American Sentinel N522PE Module Five: Neurological & Musculoskeletal Assessment

American Sentinel N522PE Module Five: Neurological & Musculoskeletal Assessment American Sentinel N522PE Module Five: Neurological & Musculoskeletal Assessment Discussion 5 This week you have studied neurological and musculoskeletal advanced physical assessment. While a diverse set of advanced physical assessment skills where do you place your greatest level of confidence and what areas need more development. What methods do you use to remember assessment of cranial nerves, mental status, or other important clinical assessments of persons with neurological or musculoskeletal problems? Of these areas of advanced physical assessment what psychomotor skill is most challenging for you to accomplish? Why? American Sentinel N522PE Module Five: Neurological & Musculoskeletal Assessment Post a concept to the discussion board that you have had difficulty with and note where you are with resolution of these difficulties. Please describe the clinical issue completely, citing your sources so that your classmates can reference the information and provide additional “clinical pearls”. In other words, please include primary sources and/or reliable electronic sources to support your arguments. Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Discussion Participation Guidelines & Grading Criteria. Permalink: https://nursingpaperessays.com/ american-sentine…letal-assessment / Example Discussion Solution and Responses A lot of interesting information was presented in the readings this week as the subject matter was relevant to my current health status. It was a week of personal reflection and well-being as I re-evaluated my current health status. I feel that “empathy” is my middle name when it comes to assessing and conversing with patients who experience migraines, tinnitus, and benign paroxysmal positional vertigo (BPPV). I would get an occasional headache (HA), but never to the point of migraines. I would get occasional lightheadedness or dizziness, however; when BPPV presents itself, it comes on with a vengeance. Migraines and HA’s are two of the most common symptoms of neurological disorders (Bickley, 2017). A year and a half ago my husband and I were in a car accident, hit from behind by a woman who was texting as we were about to come to a stop due to heavy traffic. Our car was sandwiched between the car that hit us and the car in front of us. I knew that I was pretty shaken up, feeling as though I had experienced a concussion or whiplash, but I didn’t realize the seriousness of the accident until a few days later when I was giving bedside report at the end of my shift. As a typical nurse, I thought my blood sugar was low from not eating for 12-hours. I sat and drank some orange juice as we continued with the report, being very thankful I did not pass out in the patient’s room. I have always taken neurological assessments very seriously. Our preeclamptic patients on magnesium sulfate whether they are in antepartum, in labor, or on postpartum are very sick and their neurological status can change within seconds. I continue to implement what I’ve learned over my 32 years of obstetrical nursing experience and look forward to implementing all of the cranial nerve information in my assessment. I find that my bicep reflex needs a little work as I seem to bruise my thumb and not even elicit a contraction of the patient’s bicep muscle (Bickley, 2017). Interestingly, according to Bickley (2017) stroke risk factors for women include autoimmune collagen vascular disease, history of preeclampsia, gestational diabetes, and pregnancy-induced hypertension. I find the musculoskeletal system very intriguing and interesting as it opens up a whole new world of nursing for me. As I continue to receive physical therapy (PT) I am working on strengthening my sternocleidomastoid and masseter muscle to help decrease neck discomfort and ear fullness I currently experience, thus reduce the migraines and dizziness. God willing the BPPV will not reoccur any time soon, if at all. American Sentinel N522PE Module Five: Neurological & Musculoskeletal Assessment Bickley, L. S. (2017). Bate’s Guide to Physical Examination and History Taking (Twelfth ed.). Wolters Kluwer. 454 words Permalink In reply to Diane Re: Discussion 5 – American Sentinel N522PE Module Five: Neurological & Musculoskeletal Assessment by Dona – Thursday, October 22, 2020, 7:39 AM Well done. Describe signs and symptoms consistent with osteoarthritis. 9 words Permalink Show parent In reply to Dona Re: Discussion 5 by Diane – Saturday, October 24, 2020, 10:07 PM Osteoarthritis Osteoarthritis (OA) is a degenerative joint disease that progresses slowly placing stress on the individual’s joints due to the loss of joint cartilage between the bones. OA most frequently occurs in the hips, knees, and hands. OA can also affect the cervical and lumbar spine, wrists, as well as previously injured or diseased joints. Some people call it the “wear and tear” arthritis affecting one or many joints (Osteoarthritis (Oa) | Arthritis | Cdc, 2020). Repetitive injury, obesity, and genetics increase the risk of acquiring OA as this is usually insidious in nature (Bickley, 2017). The Asian population has a lower risk for OA, while women, especially after 50, are more likely to develop OA than men (Osteoarthritis (Oa) | Arthritis | Cdc, 2020). There may be exacerbations of pain and tenderness arising from overuse of the joint or joints as typical symptoms include swelling seen as small joint effusion around the knee where fluid accumulates, or boney enlargement from new bone growth at the cartilage margin (Bickley, 2017). Inflammation may be present with an exacerbation, and possible tenderness and warmth; however, redness is rarely seen. The patient may complain of stiffness that usually lasts briefly in the morning, and with inactivity, perhaps five to ten minutes. There are usually no generalized symptoms noted with OA. Since there is no cure for OA, symptoms are usually treated. These therapies including weight loss, physical therapy, over the counter (OTC) medications, as well as prescribed medications, devices for support as well as surgery if other treatments have failed (Osteoarthritis (Oa) | Arthritis | Cdc, 2020). Limitation of movement often develops; therefore, it is suggested that movement and physical activity is important and helpful as long as you choose activities that are easy on your joints such as swimming, walking and bicycling (Osteoarthritis (Oa) | Arthritis | Cdc, 2020). References Bickley, L. S., MD, FACP. (2017). Bates’ Guide to Physical Examination and History Taking (12th ed.). Wolters Kluwer. Osteoarthritis (oa) | arthritis | cdc. (2020, August 4). https://www.cdc.gov/arthritis/basics/osteoarthritis.htm 333 words Permalink Show parent In reply to Diane Re: Discussion 5 – American Sentinel N522PE Module Five: Neurological & Musculoskeletal Assessment by Merima – Friday, October 23, 2020, 8:34 AM Hi Diane, I am very sorry about your experience and wish you a speedy recovery. I too find musculoskeletal exam very interesting, as well as neurological exam, although both seem to come slightly more difficult to me than cardiac or respiratory exam. This is probably the case, as most of my nursing experience I spent with cardiac and respiratory type patients. With the exams we covered this week I find myself having to go back to readings so I can follow the order of the assessment, it does not come intuitively to me yet. I remembered in nursing school that we use to use mnemonics to remember cranial nerves and the neuro assessment. I do not recall doing the same for musculoskeletal exam. In my searches I found this very interesting video that uses mnemonic PASS for musculoskeletal exams including knees, hips, shoulders etc. PASS stands for “Inspection, Palpation, Active & Passive ROM, Strength, Special Tests”. That really made it easy for me to remember. Some clinicians also use “Look, Move, Feel, and do Special Tests” when performing a physical exam on a particular joint. Since you mentioned that you are intrigued by this system, I thought that you might find these mnemonics useful. Another very interesting and truly brilliant suggestion, when performing musculoskeletal assessment, I found is suggestion to start with the non-affected side first to establish the baseline, so that you know how the affected side should look like. These are all great suggestions that I plan to use in the future. Reference: American Family Physician. (2018, October 22). IPASS 1: Knee Examination Mnemonic Review, Inspection and Palpation [Video]. You Tube. https://www.youtube.com/watch?v=TCuqSqwDOeQ Time of Care. (2020). I PASS: Mnemonic for Musculoskeletal Exam of Shoulder, Knee, etc. https://www.timeofcare.com/i-pass- mnemonic-for-musculoskeletal-exam-of- shoulder-knee etc/#:~:text=I%20PASS%20stands%20for%20Inspection,e.g.%20shoulder%2C%20knee%2C%20etc. 314 words Permalink Show parent In reply to Diane Re: Discussion 5 by Hannah K – Friday, October 23, 2020, 9:47 PM Diane, Sometimes our life experiences help us apply what we do to our own lives. I am sorry to hear about the accident. I find the musculoskeletal and the nervous system interrelated, especially when I think of the makeup and the location of the spinal cord. The spinal cord is encased within the bony vertebral column which terminates at the first or second lumbar vertebrae (Bickley, 2017). An injury to the skeletal structure could mean a disruption to the nervous system. An injury to the sciatic nerve can affect ambulation and by default the skeletal muscle by losing the ability to walk. References Bickley, L. S. (2017). Bates’ guide to physical examination and history taking, 12th ed. (12th ed.). Wolters Kluwer. 121 words American Sentinel N522PE Module Five: Neurological & Musculoskeletal Assessment Assignment 3 Assignment Instructions: For this 4-5 page assignment, you will conduct a focused health history and physical assessment based upon your Practice Experience work in Shadow Health. Particularly, you will complete a focused assessment on Brian, an adult who is complaining of chest pain. Please submit your summary documentation in MS Word. Use the submission parameters and rubric below to guide you in completion of this written assignment. Submission Parameters: For this written assignment, please use the following guidelines and criteria. Also, please refer to the rubric for point allocation and assignment expectations. The expected length of the paper is approximately 4-5 pages, which does not include the cover page and reference page(s). Introduction (including purpose statement) Focus of the assessment Describe the focus of this particular assessment on the patient complaining of chest pain Subjective Component Describe the ROS, PMH, and other relevant data in this section. Objective Component Describe the physical examination findings including techniques of examination Documented evidence to support clinical reasoning Describe the list of differential diagnoses Plan of care Describe the plan of care individualized to findings, life-span stage of development with culturally specific considerations for each focused area of assessment. Conclusion References (use primary and/or reliable electronic sources) In regards to APA format, please use the following as a guide: Include a cover page and running head (this is not part of the 4-5 pages limit) Include transitions in your paper (i.e. headings or subheadings) Use in-text references throughout the paper Use double space, 12 point Times New Roman font Apply appropriate spelling, grammar, and organization Include a reference list (this is not part of the 4-5 pages limit) Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. NCSBN, AANP) Rubric Competency 20 18 16 0 Points Earned Focus of the Assessment is identified with Special Considerations including Documented Focused Health History Documentation clearly shows student has completed a focused assessment with identified special considerations including a well-documented focused health history. American Sentinel N522PE Module Five: Neurological & Musculoskeletal Assessment Documentation supports the student has completed the focused assessment with minimal identification of special concerns. The focused health history is documented. Documentation supports the student has completed the focused assessment without identification of special concerns. The focused health history is documented and lacks depth and specificity of weekly topic. Documentation supports the student attempted to complete the focused assessment without identification of special concerns. The focused health history is briefly documented and lacks depth and specificity of weekly topic. /20 20 18 16 0 Documented Physical Examination Findings including Techniques of Examination Documentation clearly shows student has completed the physical examination and accurately describes the techniques of examination for the week. Documentation supports the student has completed the physical examination and describes the techniques of examination for the week. Documentation supports student completed some of the physical examination for the focused assessment of the week. Documentation is accurate but lacks depth. No evidence that the student is applying read concepts of advanced focused physical assessment. Documentation lacks depth and may lack coherence for understandability of tasks completed in this week. /20 20 18 16 0 Documented Evidence to Support Clinical Reasoning with External Course Resources Discourse clearly shows the student has studied the topic and has given thought to the focused assessed topic and documentation for the week. Discourse supports the student has studied the topic and has given thought to the focused assessment topic and documentation for the week. Discourse supports student studied some of the topic for the focused assessment topic this week. Discourse is accurate but lacks depth. American Sentinel N522PE Module Five: Neurological & Musculoskeletal Assessment No evidence that that student has read or studied the topic. Discourse lacks depth. May be presented in a rambling manner. Content is inaccurate &/or is unclear. /20 20 18 16 0 Individualized Plan of Care Based Upon Clinical Findings Accurately presents an individualized plan of care based upon clinical findings. Presents an individualized plan of care based upon clinical findings. Some minor omissions are noted. Presents a plan of care that is not individualized based upon the clinical findings. A plan of care is not presented or the plan of care presented lacks demonstration of competency or is irrelevant to the clinical findings. /20 5 4 3 0 Developmentally and Culturally Specific Accurately documents a developmentally and culturally specific assessment and plan of care for the selected patient. Documents a developmentally and culturally specific assessment and plan of care. Presents a developmentally and culturally specific assessment or plan of care and one or both are not based upon the selected patient. A developmentally and culturally specific assessment and plan of care are not presented or based upon the selected patient’s findings. /5 5 4 3 0 Demonstration of Compliance with Ethical and Legal Standards of Professional Nursing Practice Compliance with the ethical and legal standards of professional nursing practice is explicitly stated in the documentation of the focused physical assessment. Compliance with the ethical and legal standards of professional nursing practice is stated in the documentation. Compliance with the ethical and legal standards of professional nursing practice is briefly implied in the documentation of the focused physical assessment or inaccuracies are evidenced in the written assessment. Compliance with the ethical and legal standards of professional nursing practice is not included in the documentation of the focused physical assessment. /5 10 9 8 0 Grammar, Spelling, and Punctuation APA Format APA Format, grammar, punctuation and spelling is accurate with no errors. APA Format, grammar, punctuation and spelling is accurate with less than two types of errors. APA Format, grammar, punctuation and spelling is accurate with five or fewer types of errors. APA Format, grammar, punctuation and spelling is accurate with more than five types of errors. /10 COMMENTS: TOTAL: /100 Competency 20 18 16 0 Points Earned Focus of the Assessment is identified with Special Considerations including Documented Focused Health History Documentation clearly shows student has completed a focused assessment with identified special considerations including a well-documented focused health history. Documentation supports the student has completed the focused assessment with minimal identification of special concerns. The focused health history is documented. American Sentinel N522PE Module Five: Neurological & Musculoskeletal Assessment Documentation supports the student has completed the focused assessment without identification of special concerns. The focused health history is documented and lacks depth and specificity of weekly topic. Documentation supports the student attempted to complete the focused assessment without identification of special concerns. The focused health history is briefly documented and lacks depth and specificity of weekly topic. /20 20 18 16 0 Documented Physical Examination Findings including Techniques of Examination Documentation clearly shows student has completed the physical examination and accurately describes the techniques of examination for the week. Documentation supports the student has completed the physical examination and describes the techniques of examination for the week. Documentation supports student completed some of the physical examination for the focused assessment of the week. Documentation is accurate but lacks depth. No evidence that the student is applying read concepts of advanced focused physical assessment. Documentation lacks depth and may lack coherence for understandability of tasks completed in this week. /20 20 18 16 0 Documented Evidence to Support Clinical Reasoning with External Course Resources Discourse clearly shows the student has studied the topic and has given thought to the focused assessed topic and documentation for the week. Discourse supports the student has studied the topic and has given thought to the focused assessment topic and documentation for the week. Discourse supports student studied some of the topic for the focused assessment topic this week. Discourse is accurate but lacks depth. No evidence that that student has read or studied the topic. Discourse lacks depth. May be presented in a rambling manner. Content is inaccurate &/or is unclear. American Sentinel N522PE Module Five: Neurological & Musculoskeletal Assessment /20 20 18 16 0 Individualized Plan of Care Based Upon Clinical Findings Accurately presents an individualized plan of care based upon clinical findings. Presents an individualized plan of care based upon clinical findings. Some minor omissions are noted. Presents a plan of care that is not individualized based upon the clinical findings. A plan of care is not presented or the plan of care presented lacks demonstration of competency or is irrelevant to the clinical findings. /20 5 4 3 0 Developmentally and Culturally Specific Accurately documents a developmentally and culturally specific assessment and plan of care for the selected patient. Documents a developmentally and culturally specific assessment and plan of care. Presents a developmentally and culturally specific assessment or plan of care and one or both are not based upon the selected patient. A developmentally and culturally specific assessment and plan of care are not presented or based upon the selected patient’s findings. /5 5 4 3 0 Demonstration of Compliance with Ethical and Legal Standards of Professional Nursing Practice Compliance with the ethical and legal standards of professional nursing practice is explicitly stated in the documentation of the focused physical assessment. Compliance with the ethical and legal standards of professional nursing practice is stated in the documentation. Compliance with the ethical and legal standards of professional nursing practice is briefly implied in the documentation of the focused physical assessment or inaccuracies are evidenced in the written assessment. Compliance with the ethical and legal standards of professional nursing practice is not included in the documentation of the focused physical assessment. /5 10 9 8 0 Grammar, Spelling, and Punctuation APA Format APA Format, grammar, punctuation and spelling is accurate with no errors. APA Format, grammar, punctuation and spelling is accurate with less than two types of errors. APA Format, grammar, punctuation and spelling is accurate with five or fewer types of errors. APA Format, grammar, punctuation and spelling is accurate with more than five types of errors. /10 COMMENTS: TOTAL: /100 American Sentinel N522PE Module Five: Neurological & Musculoskeletal Assessment Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10