NURS 6501 Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders

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NURS 6501 Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders – Step-by-Step Guide

The first step before starting to write the NURS 6501 Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. 

It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.

How to Research and Prepare for NURS 6501 Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last words and go through each to check for credibility. Ensure that you obtain the references in the required format, for example, in APA, so that you can save time when creating the final reference list. 

You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for NURS 6501 Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders

The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested to read through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for NURS 6501 Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence conducted from the research, ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between each paragraph by using transition words and a flow of ideas.

How to Write the In-text Citations for NURS 6501 Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders

In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.

How to Write the Conclusion for NURS 6501 Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders

When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.

How to Format the Reference List for NURS 6501 Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456

Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

NURS 6501 Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders Instructions

In this exercise, you will complete a 5-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

Concepts of Neurological and Musculoskeletal Disorders Scenarios

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. Have a look at NURS 6501 Module 5 Assignment: Case Study Analysis

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:

1-Explain the pathophysiology of gout.

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:

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

Scenario 2: Osteoporosis

A 78-year-old female was out walking her small dog when her dog suddenly tried to chase a  rabbit and made her fall. She attempted to try and break her fall by putting her hand out and she landed on her outstretched hand. She immediately felt severe pain in her right wrist and noticed her wrist looked deformed. Her neighbor saw the fall and brought the woman to the local ER for evaluation. Radiographs revealed a Colles’ fracture (distal radius with dorsal displacement of fragments) as well as radiographic evidence of osteoporosis. A closed reduction of the fracture was successful, and she was placed in a posterior splint with ace bandage wrap and instructed to see an orthopedist for follow up.  

Question:

3-Discuss what is osteoporosis and how does it develop pathologically? 

Scenario 3: Rheumatoid Arthritis

A 48-year-old woman presents with a five-month history of generalized joint pain, stiffness, and swelling, especially in her hands. She states that these symptoms have made it difficult to grasp objects and has made caring for her grandchildren problematic. She admits to increased fatigue, but she thought it was due to her stressful job.

FH: Grandmothers had “crippling” arthritis. 

PE: remarkable for bilateral ulnar deviation of her hands as well as soft, boggy proximal interphalangeal joints. The metatarsals of both of her feet also exhibited swelling and warmth. 

Diagnosis: rheumatoid arthritis.

Question:

4-The pt. had various symptoms, explain how these factors are associated with RA and what is the difference between RA and OA? 

Scenario 5: Multiple Sclerosis (MS)

A 28-year-old obese, female presents today with complaints for several weeks of vision problems (blurry) and difficulty with concentration and focusing. She is an administrative para-legal for a law firm and notes her symptoms have become worse over the course of the addition of more attorneys and demands for work. Today, she noticed that her symptoms were worse and were accompanied by some fine tremors in her hands. She has been having difficulty concentrating and has difficulty voiding. She went to the optometrist who recommended reading glasses with small prism to correct double vision. She admits to some weakness as well. No other complaints of fevers, chills, URI or UTI

PMH: non-contributory

PE: CN-IV palsy. The fundoscopic exam reveals edema of right optic nerve causing optic neuritis. Positive nystagmus on positional maneuvers. There are left visual field deficits. There was short term memory loss with listing of familiar objects.

DIAGNOSIS: multiple sclerosis (MS).

5-Question:

Describe what is MS and how did it cause the above patient’s symptoms?

NURS 6501 Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders Sample Approach

Explain the Pathophysiology of Gout

Gout refers to chronic inflammatory arthritis designated by the accumulation of monosodium urate monohydrate crystals in tissues (Narang & Dalbeth, 2020). Approximately 4% of the world’s population is affected by gout (Narang & Dalbeth, 2020). Gout is considered a complex metabolic disorder whose pathophysiology encompasses an interplay of modifiable and non-modifiable factors. Modifiable factors include obesity, hypertension, hyperlipidemia, diet, alcohol, medications, diabetes mellitus, and cardiovascular disease (Narang & Dalbeth, 2020).

Meanwhile, non-modifiable factors include male gender, advanced age, family history, and ethnicity. Elevated urate levels are necessary for the development of gout. This may result from overproduction due to alterations in purine synthesis and degradation pathways, as well as renal underexcretion of urate. Elevated urate and uric acid levels result in supersaturation and precipitation of monosodium urate monohydrate crystals in tissues, particularly the synovium, kidney, bone, ligament, skin, and tendon. This process may be asymptomatic.

In some individuals, however, the deposition of these crystals induces an acute inflammatory response mediated by innate immune system activation (Narang & Dalbeth, 2020). Additionally, some patients develop advanced gout characterized by structural joint damage mediated by the direct effects of monosodium urate monohydrate crystals on tissues, as well as indirect effects of joint inflammation.

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

Patients with gout typically have elevated urate and uric acid in their blood (McCance & Huether, 2019). Uric acid is a weak organic acid and hence exists in the non-ionized form in acidic states, such as in urine. The non-ionized form is less soluble and, therefore, prone to precipitation and crystallization, resulting in the formation of calculi. Individuals with gout tend to develop renal calculi since their increased pool of urate stresses the kidney, which is tasked with urate excretion.

Urine is acidic. A low urinary pH contributes to uric acid calculi formation by altering the dissolution of uric acid, leading to its precipitation (Ma et al., 2018). Similarly, patients with gout have altered urate transporters in the proximal tubule, resulting in diminished fractional excretion of uric acid, hence predisposing to stone formation (Ma et al., 2018). Finally, individuals with gout have low levels of crystallization inhibitors such as glycosaminoglycans, further predisposing them to stone formation.

Discuss what is osteoporosis and how does it develop pathologically? 

Osteoporosis is a chronic metabolic bone disease characterized by increased bone fragility (McCance & Huether, 2019). Approximately 200 million people worldwide suffer from osteoporosis (Föger-Samwald et al., 2020). Osteoporosis commonly affects females and its incidence increases with age. Osteoporosis is a chronic progressive condition and can be primary or secondary. Primary osteoporosis is an outcome of aging and diminished sex hormones, while secondary osteoporosis results from other disease processes.

Normally, bone formation and bone resorption are in a fair balance. Consequently, conditions that increase bone resorption or decrease bone resorption interfere with bone microarchitecture, leading to decreased skeletal mass and increased bone fragility. Several factors, including environmental and genetic, have been implicated in the development of osteoporosis. For instance, increasing age, low body mass index, use of corticosteroids, family history of osteoporosis, decreased levels of physical activity, early menopause, smoking, female gender, and alcohol intake (McCance & Huether, 2019).

The pt. had various symptoms. Explain how these factors are associated with RA and what the difference is between RA and OA. 

Rheumatoid arthritis is a chronic systemic inflammatory disease that principally involves the synovial joints, although it can also present with extraarticular features (Lin et al., 2020). The patient had several articular manifestations of rheumatoid arthritis, including polyarthralgia, swelling, stiffness, and boggy proximal interphalangeal joints. Rheumatoid arthritis predominantly involves the hands and feet, particularly the metacarpophalangeal and proximal interphalangeal joints (Lin et al., 2020). Similarly, rheumatoid arthritis is three times more common in females than males and a family history significantly increases the risk.

Additionally, constitutional symptoms such as fatigue are common in patients with rheumatoid arthritis because it is a systemic disorder. Rheumatoid arthritis differs significantly from osteoarthritis. Rheumatoid arthritis is an autoimmune inflammatory condition, while osteoarthritis is considered a degenerative disease due to the degradation of the articular cartilage. Consequently, osteoarthritis develops gradually as opposed to the acute development of rheumatoid arthritis. In contrast to rheumatoid arthritis, osteoarthritis affects weight-bearing joints such as the knee, hip, and lower back. Finally, extraarticular manifestations are absent in patients with osteoarthritis.

Describe what MS is and how it caused the above patient’s symptoms.

Multiple sclerosis refers to an immune-mediated inflammatory disease of the central nervous system that results in demyelination, gliosis, and neuronal loss (Dobson & Giovannoni, 2019). According to Dobson and Giovannoni (2019), multiple sclerosis stems from acquired immune dysregulation and anomalous immune activation, leading to an inflammatory process resulting in demyelination and axonal damage.

The exact etiology of this condition remains unclear, although genetic and environmental factors have been implicated. This disabling condition commonly affects young and middle-aged adults. The patient in the scenario presented with various neurological manifestations, including tremors, impaired memory, difficulty voiding, difficulty concentrating, weakness, and blurring of vision. These symptoms correlate with multifocal areas of demyelination, predominantly in the brain, spinal cord, and optic nerves. 

References

Dobson, R., & Giovannoni, G. (2019). Multiple sclerosis – a review. European Journal of Neurology: The Official Journal of the European Federation of Neurological Societies, 26(1), 27–40. https://doi.org/10.1111/ene.13819

Föger-Samwald, U., Dovjak, P., Azizi-Semrad, U., Kerschan-Schindl, K., & Pietschmann, P. (2020). Osteoporosis: Pathophysiology and therapeutic options. EXCLI Journal, 19, 1017–1037. https://doi.org/10.17179/excli2020-2591

Lin, Y.-J., Anzaghe, M., & Schülke, S. (2020). Update on the pathomechanism, diagnosis, and treatment options for rheumatoid arthritis. Cells (Basel, Switzerland), 9(4), 880. https://doi.org/10.3390/cells9040880

Ma, Q., Fang, L., Su, R., Ma, L., Xie, G., & Cheng, Y. (2018). Uric acid stones, clinical manifestations and therapeutic considerations. Postgraduate Medical Journal, 94(1114), 458–462. https://doi.org/10.1136/postgradmedj-2017-135332

McCance, K., & Huether, S. (2019). Pathophysiology: The biologic basis for disease in adults and children 8e (8th ed.). Mosby.

Narang, R. K., & Dalbeth, N. (2020). Pathophysiology of gout. Seminars in Nephrology, 40(6), 550–563. https://doi.org/10.1016/j.semnephrol.2020.12.001