10/17/23, 5:31 PM Topic: Week 8: Discussion

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This is a graded discussion: 100 points possible
due Oct 18 at 10:59pm

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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 provides 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.

ASSESSING MUSCULOSKELETAL PAIN

RESOURCES

10/17/23, 5:31 PM Topic: Week 8: Discussion

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To prepare:

By Day 1 of this week, you will be assigned to one of the following specific case studies for this
Discussion. Please see the “Course Announcements” section of the classroom for your
assignment from your Instructor.
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.
Review the following case studies:

Case 1: Back Pain

(https://waldenu.instructure.com/courses/85632/files/5407561/preview) 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?

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES (https://waldenu.instructure.com/courses/85632/modules/items/2747342)

10/17/23, 5:31 PM Topic: Week 8: Discussion

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Case 2: Ankle Pain

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courses/85632/files/5407623/preview)

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 Ottawa ankle rules to determine
if you need additional testing?

10/17/23, 5:31 PM Topic: Week 8: Discussion

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Case 3: Knee Pain

(https://waldenu.instructure.com/courses/85632/files
/5407665/preview)

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?

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: When you submit your initial post, please include a header as the first line
indicating your assigned case study. For example, “Review of Case Study ___.” Fill in
the blank with the number of the case study you were assigned.

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 the 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.

BY DAY 3 OF WEEK 8

10/17/23, 5:31 PM Topic: Week 8: Discussion

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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 Reply button to complete your initial post. Remember, once you click on Post
Reply, you cannot delete or edit your own posts and you cannot post anonymously.
Please check your post carefully before clicking on Post Reply!

Read a selection of your colleagues' responses.

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.

BY DAY 6 OF WEEK 8

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MSN 5550 Health Promotion: Prevention of Disease
Case Study Module 10

Instructions: Read the following case study and answer the reflective questions. Please provide
evidence-based rationales for your answers. APA, 7th ed. must be followed.

Deadline: Due by Saturday at 23:59 p.m.

CASE STUDY: Preschool Child: Ricky

Ricky, age 4 years, arrives in the clinic with his mother. Ricky lives with his mother and father,
who both work full-time, and his infant sister. Their extended family lives in a different state
more than 100 miles away. Both parents are of average height and in good health. Ricky’s
mother mentions that Ricky often expresses frustration, particularly in regard to food. Conflict
over food occurs every day. Mealtime is a battle to get him to eat, unless his mother feeds him.
Ricky’s baby sister seems to tolerate all baby foods but requires her mother to spoon-feed.
Ricky’s mother is quite frustrated and concerned that he will become malnourished.

Reflective Questions

1. What additional assessment information would you collect?

2. What questions would you ask, and how would you further explore this issue with the
mother?

3. In what ways does the distance of the extended family influence this family’s approach

to health promotion?

4. What factors would you consider to determine whether malnourishment is a factor in
this family?