Assignment: i-Human Case Study: Evaluating and Managing Musculoskeletal Conditions
Patients frequently present with complaints of pain, such as chronic back pain. They often seek medical care with the intent of receiving drugs to manage the pain. Typically, for this type of pain, narcotic drugs are often prescribed. This can pose challenges for you as the advanced practice nurse prescribing the drugs. While there is a process for evaluating back pain, it can be difficult to assess the intensity of a patient’s pain since pain is a subjective experience. Only the person experiencing the pain truly knows whether there is a need for drug treatments.
For this Case Study Assignment, you will analyze an i-Human simulation case study about an adult patient with a musculoskeletal condition. Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and create an appropriate treatment plan for the patient.
Photo Credit: SCIEPRO / Science Photo Library / Getty Images
To prepare:
Review this week’s Learning Resources. Consider how to assess, diagnose, and treat patients with musculoskeletal conditions.
Access i-Human from this week’s Learning Resources and review this week’s i-Human case study. Based on the provided patient information, think about the health history you would need to collect from the patient.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
Identify three to five possible conditions that may be considered in a differential diagnosis for the patient.
Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
Develop a treatment plan for the patient that includes health promotion and patient education strategies for patients with musculoskeletal conditions.
Assignment: i-Human Case Study: Evaluating and Managing Musculoskeletal Conditions
Assignment
As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Graduate Programs Help link within the i-Human platform.
By Day 7
Complete your Assignment in i-Human.
Submission and Grading Information
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Grading Criteria
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Week 9 Assignment Rubric
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Submit your Week 9 Assignment draft and review the originality report.
Submit Your Assignment by Day 7
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Week 9 Assignment
What’s Coming Up in Week 10?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
Next week, you will analyze an i-Human simulation case study about a neurologic condition. Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and create an appropriate treatment plan for the patient.
Module 4 Knowledge Check
In Week 10, you will complete the next Knowledge Check, which covers the Module 4 topics from Weeks 9 and 10. Refer to the Week 10 Knowledge Check Assignment for further details related to the topics covered. Plan your time accordingly.
Photo Credit: ARTQU / iStock / Getty Images Plus / Getty Images
To go to the next week:
Week 9: Evaluation and Management of Musculoskeletal Conditions
In clinical settings, patients often present with musculoskeletal conditions such as chronic back pain. In recent years, there has been a dramatic increase in the acceptance and use of prescription opioids to help patients manage chronic, non-cancer pain, such as back pain or osteoarthritis, despite serious risks and the lack of evidence about their long-term effectiveness (Centers for Disease Control and Prevention, 2017). Of all drugs prescribed, opioids are one of the most common, with more than 168 million prescriptions prescribed in 2018 in the United States and prescribing rates varying widely across different states and counties (Centers for Disease Control and Prevention, 2020b). 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 conditions require narcotics, a thorough patient evaluation will help to ensure the development of an appropriate treatment plan with patient safety in mind.
For this week, you will analyze an i-Human simulation case study about an adult patient with a musculoskeletal condition. Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and create an appropriate treatment plan for the patient.
Learning Objectives
Students will:
Formulate differential diagnoses for adult patients with musculoskeletal conditions
Analyze pattern recognition in adult patient diagnoses
Analyze the role of patient information in differential diagnosis
Evaluate pharmacologic and non-pharmacologic treatment options for adult patients
Create an appropriate treatment plan that includes health education and follow-up care
Learning Resources
Required Readings (click to expand/reduce)
Buttaro, T. M., Trybulski, J., Polgar-Bailey, P., & Sandberg-Cook, J. (2021). Primary care: Interprofessional collaborative practice (6th ed.). Elsevier.
Part 15, “Evaluation and Management of Musculoskeletal and Arthritic Disorders” (pp. 950–1051)
Chapter 154, “Ankle and Foot Pain”
Chapter 155, “Bone Lesions: Neoplasms and Tumor Mimickers”
Chapter 156, “Bursitis”
Chapter 157, “Fibromyalgia and Myofascial Pain Syndrome”
Chapter 158, “Gout”
Chapter 159, “Septic Arthritis”
Chapter 160, “Low Back Pain”
Chapter 161, “Hip Pain”
Chapter 162, “Knee Pain”
Chapter 163, “Metabolic Bone Disease: Osteoporosis and Paget’s Disease of the Bone”
Chapter 164, “Neck Pain”
Chapter 165, “Osteoarthritis”
Chapter 166, “Osteomyelitis”
Chapter 167, “Shoulder Pain”
Chapter 168, “Sprains, Strains, and Fractures”
Chapter 169, “Elbow Pain”
Chapter 170, “Hand and Wrist Pain”
Part 18, “Evaluation and Management of Rheumatic Disorders” (pp. 1196–1207, 1216–1228)
Chapter 195, “Polymyalgia Rheumatica and Giant Cell Arteritis”
Chapter 196, “Raynaud’s Phenomenon”
Chapter 197, “Rheumatoid Arthritis”
Chapter 199, “Systemic Lupus Erythematosus”
Chapter 200, “Vasculitis”
Centers for Disease Control and Prevention. (2020a). Opioid overdose. https://www.cdc.gov/drugoverdose/epidemic/index.html
American Nurses Association. (2018, August). The opioid epidemic: The evolving role of nursing. https://www.nursingworld.org/~4a4da5/globalassets/practiceandpolicy/work-environment/health–safety/opioid-epidemic/2018-ana-opioid-issue-brief-vfinal-pdf-2018-08-29.pdf
Centers for Disease Control and Prevention. (2020c). What states need to know about PDMPs. https://www.cdc.gov/drugoverdose/pdmp/states.html
Required Media (click to expand/reduce)
Musculoskeletal Disorders
Dr. Helene Creger discusses musculoskeletal disorders and what to look for as you assess your patient. (20m)
Case Study: Evaluating Back Pain
This media presentation features an evaluation of a patient with back pain. (7m)
i-Human Patients. (2020a). i-Human case player [Interactive media]
Knee Exams
Ebraheim, N. (2015, August 21). Tests for examination of the knee – everything you need to know – Dr. Nabil Ebraheim [Video]. YouTube. https://www.youtube.com/watch?v=c3643PM0a2o&feature=youtu.be
Note: The approximate length of this media piece is 17 minutes.
