Alterations in Neuromotor Functions Discussion Essay Paper

NURS 6105N WEEK 8 MODULE  5 ASSIGNMENT

TOPIC: CASE STUDY ANALYSIS

An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other.

Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role. Alterations in Neuromotor Functions Discussion Essay Paper

An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

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Week 8 Case Scenario

A 58-year-old obese white male presents to ED with chief complaint of fever, chills, pain, and swelling in the right great toe. He states the symptoms came on very suddenly and he cannot put any weight on his foot. Physical exam reveals exquisite pain on any attempt to assess the right first metatarsophalangeal (MTP) joint. Past medical history positive for hypertension and Type II diabetes mellitus. Current medications include hydrochlorothiazide 50 mg po q am, and metformin 500 mg po bid. CBC normal except for elevated sedimentation rate (ESR) of 33 mm/hr and C-reactive protein (CRP) 24 mg/L. Metabolic panel normal. Uric acid level 10.7 mg/dl. Alterations in Neuromotor Functions Discussion Essay Paper

INSTRUCTIONS:

The Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following:

• Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
• Any racial/ethnic variables that may impact physiological functioning.
• How these processes interact to affect the patient.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templatesLinks to an external site.). All papers submitted must use this formatting. Alterations in Neuromotor Functions Discussion Essay Paper

REQUIRED READING:

• McCance, K. L. & Huether, S. E. (2019). Pathophysiology: the biologic basis for disease in adults and children(8th ed.). St. Louis, MO: Mosby/Elsevier.
  • Chapter 15: Structure and Function of the Neurologic System
  • Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function (stop at Sleep); Summary Review
  • Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function (start at Acute confusional states and delirium) (stop at Alterations in neuromotor functions); (Parkinson’s Disease); Summary Review
  • Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction (stop at Degenerative disorders of the spine); (start at Cerebrovascular disorders) (stop at Tumors of the central nervous system); Summary Review
  • Chapter 44: Structure and Function of the Musculoskeletal System (stop at Components of muscle function); Summary Review
  • Chapter 45: Alterations of Musculoskeletal Function (stop at Bone tumors); (start at Disorders of joints); Summary Review
  • Chapter 47: Structure, Function, and Disorders of the Integument (section on Lyme Disease) Alterations in Neuromotor Functions Discussion Essay Paper

Case Study Analysis

Specific neurological and musculoskeletal pathophysiologic processes would account for the 58-year old patient presenting symptoms of pain, fever, chills and swelling in the right great toe. Considering that the patient had a known history of diabetes mellitus and hypertension, a more likely clinical diagnosis based on the presenting symptoms is osteomyelitis. In relation to the musculoskeletal pathophysiologic of osteomyelitis, this condition tend to occlude blood vessels, triggering local spread of infection and bone necrosis. Momodu and Savaliya (2023) explained that this condition which affects the musculoskeletal system includes a wide range of disease mechanisms with the most common categories being contiguous contamination, hematogenous (blood borne) spread and neurologic or vascular insufficiency-associated infection. Whilst contiguous infection gains traction from an infected site, primary hematogenous spread of bacteria in the bloodstream largely affects the metaphysics of skeletally-immature patients as well as vertebral bodies at all ages (Jha & Chaudhary, 2022). On the other hand, neurologic or vascular insufficiency associated with this condition occurs due to a range of factors including diabetic wounds, poor blood supply, altered immune defenses and decline in protective sensation, most often inflicting the lower extremity. In terms of effects on the nervous system, a patient with vertebral osteomyelitis tend to experience localized back pain as well as compression of the nerve roots or spinal code, causing numbness or extremity weakness and radicular pain as well as the onset of neurological deficits (Shikhare & Peh, 2019).

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Research has shown that racial/ethnic variables could have implications on the physiological functioning of patients. Carvour, Chiu and Page (2019) noted that although race/ethnicity have no recognized effect on the risk for osteomyelitis, the genetic basis of race and ethnic may offer insights into the role of ethnic variables. Campbell et al. (2023) noted that significant differences in the length of stay (LOS) for patients with acute osteomyelitis, with patients from racial/ethnic minorities experiencing prolonged LOS in comparison to their white counterparts. Moreover, Xie et al. (2021) commented that both genetic and environmental factors play a role in the occurrence of bacterial osteomyelitis, and populations who experience gene polymorphisms (e.g. single-nucleotide polymorphisms) have been identified to be increasingly vulnerable to this condition. Although the current research findings on the specific racial/racial variables that may impact physiological functioning is still inconclusive, further empirical investigation is needed to link racial/ethnic factors to the pathogenesis of osteomyelitis. Alterations in Neuromotor Functions Discussion Essay Paper

The interaction between neurological and musculoskeletal pathophysiological processes has effects on the patient. Nather and Chan (2023) noted that an immune-compromised patient with this condition may report a range of symptoms including pain in the infected area, fever, neurological deficits, chills, erythema and swelling at the site of infection. Similarly, Birt et al. (2017) insisted that in subacute presentations, some patients may experience mild pain and generalized malaise over a couple of weeks in the case of acute osteomyelitis. Research indicates that the occurrence of bone inflammation and pain in adults could lead to impairment in physical function, thus affecting the patient’s quality of life. Equally, a significant reduction in the patient’s immune responses as indicated by a positive past medical history for hypertension and diabetes mellitus could mean that interactions of neurological and pathophysiologic processes are largely responsible for the worsening health condition, and subsequent hospitalization of the patient in the emergency department (Momodu & Savaliya, 2023; Jha & Chaudhary, 2022). These findings indicate that whilst many of the adult patients with this condition tend to present vague complaints, the both contiguous and hematogenous osteomyelitis have the potential to advance to a chronic condition. Alterations in Neuromotor Functions Discussion Essay Paper