NUR 634 Topic 8 DQ 1

Discussion: Select one musculoskeletal system or extremity condition or disorder.

NUR 634 Topic 8 DQ 1 Assessment Description

Select one musculoskeletal system or extremity condition or disorder. Then complete the following:
Briefly discuss the condition/disorder.

Describe the symptoms and physical exam findings associated with the condition/disorder.

Identify appropriate laboratory, imaging, and other diagnostic/screening tools that apply to the disorder and explain how they will help you with your diagnosis.

List two other conditions that could cause a similar presentation (differential diagnoses) and explain how you would “rule out” those differentials.

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Support your description with a minimum of two APRN-approved scholarly resources. NUR 634 Topic 8 DQ 1 You may not select a condition or disorder that has already been profiled by another learner; you must select a different one.

American Association of Colleges of Nursing Core Competencies for Professional Nursing Education

This assignment aligns to AACN Core Competencies 1.2, 1.3.

NUR 634 Topic 8 DQ 1 Sample

Fibromyalgia is a chronic musculoskeletal condition characterized by worsening pain. The condition results from alterations in the pain-processing neurotransmission in the brain. Alterations in mono-aminergic neurotransmission result in elevated excitatory neurotransmitters such as glutamate and substance P and decreased serotonin and norepinephrine levels in the spinal cord (Siracusa et al., 2021). This results in the enhancement of the nociceptive pathway in the brain, causing increased pain perception. In other scenarios, nociceptor nerves may have a reduced threshold to pain stimulation, resulting in overstimulation of the pain pathway and hyperalgesia.

Most patients with fibromyalgia present with chronic widespread musculoskeletal pain characterized by multiple joint pain that is mostly constant. NUR 634 Topic 8 DQ 1 In addition, they also have chronic fatigue, insomnia, irritable bowel, and mood symptoms such as increased anxiety, irritability, and decreased attention span. The recommended physical examination for fibromyalgia involves deep palpation of the examiner’s thumb into 18 tender sites (Kang et al., 2021). The sites include a pair at the following points: occiput at the nuchal ridge, trapezius, supraspinatus, gluteus, lower cervical region, second rib, lateral epicondyle, greater trochanter, and medial knee. However, deep palpation of the thumb, distal middle third of the right forearm, and nail of the left thumb need to be used as control sites.

A complete blood test, basic metabolic panel, iron studies, Vitamin D, thyroid function tests, and erythrocyte sedimentation rate (ESR) are crucial in the initial evaluation of the disease. NUR 634 Topic 8 DQ 1 Additionally, imaging tests such as magnetic resonance imaging at different joints are crucial in evaluating the cause of the pain (Qureshi et al., 2021). However, it is essential to note that fibromyalgia lacks a definite imaging and laboratory test; hence, the tests performed are crucial in excluding differential diagnoses such as hypothyroidism myopathy and rheumatoid arthritis (RA). Thyroid function tests are thus crucial in excluding hypothyroidism myopathy. On the other hand, an elevation in ESR can differentiate fibromyalgia from RA.

NUR 634 Topic 8 DQ 1 References

Kang, H., Choi, E., Park, J., & Lee, S. (2021). Disentangling Diagnosis and Management of Fibromyalgia. Journal of Rheumatic Diseases, 29(1), 4-13. https://doi.org/10.4078/jrd.2022.29.1.4

Qureshi, A. G., Jha, S. K., Iskander, J., Avanthika, C., Jhaveri, S., Patel, V. H., Potini, B. R., & Azam, A. T. (2021). Diagnostic Challenges and Management of Fibromyalgia. Cureus, 13(10). https://doi.org/10.7759/cureus.18692

Siracusa, R., Paola, R. D., Cuzzocrea, S., & Impellizzeri, D. (2021). Fibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options Update. International Journal of Molecular Sciences, 22(8). https://doi.org/10.3390/ijms22083891 NUR 634 Topic 8 DQ 1