NR305 Week 7 Discussion: Assessment of the Musculoskeletal System and Pain

This week’s graded discussion topic relates to the following Course Outcomes (COs).

CO1 Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1)
CO2 Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO 1)
CO3 Utilize effective communication when performing a health assessment. (PO 3)

Fred is an 83-year-old male who is being admitted to the medical-surgical unit status post fall. He is alert and oriented and reports that while visiting a local casino with his wife Margaret earlier this evening, he tripped over a curb and fell landing on his right side.

After receiving morphine in the emergency room prior to transfer to your unit, Fred is rating his pain at 6/10. He has multiple bruises from his jawbone to his knee as well as a slight rotation of his right leg.

Past medical history includes: myocardial infarction (MI) x 2, peripheral vascular disease (PVD) with bilateral iliac stents, non-insulin-dependent diabetes mellitus (NIDDM), sleep apnea, and degenerative joint disease.

Medications include: aspirin, Plavix, Lopressor, Lisinopril, and Metformin.

After reviewing the above scenario please answer the following questions.

Based on the information provided, how will you prioritize your care, what assessments will you include and in what order? Please provide rationale for your response.
Considering this patient’s age, injury, past medical history, and list of current medications, what, if any, concerns do you have related to his potential need for surgery?
Should surgery to repair his right femur be required; what type of clearance and pre-op orders would you anticipate receiving related to his diet, meds, lab work, and so on?

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NR305 Week 8 Discussion: Rapid Assessment of a Client

This week’s graded discussion topic relates to the following Course Outcomes (COs).

CO1 Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1)
CO2 Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO 1)
CO3 Utilize effective communication when performing a health assessment. (PO 3)
CO5 Explore the professional responsibilities involved in conducting a comprehensive health assessment and provide appropriate documentation. (PO 6)

Please choose one of the patient scenarios below. Next, complete a rapid assessment, and provide a SBAR report to a classmate. Remember to include all concepts of patient safety, standard precautions, and professional standards.

You are covering for a coworker who is off the floor for lunch, when you suddenly hear a loud crash coming from a nearby patient room. You quickly run in and discover Mr. Johnson who was admitted yesterday with a diagnosis of cerebral vascular accident (CVA) unconscious on the floor between the bed and the bathroom.

You are called to the room of 2-year-old Jonah by his mother who states the child has suddenly started breathing very loudly and does not look right. Upon entering the room you quickly recognize that the child is in respiratory distress as his lips are cyanotic and the use of accessory muscles is evident.

You are in the process of admitting Ashley, a 27 year old who is 28 weeks pregnant with her first child, to the obstetric unit for complaints of headache, dizziness, and swelling of her lower extremities when she suddenly begins seizing.

NR305 Week 7 Discussion: Assessment of the Musculoskeletal System and Pain