nurs6512 week 8 discussion latest 2018 april

Week 8
discussion

Discussion: Assessing Muscoskeletal Pain

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
provide 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.

Note: By Day 1 of this week, your Instructor will have
assigned you to one of the following specific case studies for this Discussion.
Also, 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.

Case 1: Back Pain

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?

spine

Case 2: Ankle Pain

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 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 Ottowa ankle rules to determine if you need
additional testing?

ankle

Case 3: Knee Pain

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?

knee

To prepare:

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

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 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

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.

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