NURS 6512 Assessment of the Musculoskeletal System
Walden University NURS 6512 Assessment of the Musculoskeletal System-Step-By-Step Guide
This guide will demonstrate how to complete the Walden University NURS 6512 Assessment of the Musculoskeletal System 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 6512 Assessment of the Musculoskeletal System
Whether one passes or fails an academic assignment such as the Walden University NURS 6512 Assessment of the Musculoskeletal System 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 6512 Assessment of the Musculoskeletal System
The introduction for the Walden University NURS 6512 Assessment of the Musculoskeletal System 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 6512 Assessment of the Musculoskeletal System
After the introduction, move into the main part of the NURS 6512 Assessment of the Musculoskeletal System 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 6512 Assessment of the Musculoskeletal System
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 6512 Assessment of the Musculoskeletal System
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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NURS 6512 Assessment of the Musculoskeletal System
A 46-year-old man walks into a doctor’s office complaining of tripping over doorways more frequently. He does not know why. What could be the causes of this condition?
Without the ability to use the complex structure and range of movement afforded by the musculoskeletal system, many of the physical activities individuals enjoy would be curtailed. Maintaining the health of the musculoskeletal system will ensure that patients live a life of full mobility. One of the most basic steps that can be taken to preserve the health of the musculoskeletal system is to perform an assessment.
This week, you will explore how to assess the musculoskeletal system.
Learning Objectives
Students will:
• Evaluate abnormal musculoskeletal findings
• Apply concepts, theories, and principles relating to health assessment techniques and diagnoses for the musculoskeletal system
• Evaluate musculoskeletal X-Ray imaging
________________________________________
Learning Resources
Required Readings (click to expand/reduce)
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
• Chapter 4, “Vital Signs and Pain Assessment” (Previously read in Week 6)
• Chapter 22, “Musculoskeletal System”
This chapter describes the process of assessing the musculoskeletal system. In addition, the authors explore the anatomy and physiology of the musculoskeletal system.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.
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Chapter 22, “Lower Extremity Limb Pain”
This chapter outlines how to take a focused history and perform a physical exam to determine the cause of limb pain. It includes a discussion of the most common tests used to assess musculoskeletal disorders.
Chapter 24, “Low Back Pain (Acute)”
The focus of this chapter is the identification of the causes of lower back pain. It includes suggested physical exams and potential diagnoses.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
• Chapter 2, “The Comprehensive History and Physical Exam” (“Muscle Strength Grading”) (Previously read in Weeks 1, 2, 3, 4, and 5)
• Chapter 3, “SOAP Notes”
This section explains the procedural knowledge needed to perform musculoskeletal procedures.
Note: Download this Student Checklist and Abdomen Key Points to use during your practice abdominal examination.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Musculoskeletal system: Student checklist. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Musculoskeletal system: Key points. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.
Katz, J. N., Lyons, N., Wolff, L. S., Silverman, J., Emrani, P., Holt, H. L., … Losina, E. (2011). Medical decision-making among Hispanics and non-Hispanic Whites with chronic back and knee pain: A qualitative study. BMC Musculoskeletal Disorders, 12(1), 78–85.
This study examines the medical decision making among Hispanics and non-Hispanic whites. The authors also analyze the preferred information sources used for making decisions in these populations.
Smuck, M., Kao, M., Brar, N., Martinez-Ith, A., Choi, J., & Tomkins-Lane, C. C. (2014). Does physical activity influence the relationship between low back pain and obesity? The Spine Journal, 14(2), 209–216. doi:10.1016/j.spinee.2013.11.010
Shiri, R., Solovieva, S., Husgafvel-Pursiainen, K., Telama, R., Yang, X., Viikari, J., Raitakari, O. T., & Viikari-Juntura, E. (2013). The role of obesity and physical activity in non-specific and radiating low back pain: The Young Finns study. Seminars in Arthritis & Rheumatism, 42(6), 640–650. doi:10.1016/j.semarthrit.2012.09.002
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Subjective
CC: Lower back pain
HPI: Hispanic male patient JM, age 42, presented to the clinic today complaining of severe lower back pain over the past month. Periodically, the pain travels along his left leg. He felt a sharp, throbbing pain in his left lower leg, along with a tingling feeling. He said the ache in his back was an eight out of ten. He feels more discomfort when he lifts heavy objects, bends, or sits for lengthy periods of time. He says over-the-counter ibuprofen helps a little.
Current Medications:
OTC Ibuprofen 400mg Q4hrs as needed for pain.
Claritin 10mg daily for allergies
Lisinopril 5mg daily for hypertension
Allergies: No known drug allergy; environmental allergies: Pollen (Reaction- sneezing and watery eyes).
PMHx: Medical history includes hypertension 5 years ago. No hospitalizations. His vaccinations are all current.
Past surgical Hx: No surgical history reported.
Social Hx: JM has a high school diploma and is employed as a bricklayer for a local construction company. He is married and resides in a three-bedroom home with his wife and 10-year-old son. For the last ten years, he has been smoking one pack of cigarettes per day. He denied consuming alcohol or using illegal substances. Because of his back pain, he refuses to exercise on a regular basis. He follows a healthy diet that includes fruits and vegetables.
Family Hx: Mother is 65 years old, living, and has been diagnosed with high blood pressure and high cholesterol. His father is 70 years old, living and suffering from hypertension and benign prostatic hyperplasia. Grandpa on the mother’s side passed away at age 64 due to heart attack complications. Maternal grandmother died at age 73 from asthma and diabetes related problems. His paternal grandfather passed away at age 71 due to COPD-related illnesses. His paternal grandmother was 55 years old when she passed away from lung cancer. At the age of 45, one sibling was diagnosed with multiple sclerosis. One healthy kid of 10 years old.
ROS:
General: Reported intermittent tingling and numbness in the left limb. No reports of fever, chills, or weight loss.
HEENT: Denies head injury, blurred vision, hearing loss. No changes in smell or taste reported. No complaints of epistaxis. No sore throat was reported.
Skin: No skin lesion, mole, or rash.
Cardiovascular: No reports of heart murmur, chest discomfort, and irregular heartbeat. No edema in the extremities.
Respiratory: No reports of cough or dyspnea.
Neurological: Denies migraines, fainting, or convulsions. No reports of coordination problems.
Musculoskeletal: Pain in the lower back and sometimes in the left leg. Denies that other parts of the body have swollen joints or muscle pain.
Hematologic/Lymphatic: Denies bleeding or bruising. Denies enlarged nodes or history of splenectomy.
Endocrine: No heat or cold intolerance reported. No c/o polydipsia or polyuria.
Objective
Physical Exam:
General: Patient is alert and oriented x3. He is calm and answers interview questions appropriately. He is well-nourished and well- developed. He reports weakness to the left lower extremity.
Vitals: BP- 145/88mmHg; HR- 90bpm and regular; Resp- 19bpm and regular; Temp- 98.5F orally; SPO2 99%R/A; Height- 5’8”; Weight- 166lbs; BMI- 25.2.
Skin: Turgor is good. No rashes or lesions.
HEENT: Head is normocephalic. PERRLA. Conjunctivae negative for exudate and hemorrhage. External auditory canal is patent. Ears are nontender and not swollen. Nares are patent. Nasal mucosa is pink without drainage. Oral mucosa is moist, pink with no lesions. No tonsillar swelling, no pharyngeal swelling.
Cardiovascular/peripheral Vascular: Presence of S1S2 heart sounds during auscultation; no murmurs. Heart rate regular rhythm. Peripheral pulses 2+ symmetrical bilaterally. No peripheral edema.
Respiratory: Chest symmetrical. No adventitious lung sound auscultated.
Gastrointestinal: Abdomen is symmetrical. Normoactive bowel sounds x four quadrants. Abdomen is soft, nontender. No palpable masses.
Musculoskeletal: Low back pain with flexion, extension, and twisting. Limited ROM to lower extremities. No sign of trauma to lower back.
Neurological: Alert and oriented x3. Appropriate affect and mood.
Diagnostic Test:
- Complete blood count (CBC) to verify infection (high WBC count).
- Erythrocyte sedimentation rate (ESR) to detect inflammation.
- A computed tomography (CT) scan to detect unusual tissues and analyze the patient’s spinal status.
- Imaging of the spinal cord and nerves using (MRI) magnetic resonance imaging (Dains et al., 2019).
Assessment
Differential Diagnosis:
- Lumber disc herniation (LDH): Lumbar disc herniation is defined as the movement of disc material (annulus fibrosis or nucleus pulposus) over the intervertebral disc area, causing low back and/or leg pain (Yang et al., 2022). It usually starts with lower back discomfort that spreads down one leg and is often followed by sensations of numbness or tingling in the lower leg. The symptoms of LDH correspond to the patient’s chief concern.
- Sciatica: Sciatica is characterized by radiating and tingling pain down the leg and lower back caused by inflammation or compression of the lumbosacral nerve roots (Jensen et al., 2019). Furthermore, sciatica is frequently brought on by a herniated spinal disk, excessive movement, or heavy lifting, according to Dains et al. (2019). The patient is overweight, and his job requires heavy lifting and recurrent movements, which may contribute to his lower back pain.
- Lumber Spinal Stenosis (LSS): Lumbar spinal stenosis (LSS) is a degenerative disc condition that causes the area encompassing the vertebrae’s neurovascular systems to narrow (Fishchenko et al., 2018). Symptoms of nerve inflammation or compression include discomfort and weakness or numbness in the legs. A history, physical examination, and imaging studies are used to make the diagnosis. The assessment should concentrate on leg or buttock pain while ambulating and stretching to alleviate symptoms (Chagnas et al., 2019).
- Piriformis Syndrome (PS): Muscle spasm in the piriformis and/or irritation of the sciatic nerve in the area are the root causes of piriformis syndrome, as stated by Siddiq & Rasker (2019). Physical examination, patient history, and imaging studies like x-rays are used to determine the diagnosis of PS. The authors indicated that the flexion-adduction-internal rotation test, the Pace sign, and the Freiberg techniques are used to identify individuals with PS. Pain and weakness by resisted abduction and external rotation of the hip while seated suggests signs of Pace. The Freiberg sign manifests as pain and weakness with passive forced internal rotation of the hip in a supine position.
- Lumbar spondylolisthesis: Low back pain, lower limb radiating pain, and sporadic neurogenic claudication are symptoms of lumbar spondylolisthesis, a degenerative condition of the lumbar spine (Wang et al., 2022). The patient’s symptoms match the above statement, too.
References
Chagnas, M.-O., Poiraudeau, S., Lef vre-Colau, M.-M., Rannou, F., & Nguyen, C. (2019).
Diagnosis and management of lumbar spinal stenosis in primary care in france: A survey
of general practitioners. BMC Musculoskeletal Disorders, 20(1).
https://doi.org/10.1186/s12891-019-2782-y
Dains, J.E., Baumann, L.C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St.
Louis, MO: Elsevier Mosby.
Fishchenko, I. V., Kravchuk, L. D., & Perepechay, O. A. (2018). Lumbar spinal stenosis: symptoms, diagnosis and treatment (meta-
analysis of literature data). Pain Medicine, 3(1), 18–32. https:// doi -org.ezp.waldenulibrary.org/10.31636/pmjua.v3i1.83
Jensen, R.K., Kongstead, A., Kjaer, P., & Koes, B. (2019). Diagnosis and treatment of sciatica. BMJ. 16273.
https://doi.org/10.1136/bmj.16273
Siddiq, M. B., & Rasker, J.J (2019). Piriformis pyomyositis, a cause of piriformis syndrome-a systematic search and review. Clinical
Rheumatology, 38(7), 1811-1821. https://doi.org/10.1007/s10067-019-04552-y
Wang, P., Zhang, J., Liu, T., Yang, J., & Hao, D. (2022). Comparison of degenerative lumbar
spondylolisthesis and isthmic lumbar spondylolisthesis: Effect of pedicle screw
placement on proximal facet invasion in surgical treatment. BMC Musculoskeletal
Disorders, 23(1). https://doi.org/10.1186/s12891-021-04962-7
Yang, S., Shao, Y., Yan, Q., Wu, C., Yang, H., & Zou, J. (2021). Differential diagnosis strategy
between lower extremity arterial occlusive disease and lumbar disc herniation. BioMed
Research International, 2021, 1–5. https://doi.org/10.1155/2021/6653579