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NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1

NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1

Walden University NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1-Step-By-Step Guide

 

This guide will demonstrate how to complete the Walden University  NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1 assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

 

How to Research and Prepare for NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1

 

Whether one passes or fails an academic assignment such as the Walden University  NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1 depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

 

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

 

How to Write the Introduction for  NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1 

 

The introduction for the Walden University  NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1 is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

 

How to Write the Body for  NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1 

 

After the introduction, move into the main part of the  NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1 assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

 

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

 

How to Write the Conclusion for  NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1 

 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

 

How to Format the References List for  NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1

 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1

It is no coincidence that the neurological system and the musculoskeletal system share both anatomical, physiological, and functional connectivity. This structure-function relationship between the neuronal and muscular topology is responsible for influencing the disease process, the pathogenesis, presentation, diagnostic formulation, and treatment of both systems. Therefore, an understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment and helps in educating the affected patients. This paper provides an account of the interplay between the neurological and the musculoskeletal system, how the racial and ethnic variables impact the physiological functioning, and how these processes interact to affect the patient.

Pathophysiologic processes that would account for the patient presenting these symptoms

Conspicuously, the patient has a history of hypertension and smoking that form the basis of his clinical symptoms including left-sided weakness of both the upper and lower limbs and a mild left facial droop. These features suggest a stroke. Hypertension is a well-established cause of stroke through various mechanisms that include acceleration of the arteriosclerotic process in the cerebral arteries thus increasing the risk of stenosis, embolism, and consequently infarction. Furthermore, high intravascular pressure within the cerebral arteries leads to considerable damage to the endothelial lining and alteration of the smooth muscle function (Wajngarten & Silva, 2019). This endothelial damage and altered blood cell-endothelium interaction lead to the formation of local thrombi, ischemia, and cerebral infarction whereas smooth muscle cell degeneration leads to intracerebral hemorrhages.

Smoking on the other hand is associated with an increased risk of developing a stroke. According to Pan et al. (2019) smokers have an increased risk of overall stroke compared with nonsmokers, with a pooled odds ratio of 1.61 (95% CI: 1.34–1.93). Tobacco smoke contains a lot of chemicals that include nicotine, carbon monoxide, and cyanide among many others. These chemicals increase the risk of developing atherosclerosis, platelet aggregation, hypertension, low levels of high-density cholesterol, and high levels of low-density cholesterol. A complex and multifactorial interaction of the abovementioned factors leads to impaired vascular function resulting in both cardiovascular compromise and cerebral embolism and infarction.

Racial/ethnic variables that may impact physiological functioning

Generally, evidence shows that a racial disparity exists in the presentation of this physiological process, affecting more blacks as compared to whites. According to a study by Howard et al. (2019), the black individuals aged between 45 and 64 years had a 3-fold increase of developing stroke as compared with the whites. Black individuals have a higher preponderance of stroke because of their high risk to develop metabolic conditions such as diabetes mellitus, hypertension, obesity, hypercholesterolemia, and smoking (Tong et al., 2021).

How these processes interact to affect the patient

Neurological and musculoskeletal processes work hand in hand. Every movement the body makes requires communication between the brain and the muscles. Consequently, a pathologic process affecting the neurological process can lead to musculoskeletal manifestations such as hemiplegia, muscle spasms, muscle atrophy, and muscle pain among others. For instance, chronic musculoskeletal pain is principally considered a nervous system disorder as a result of nervous system plasticity (George & Bishop, 2018). Similarly, several factors such as smoking, hypertension, aging, and racial variables impact these physiologic systems resulting in an inherent complexity of interactions that affect patient functioning.

Conclusion

Musculoskeletal and neurological systems are correlated. Nurses must assess both systems at a given point for effective diagnosis and treatment. It is also elemental to educate the patient concerning modifiable risk factors such as smoking and hypertension that result in occurrences that limit the functioning of the musculoskeletal and neurological systems.

Also Read:

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References

George, S. Z., & Bishop, M. D. (2018). Chronic musculoskeletal pain is a nervous system disorder… now what? Physical Therapy98(4), 209–213. https://doi.org/10.1093/ptj/pzy002

Howard, V. J., Madsen, T. E., Kleindorfer, D. O., Judd, S. E., Rhodes, J. D., Soliman, E. Z., Kissela, B. M., Safford, M. M., Moy, C. S., McClure, L. A., Howard, G., & Cushman, M. (2019). Sex and race differences in the association of incident ischemic stroke with risk factors. JAMA Neurology76(2), 179–186. https://doi.org/10.1001/jamaneurol.2018.3862

Pan, B., Jin, X., Jun, L., Qiu, S., Zheng, Q., & Pan, M. (2019). The relationship between smoking and stroke: A meta-analysis: A meta-analysis. Medicine98(12), e14872. https://doi.org/10.1097/MD.0000000000014872

Tong, X., Schieb, L., George, M. G., Gillespie, C., Merritt, R. K., & Yang, Q. (2021). Racial/ethnic and geographic variations in long-term survival among Medicare beneficiaries after acute ischemic stroke. Preventing Chronic Disease18(200242), E15. https://doi.org/10.5888/pcd18.200242

Wajngarten, M., & Silva, G. S. (2019). Hypertension and stroke: Update on treatment. European Cardiology14(2), 111–115. https://doi.org/10.15420/ecr.2019.11.1

Sample Answer 2 for NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1

  • Question 2

4 out of 4 points

Scenario 1: Gout

A 68-year-old obese male presents to the clinic with a 3-day history of fever with chills, and Lt. great toe pain that has gotten progressively worse. Patient states this is the first time that this has happened, and nothing has made it better and walking on his right foot makes it worse. He has tried acetaminophen, but it did not help. He took several ibuprofen tablets last night which did give him a bit of relief.

HPI: hypertension treated with Lisinopril/HCTZ .

SH: Denies smoking. Drinking: “a fair amount of red wine” every week. General appearance: Ill appearing male who sits with his right foot elevated.

PE:  remarkable for a temp of 100.2, pulse 106, respirations 20 and BP 158/92. Right great toe (first metatarsal phalangeal [MTP]) noticeably swollen and red. Unable to palpate to assess range of motion due to extreme pain. CBC and Complete metabolic profile revealed WBC 15,000 mm3 and uric acid 9.0 mg/dl.

Diagnoses the patient with acute gout.

Question:

Explain why a patient with gout is more likely to develop renal calculi.

Selected Answer: Most uric acid is eliminated from the body through the kidneys. Urate is filtered at the glomerulus and undergoes reabsorption and excretion within the proximal renal tubules. In primary gout, urate excretion by the kidneys is sluggish. This may be caused by a decrease in glomerular filtration of urate or acceleration in urate reabsorption. This allows for urate crystals to be deposited in the renal tubules.
Correct Answer: Most uric acid is eliminated from the body through the kidneys. Urate is filtered at the glomerulus and undergoes reabsorption and excretion within the proximal renal tubules. In primary gout, urate excretion by the kidneys is sluggish. This may be caused by a decrease in glomerular filtration of urate or acceleration in urate reabsorption. This allows for urate crystals to be deposited in the renal tubules.
Response Feedback: [None Given]

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

    • Stroke
    • Multiple sclerosis
    • Transient Ischemic Attack
    • Myasthenia gravis
    • Headache
    • Seizure disorders
    • Head injury
    • Spinal cord injury
    • Inflammatory diseases of the musculoskeletal system
    • Osteoporosis
    • Osteopenia
    • Bursitis
    • Tendinitis
    • Gout
    • Lyme Disease
    • Spondylosis
    • Fractures
    • Parkinson’s
    • Alzheimer’s

Three basic bone-formations:

    • Osteoblasts
    • Osteocytes
    • Osteoclasts

Photo Credit: Getty Images/Science Photo Libra

Complete the Knowledge Check By Day 7 of Week 7

To complete this Knowledge Check:

Module 5 Knowledge Check

Next Week

To go to the next week:

Week 8

 Week 7: Concepts of Neurological and Musculoskeletal Disorders – Part 1

Anatomists often use the analogy of a house to explain the human body, with skeletal systems, respiratory systems, and circulatory systems represented as a home’s framing structure, ventilation, and piping, respectively. Such analogies further emphasize the point that relationships between systems can result in complications when issues arise in one system.

With hundreds of diseases that can impact the brain, spine, and nerves, neurological disorders represent a complicated array of issuesNURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1

that present significant health concerns. Disorders such as strokes and Parkinson’s disease not only affect the nervous system, however; they can have secondary impacts in other areas, especially the musculoskeletal system.

This week, you examine fundamental concepts of neurological disorders. You explore common disorders that impact these systems and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

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Students will:

  • Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings (click to expand/reduce)

 McCance, K. L. & Huether, S. E. (2019). Pathophysiology: the biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

  • Chapter 15: Structure and Function of the Neurologic System
  • Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function (stop at Sleep); Summary Review
  • Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function (start at Acute confusional states and delirium) (stop at Alterations in neuromotor functions); (Parkinson’s Disease); Summary Review
  • Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction (stop at Degenerative disorders of the spine); (start at Cerebrovascular disorders) (stop at Tumors of the central nervous system); Summary Review
  • Chapter 44: Structure and Function of the Musculoskeletal System (stop at Components of muscle function); Summary Review
  • Chapter 45: Alterations of Musculoskeletal Function (stop at Bone tumors); (start at Disorders of joints); Summary Review
  • Chapter 47: Structure, Function, and Disorders of the Integument (section on Lyme Disease)

Chin, L. S. (2018). Spinal cord injuries. Retrieved from https://emedicine.medscape.com/article/793582-overview#a4

Required Media (click to expand/reduce)

Module 5 Overview with Dr. Tara Harris 

Dr. Tara Harris reviews the structure of Module 5 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check and your Assignment. (3m)

Khan Academy. (2019b). Ischemic stroke . Retrieved from https://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/stroke/v/ischemic-stroke 

Note: The approximate length of the media program is 8 minutes.

Osmosis.org. (2019, June 12). Osteoporosis  – causes, symptoms, diagnosis, treatment, pathology [Video file]. Retrieved from https://www.youtube.com/watch?v=jUQ_tt_zJDo 

Note: The approximate length of the media program is 9 minutes.

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 15, 16, 18, and sections of Chapters 44 and 45 that relate to the neurological and musculoskeletal systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Sample Answer 3 for NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1

  • Question 16

Needs Grading

A 22-year-old male is in the Surgical Intensive Care Unit (SICU) following a motor vehicle crash (MVC) where he sustained multiple life-threatening injuries including a torn aorta, ruptured spleen, and bilateral femur fractures. He has had difficulty maintaining his mean arterial pressure (MAP) and has required various vasopressors. He has a triple lumen central venous catheter (CVC) for monitoring his central venous pressure, administration of medications and blood products, as well as total parenteral nutrition. Per hospital protocol, he is receiving an unfractionated heparin 1:1000 flush after administration of each of the triple antibiotics that have been ordered to maintain patency of the lumens.  Seven days post injury, the APRN in the SICU is reviewing the patient’s morning labs and notes that his platelet count has dropped precipitously to 50,000 /mm3 from 148,000/mm3 two days ago. The APRN suspects the patient is developing heparin induced thrombocytopenia (HIT).

 

Question 1 of 2:

 

What is underlying pathophysiology of heparin induced thrombocytopenia? 

Selected Answer: Antibodies which bind to platelet factor 4 (PF4), and heparin complexes promote the development of HIT since they activate platelets and trigger a prothrombotic state. However, HIT occurs commonly with unfractionated heparin (UFH) as compared to low molecular weight heparin (LMWH). It is often an adverse drug reaction mediated by IgG antibodies against heparinplatelet factor 4 complexes leading to the activation of platelets. This increases the consumption of platelets and reduces the platelets counts within 5-10 days after unfractionated heparin. Has been administered.
Correct Answer: Heparin-induced thrombocytopenia (HIT) is caused by antibodies that bind to complexes of heparin and platelet factor 4 (PF4), activating the platelets and promoting a prothrombotic state. HIT is more frequently encountered with unfractionated heparin (UFH) than with low molecular weight heparin (LMWH). It is an immune mediated adverse drug reaction caused by IgG antibodies against the heparinplatelet factor 4 complex leading to platelet activation through platelet FcyIIa receptors. The release of additional platelet factor 4 from activated platelets and activation of thrombin lead to increased platelet consumption and a decrease in platelet counts beginning 5-10 days after administration of unfractionated heparin.
Response Feedback: [None Given]
  • Question 17

Needs Grading

A 22-year-old male is in the Surgical Intensive Care Unit (SICU) following a motor vehicle crash (MVC) where he sustained multiple life-threatening injuries including a torn aorta, ruptured spleen, and bilateral femur fractures. He has had difficulty maintaining his mean arterial pressure (MAP) and has required various vasopressors. He has a triple lumen central venous catheter (CVC) for monitoring his central venous pressure, administration of medications and blood products, as well as total parenteral nutrition. Per hospital protocol, he is receiving an unfractionated heparin 1:1000 flush after administration of each of the triple antibiotics that have been ordered to maintain patency of the lumens.  Seven days post injury, the APRN in the SICU is reviewing the patient’s morning labs and notes that his platelet count has dropped precipitously to 50,000 /mm3 from 148,000/mm3 two days ago. The APRN suspects the patient is developing heparin induced thrombocytopenia (HIT).

Question 2 of 2:

 

The APRN assesses the patient and notes there is a decreased right posterior tibial pulse with cyanosis of the entire foot. The APRN recognizes this probably represents arterial thrombus formation. How does someone who is receiving heparin develop arterial and venous thrombosis? 

Selected Answer:  

After platelets are activated, procoagulant platelet microparticles are released, and thrombocytopenia occurs. This is followed by the production of thrombin, and activation of inflammatory cells, and injury to the endothelium which produce the arterial and venous thrombus features observed in HIT. The ris of HIT increases with continued use of thrombophylaxis post-operatively. However, it can also develop even with minor exposure to heparin through intravascular flushes especially when trying to maintain patency of an indwelling venous catheter. The platelets usually collect in the micro-circulation to form an emboli or thrombus. In large arteries of lower and upper extremities, the formation of arterial emboli can lead to necrosis if not promptly identified.

Correct Answer: Platelet activation results in the release of procoagulant platelet microparticles, platelet consumption, and thrombocytopenia. Marked generation of thrombin, activation of monocytes and other inflammatory cells, and endothelial injury and activation follow, producing the characteristic venous and arterial thromboses of HIT. The risk of HIT is highest with prolonged use of heparin for postoperative thrombophylaxis. However, case studies have also demonstrated the possibility of developing HIT with minimal heparin exposure via intravascular flushes to maintain the patency of indwelling arterial or venous catheters.

The platelets aggregate in the microcirculation, leaving to systemic thrombocytopenia but the platelets clump together and form thrombi and emboli. Arterial emboli usually form in the larger arteries of the upper and lower extremities and if not identified quickly, limb necrosis occurs. Treatment is not warfarin which could lead to skin necrosis but rather withdrawal of the heparin and the use of thrombin inhibitors such as argatroban.

Response Feedback: [None Given]

Sample Answer 4 for NURS 6501 Concepts of Neurological and Musculoskeletal Disorders – Part 1

 

Alzheimer’s is a common progressive neurological disorder caused by dementia among older adults. The disorder is characterized by mild to moderate cognitive symptoms at first which lead to severe memory loss as the individual ages. Several treatment options have however been provided to help promote the quality of life and reduce suffering among patients diagnosed with this disorder (Tsolaki, 2018). The purpose of this paper is to demonstrate the choice of medication based on pharmacokinetic and pharmacodynamic factors for an elderly patient with Alzheimer’s disease.

Patient Case Study Summary

The patient in the provided case study is a 76-year-old Iranian male who presented to the clinic with strange behaviors. The patient reports symptoms of Alzheimer’s such as confusion, loss of interest in religious activities, and forgetfulness for the past 2 years. Some of the pharmacodynamic and pharmacokinetic factors that might affect the choice of medication for the patient include his male gender, advanced age, and Iranian race, in addition to the mini-mental examination results which reveal moderate dementia (Tan et al., 2018). The patient’s diagnosis of major neurocognitive disorder resulting from Alzheimer’s disease will also be considered.

Treatment Decisions

Based on the above-mentioned pharmacokinetic and pharmacodynamic factors, the best treatment choice for the patient out of the available options was to initiate 1.5 mg Exelon (rivastigmine) twice daily. Studies have reported great effectiveness with the use of rivastigmine as the first-line medication for the management of Alzheimer’s disease, with great tolerance and safety profile (dos Santos et al., 2018). The second intervention was to titrate the dose upwards from 1.5mg to 4.5 mg twice daily as recommended by clinical guidelines, given that the patient displayed limited reemission of symptoms with the use of 1.5 mg rivastigmine for the past 4 weeks. Despite the patient exhibiting great tolerance to the medication, its effectiveness was still limited which led to the final decision to increase the dose to 6mg orally twice daily.

Expected Outcome

Studies show that rivastigmine may take up to 8 to 12 weeks to completely manage the symptoms of dementia. The dose must however be titrated at intervals of 1.5mg after every 2 weeks, after an initial dose of 1.5mg twice daily, to attain the optimum dose for an effective outcome. The patient should however not exceed 6mg twice daily (Nguyen et al., 2021). As such, the patient was expected to display remission of symptoms, within 8 weeks, with minimal mental examination results of less than 10.

Difference Between Expected Outcome and Actual Outcome

The patient responded adequately to the medication as expected. Within the first four weeks, minimal remission of symptoms was experienced with no side effects as expected. The dose was increased which led to better results until the optimum dose was attained with no side effects (Khoury et al., 2018). As such the patient exhibited great tolerance and adherence to the medication with great effectiveness just as expected.

Conclusion

Alzheimer’s disorder is a disabling condition that requires timely treatment to promote the patient’s quality of life. Several treatment options are however available which require keen consideration of the patient’s pharmacokinetic and pharmacodynamic factors when selecting which drug to use for which patient. The 76-year-old Iranian male patient described above displayed great tolerance and adherence to the use of rivastigmine.

 

References

dos Santos, P., Leide, C., Ozela, P. F., de Fatima de Brito, M., Pinheiro, A. A., Padilha, E. C., … & Izabel, L. (2018). Alzheimer’s disease: a review from the pathophysiology to diagnosis, new perspectives for pharmacological treatment. Current medicinal chemistry25(26), 3141-3159. https://doi.org/10.2174/0929867323666161213101126

Khoury, R., Rajamanickam, J., & Grossberg, G. T. (2018). An update on the safety of current therapies for Alzheimer’s disease: focus on rivastigmine. Therapeutic Advances in Drug Safety9(3), 171-178. https://doi.org/10.1177/2042098617750555

Nguyen, K., Hoffman, H., Chakkamparambil, B., & Grossberg, G. T. (2021). Evaluation of rivastigmine in Alzheimer’s disease. Neurodegenerative Disease Management11(1), 35-48. https://doi.org/10.2217/nmt-2020-0052

Tan, E. C., Hilmer, S. N., Garcia-Ptacek, S., & Bell, J. (2018). Current approaches to the pharmacological treatment of Alzheimer’s disease. Australian Journal of general practice47(9), 586-592. https://search.informit.org/doi/10.3316/informit.849432651288623

Tsolaki, M. (2018). An old and new challenge for the treatment of Alzheimer’s disease. Journal of Neurology and Neuroscience09. https://doi.org/10.21767/2171-6625-c3-013