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Week 8: Evaluation and Management of Musculoskeletal Disorders

Coursework Instructions:

please use the material and the template for this assignment. you can chose any musculoskeletal disorder for this work. ages between 18 -65 years old.

 

Week 8: Evaluation and Management of Musculoskeletal Disorders

In clinical settings, patients often present with musculoskeletal disorders such as chronic back pain. Drugs are typically prescribed to help manage this type of pain for patients. Of all drugs prescribed, narcotic analgesics are one of the most common, with over 238 million prescriptions prescribed in 2011 (IMS Health, 2012). This prevalence of prescribing narcotics has led to controversy among patients, providers, pharmacies, and lawmakers. Due to the short- and long-term effects of narcotic drugs, the controversy spans from overuse of narcotics to non-medical use of narcotics. For advanced practice nurses, it is essential to carefully observe and watch for signs of drug abuse during patient evaluations. Because not all musculoskeletal disorders require narcotics, a thorough patient evaluation will help to ensure the development of an appropriate treatment plan with patient safety in mind.

This week, you examine the process of evaluating and prescribing treatment to patients with musculoskeletal disorders. You also explore the ethical implications of prescribing narcotics for pain.

Learning Objectives

By the end of this week, students will:

  • Assess differential diagnoses for patients with musculoskeletal disorders
  • Analyze the role of patient information in differential diagnosis for musculoskeletal disorders
  • Evaluate patient treatment options, including opioids, for patients with musculoskeletal disorders
  • Understand and apply key terms, concepts, and principles related to musculoskeletal disorders and the opioid epidemic
  • Analyze pattern recognition in patient diagnoses

 

 

Learning Resources

Required Readings

Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2017). Primary care: A collaborative practice (5th ed.). St. Louis, MO: Elsevier.

  • Part 19, “Evaluation and Management of Multisystem Disorders”
  • Chapter 222, “Chronic Pain” (pp. 1186-1188)
  • Part 15, “Evaluation and Management of Musculoskeletal and Arthritic Disorders” (pp. 897-998)

This part covers the pathophysiology, clinical manifestations, and management of musculoskeletal disorders. It also explores diagnostic tests for diagnosing these disorders.

 

  • Part 18, “Evaluation and Management of Rheumatic Disorders” (pp. 1152-1180)
  • This chapter examines the epidemiology, pathophysiology, clinical presentation, and evaluation of rheumatic disorders, including rheumatoid arthritis and systemic lupus E. It also provides a differential diagnosis for rheumatic disorders.

 

Centers for Disease Control and Prevention. (2017). Opioid overdose. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html

 

American Nurses Association. (2016). The Opioid epidemic: Addressing the growing drug overdose problem. Retrieved from http://nursingworld.org/DocumentVault/Health-Policy/Issue-Briefs/ANA-IssueBrief-Opioid-Epidemic.pdf

 

Centers for Disease Control and Prevention. (2017). What states need to know about PDMPs. Retrieved from https://www.cdc.gov/drugoverdose/pdmp/states.html

 

Coursework Sample Content Preview:
Comprehensive SOAP Template
This template is for a full history and physical. This course include only areas that are related to the case.
Patient Initials: A.J.Age: FemaleGender: 23 years-old
SUBJECTIVE DATA:
Chief Complaint (CC): The patient went for consult due to the chronic pain.
History of Present Illness (HPI): The condition started approximately 3 months ago. 1 month PTC, the patient felt slight discomfort (2/10 on the subjective pain scale) on her bilateral upper back when she sits or stands for prolonged hours. This is relieved by rotating her head and shoulders. 2 months PTC, the pain started to intensify to 6/10 and now characterized as “fatigued muscles” when she assumes a certain position for prolonged hours. The pain is relieved to 2/10 after doing stretching and taking an OTC Ibuprofen (500mg). This month, the pain exacerbated to 8/10 whenever she assumes a position for approximately an hour. The upper back pain now radiates to her right thumb and is characterized as a feeling of numbness.
Medications: Ibuprofen (500mg) prn for pain relief
Allergies: No known allergies
Past Medical History (PMH): The patient has a dextroscoliosis (10 degrees rotation), which was diagnosed when she was 19 years old.
Past Surgical History (PSH): No surgical history since birth
Sexual/Reproductive History: The patient is a G0P0 (0-0-0-0). Her LMP is on March 30, 2020, that lasted for 5 days. She is heterosexual with inactive sex life.
Personal/Social History: She is a non-smoker, non-alcoholic beverage drinker, and denies the use of illicit drugs. The patient works as a call center agent with a graveyard shift for 8 hours a night, from 9pm to 5am, 5 days a week, with an occasional restroom and dinner break. The patient is physically active and usually lifts heavyweights for exercising. During her day-off, she cleans her apartment and goes out to meet friends and watch Netflix with them the whole day. When sleeping, she uses one 2-inch hard pillow, but her mattress is soft. The patient is right-handed and carries her bag on her right shoulder.
Immunization History: None recently
Significant Family History: Her younger brother has a spina bifida, and both of her parents are hypertensive and have osteoarthritis.
39497062293500Lifestyle: She lives alone and independently in her apartment. She pays all her bills alone. She has a boyfriend for 3 years and 3 close friends to whom she spends weekends.
OBJECTIVE DATA:
Physical Exam:
Vital signs: BP 100/70 mmHg, PR 90bpm, RR 16cpm, Ht 5’8”, Wt 140lbs,
BMI 21.3 (normal)
GENERAL SURVEY: The patient is conscious, coherent, and alert. She has dressed appropriately to the weather and is oriented to person, time, and space. She is a mesomorph.
SKIN: The skin is light in color with no observed scars, lesion, tattoos, or edema.
HEENT:
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ASSESSMENT:
Impression: Myofascial Pain Syndrome (MPS)
This is a chronic musculoskeletal condition that develops over time, secondary to the biases in postur...
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