Week 11 Discussion 1: Musculoskeletal Patient
Week 11 Discussion 1: Musculoskeletal Patient
Initial Post
A 41-year-old male patient presents at the community walk-in clinic with complaints of severe elbow pain radiating into the forearm. His 13-year-old daughter is serving as a translator because her father is unable to speak English and understands only a few words in English. The daughter explains that he has been taking Tylenol to manage pain, but the pain is getting worse and is keeping him from working. You ask the daughter to describe the type of work her father does, and you notice she is hesitant to respond, first checking with her father. He responds, and she translates that he works in construction. Based on the response and the apparent concern, you suspect that the patient may be an undocumented worker. Further conversation reveals that several members of the family are working with the same local construction company.
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Initial Post by Wednesday (Day 3) at 11:59 p.m.
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List 10 to 20 additional pieces of subjective information you need to elicit from the patient to help formulate your differential diagnoses and plan. You may not ask questions that were already addressed in the HPI/ROS. You will need two scholarly references for the questions you ask. See the rubric for more detail.
Reply Posts
Initial Response Post by Friday (Day 5) 11:59 p.m. Choose a classmate’s questions to answer:
Choose a classmate’s questions to answer.
Every peer post should have only one response post. Please do not reply to a peer if a response is already posted.
You are answering as the patient. Make it case-appropriate but imaginative. Be creative and answer thoroughly. No references are needed.
Objective
While performing the physical examination, you ask the patient, through his daughter, if he has reported this injury to his employer, because the injury is most likely work-related. The daughter responded without consulting her father that this is an old injury that happened before he started working at his current place of employment. You could tell that she was becoming more distressed. Visual inspection reveals erythema around the affected area with no evidence of overlying skin lesions, scars, or deformities.
Assessment/Plan
When discussing possible treatment approaches, you notice that the patient is very worried and seems to suggest to his daughter that they should leave. The daughter begins trying to explain why they have to leave right away. What would you tell the patient and his daughter to help them feel comfortable staying for treatment?
Reflective Response Post by Sunday (Day 7). Please respond with the following:
Four differential diagnoses and rationales with references. Support your answers with references.
Create a plan of care for that patient.
Plan must include pharmacology, non-pharmacology, labs/diagnostics, referrals/interprofessional communications, patient education (10 to 15 individual items minimum), and follow-up.
Make sure to pick one health maintenance item for this patient (primary or secondary) and explain to the patient why this is important.
Address one existing or potential social determinant of health for this patient during your visit. How will you help the patient overcome this obstacle to health care?
Please refer to the?Grading Rubric?for details on how this activity will be graded.
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Simulated Office Visit Assignment Rubric
Note: Scholarly resources are defined as evidence–based practice, peer–reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.
| Criteria | Exemplary Exceeds Expectations |
Advanced Meets Expectations |
Intermediate Needs Improvement |
Novice Inadequate |
Total Points |
|---|---|---|---|---|---|
| Initial Post | Post includes 10–20 questions of subjective information that are appropriate for the patient vignette. Questions are targeted toward the content of the vignette.
Questions are supported by appropriate references. Initial Post by Wednesday (Day 3) at 11:59 p.m. 30 points |
Post includes questions of subjective information that are appropriate for the patient vignette. Questions are general and NOT targeted toward the content of the vignette.
Questions are supported by appropriate references. Initial Post by Wednesday (Day 3) at 11:59 p.m. 26 points |
Post includes less than 10–20 questions of subjective information and/or are not appropriate for the patient vignette. Questions are vague.
Questions are supported by appropriate references. Initial Post is late. 23 points |
Post includes less than 10–20 questions of subjective information and/or are not appropriate for the patient vignette. Questions are vague or not appropriate for patients.
Questions are NOT supported by appropriate references. Initial Post is late. 20 points |
30 |
| Initial Response Post | Student answers ALL peer’s questions appropriately, as the patient. Answers drive discussion and analysis forward.
Initial Response Post by Friday (Day 5) 11:59 p.m. 30 points |
Student answers ALL peer’s questions appropriately, as the patient. Answers struggle to drive discussion and analysis forward.
Initial Response Post by Friday (Day 5) 11:59 p.m. 26 points |
Student does not answer ALL questions appropriately or from patient perspective.
Initial Response Post by Friday (Day 5) 11:59 p.m. 23 points |
Student does not answer ALL questions appropriately or from patient perspective. Questions are irrelevant or do not makes sense.
Initial Response Post is late. 20 points |
30 |
| Reflective Response Post | Student replies to additional post with 4 appropriate differentials and rationale that are well supported by evidence.
Appropriate and evidence–based plan of care is developed for one differential; supported by references. Reflective Response Post due by Sunday (Day 7) 11:59 p.m. 30 points |
1–2 minor omissions from differentials or plan of care. These do not constitute missing must not miss differentials or safety issues.
Reflective Response Post due by Sunday (Day 7) 11:59 p.m. |
3+ minor omissions from differentials or plan of care. These do not constitute missing must not miss differentials or safety issues.
Reflective Response Post due by Sunday (Day 7) 11:59 p.m. 23 points |
1–2 major omissions from differentials or plan of care. These constitute missing must not miss differentials or safety issues.
Reflective Response Post due by Sunday (Day 7) 11:59 p.m. Responses after Day 7 will not receive any credit. 20 points |
30 |
| Organization | Well–organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.
5 points |
Organized content with minimal issues in content flow.
4 points |
Poor organization, and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work.
3 points |
Illogical flow of ideas. Missing significant content. Prose rambles. Purpose statement is unclear or missing.
Demonstrates incomplete understanding of content and/or inadequate preparation. 2 points |
5 |
| APA, Grammar, and Spelling | Correct APA formatting with no errors.
There are no spelling, punctuation, or word–usage errors 5 points |
Correct and consistent APA formatting of references and cites all references used. No more than two unique APA errors.
The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability. There are minimal to no grammar, punctuation, or word–usage errors. 4 points |
Three to four unique APA formatting errors.
The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused. Multiple grammar, punctuation, or word usage errors. 3 points |
Five or more unique formatting errors or no attempt to format in APA.
The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language). The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented. Grammar and punctuation are consistently incorrect. Spelling errors are numerous. |
5 |
| Total Points | 100 | ||||
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