Write a nursing care plan for this client that includes a short-term and long-term SMART goal for the priority diagnosis
Interpret the health history and physical assessment findings of the musculoskeletal system.
Describe the special considerations in the assessment of the musculoskeletal system.
Fortunately, when assessing musculoskeletal problems of the upper and lower extremities, it is common to have an uninjured area from the opposite side of the body for comparison. The value of this type of reference point cannot be underestimated, as comparing one side to the other allows the nurse to better understand factors like the limitations of range of motion, the extent of swelling, and the strength of the area.
It’s also worth remembering that, due to the pain that may be present and aggravated at the time of the physical exam, that examination may be the only opportunity to gather certain information. During repeated exams, a patient’s apprehension at the recurrence or worsening of pain can lead them to unknowingly “stiffen” their muscles and limit the accuracy of measurements.
Read the following case scenario:
You are working at the campus clinic when Rebecca Clark, a 22-year-old female junior English major, comes in complaining of bilateral knee pain. The pain began after she spent the weekend installing carpet in an upstairs bedroom. She was not using any knee pads. She claims to never have had knee problems before, and she says her knees look swollen where they hurt (pain is 5 on an 1 to 10 scale). On exam, you notice bilateral lower patellar knee swelling, intact skin, and normal skin coloration. The bony anatomy of the tibial tuberosity is obscured by bilateral swelling. Mild heat on palpation is noted. Positive bulge sign and ballottement is noted bilaterally. These two exams are tender to the patient. Bilateral range of motion is normal and there is no varus nor valgus abnormalities. Gait is grossly normal, but does aggravate the pain.
Navigate to the threaded discussion and respond to the following:
What types of assessment techniques would you use to assess a client with this type of injury?
Explain the special considerations, such as the symptoms in the scenario above, that nurses should be aware of when assessing the musculoskeletal system, interpreting findings, and planning nursing care for clients.
How would you interpret your findings in relation to the case scenario? What nursing diagnoses related to the musculoskeletal system are indicated?
Write a nursing care plan for this client that includes a short-term and long-term SMART goal for the priority diagnosis and at least four evidence-based nursing interventions, including rationales. What should this client be taught immediately? What should this client be taught concerning her future healthcare needs?
Incorporate at least one scholarly, evidence-based resource to support your response. Include citations and references for sources using correct APA formatting.
Share your personal experiences with the history taking, physical assessment, and interpretation of findings related to the musculoskeletal system in clients with special considerations:
What were the challenges?
How did you overcome these challenges?