Some congenital conditions such as achondroplasia, osteogenesis imperfecta, acromegaly, and talipes equinovarus significantly impair bone anatomy and can cause deformities (Gómez-Galán et al., 2021). Early recognition of such conditions is key to reducing misdiagnosis.

Psychosocial Profile

Have you been using any illicit drugs in the past? The use of drugs not only affects the immune system but also affects bone density and synovial fluid. Reduction in immunity increases the risk of musculoskeletal infections and fractures.

References

Gómez-Galán, M., Callejón-Ferre, Á.-J., Díaz-Pérez, M., Carreño-Ortega, Á., & López-Martínez, A. (2021). Risk of musculoskeletal disorders in pepper cultivation workers. EXCLI Journal, 20, 1033–1054. https://doi.org/10.17179/excli2021-3853

Mishra, S., & Sarkar, K. (2021). Work-related musculoskeletal disorders and associated risk factors among urban metropolitan hairdressers in India. Journal of Occupational Health, 63(1), e12200. https://doi.org/10.1002/1348-9585.12200 NUR643 Health Assessment Of Musculoskeletal System Paper

Topic 4 DQ2

Disorders of the musculoskeletal system are among the most common presentation in healthcare settings. Like other systemic diseases, healthcare providers make a complete assessment of the musculoskeletal system to produce a diagnosis and provide interventions. Various modalities of interventions include medical therapy, physiotherapy, and education on health promotion and prevention. Unlike medical therapy, which aims to cure the disease, health promotion seeks to improve the quality of life, increase patient knowledge, promote recovery, and prevent future illness. As a result, there is a need to adopt a teaching plan for patients with musculoskeletal conditions. In addition, the devised plan should include risk factors, potential problems, interventions, and prevention strategies to reduce the occurrence of musculoskeletal disorders.

The risk factors are either modifiable or non-modifiable. The former includes smoking cigarettes, alcohol consumption, dangerous sports, prolonged sitting in an uncomfortable posture, obesity, increasing stress at the workplace, and use of medications such as steroids and chemotherapy (Roll et al., 2019)NUR643 Health Assessment Of Musculoskeletal System Paper. On the other hand, the non-modifiable factors include increasing age, being female, and family history of inheritable conditions. Therefore, patients must understand these risk factors and be educated on adopting preventive measures and living a healthy lifestyle. Nonetheless, the known preventive measures include engaging in regular exercise, reducing dietary intake of saturated fats, cessation of smoking, reducing alcohol intake, avoiding dangerous sports, stretching, or standing between sitting, avoiding the use of steroids and illicit drugs, and having regular check-ups. Consequently, failure to adopt preventive measures can worsen musculoskeletal disorders leading to various health problems.

Musculoskeletal problems can affect the entire system, including muscles, bones, nerves, joints, tendons, ligaments, cartilages, and spinal discs. Various effects that could result include osteoarthritis, ankylosing spondylitis, gout, and rheumatoid arthritis of joints; sarcopenia of muscles; osteoporosis and fractures of bones, and back pains. Regrettably, these conditions can negatively affect the quality of life as well as result in other health problems such as disability, immobility, chronic pain, and amputation (Roll et al., 2019). Therefore, early recognition and intervention are as crucial as educating patients to take precautionary measures to prevent diseases and improve their quality of life.

Reference

Roll, S. C., Tung, K. D., Chang, H., Sehremelis, T. A., Fukumura, Y. E., Randolph, S., & Forrest, J. L. (2019). Prevention and rehabilitation of musculoskeletal disorders in oral health care professionals: A systematic review. Journal of the American Dental Association (1939), 150(6), 489–502. https://doi.org/10.1016/j.adaj.2019.01.031 NUR643 Health Assessment Of Musculoskeletal System Paper

Topic 4: Health Assessment Check-Off

I will present both the subjective and objective findings of MA, a 52-year-old man with COPD.

Chief complaint: the patient present with shortness of breath (SOB). There was an associated cough, loss of weight, and inability to complete sentences.

History of presenting illness: M.A is a 52-year-old African American presenting with an SOB that was of sudden onset and progressively increasing that he almost lost his breath. His symptoms are worst on activity while relieved with rest. His symptoms followed an episode in which he did not take his prescribed medications. There was associated chronic cough, malaise, and lower limb edema. He could barely complete sentences.

Past Medical and Surgical History: he was diagnosed with COPD two years ago. He has had one previous admission due to the same symptoms. No previous surgery.

Family history: his father died from exacerbated COPD symptoms. His mother has diabetes.

Social History: he drinks alcohol and has been smoking 2 cigarettes a day since he was 17 years. NUR643 Health Assessment Of Musculoskeletal System Paper

Allergies: none

Medication: inhaled salmeterol-tiotropium PRN.

Review of Systems: unremarkable.

Physical Examination: on general examination, he was an elderly male, sick-looking, in respiratory distress, cyanotic, and could barely complete sentences. Edema++, finger clubbing+, pallor+, and cachexic. Vital sings T 99, P 122, BP 108/64, O₂saturation at 87% on 2L/Min Oxygen. On respiratory examination, the chest was barrel-shaped with evident use of accessory muscles. He had expiratory wheeze with a bilateral reduction in air entry.

Assessment: the following tests were ordered ABGs, spirometry, chest radiography, sputum culture, and complete blood count. A diagnosis of exacerbated COPD and CO2 retention was made.

Treatment: oxygen therapy via face mask at 8L/Min to improve oxygen saturation. Nebulization with Salmeterol-tiotropium to achieve bronchodilation (Keshishian et al., 2019). Cessation of smoking.

Reference.

Keshishian, A., Xie, L., Dembek, C., & Yuce, H. (2019). Reduction in hospital readmission rates among Medicare beneficiaries with chronic obstructive pulmonary disease: A real-world outcomes study of nebulized bronchodilators. Clinical Therapeutics, 41(11), 2283–2296. https://doi.org/10.1016/j.clinthera.2019.09.001 NUR643 Health Assessment Of Musculoskeletal System Paper

NRS 643 Topic 4 Reflection

Complete a written reflection (250-350 words) on what you learned during this topic. Include the following in your reflection, considered through the lens of a nurse educator.

Think about an experience you have encountered when viewing or completing the particular assessment.
Describe the steps you took when completing this particular assessment.
Discuss difficulties that could potentially arise or specific questions related to completing this type of assessment.
Include illustrative examples of potential strategies used to overcome the difficulties encountered when completing the particular assessment.
Describe how the Christian worldview and compassion for all play a role in this type of assessment.

APA style is not required, but solid academic writing is expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. NUR643 Health Assessment Of Musculoskeletal System Paper

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NRS 643 Topic 4 Reflection

Complete a written reflection (250-350 words) on what you learned during this topic. Include the following in your reflection, considered through the lens of a nurse educator.

Think about an experience you have encountered when viewing or completing the particular assessment.
Describe the steps you took when completing this particular assessment.
Discuss difficulties that could potentially arise or specific questions related to completing this type of assessment.
Include illustrative examples of potential strategies used to overcome the difficulties encountered when completing the particular assessment.
Describe how the Christian worldview and compassion for all play a role in this type of assessment.

APA style is not required, but solid academic writing is expected.