Evaluation and Management of Musculoskeletal Disorders
In clinical settings, patients often present with musculoskeletal disorders such as chronic back pain. Drugs are typically prescribed to help manage this type of pain for patients. Of all drugs prescribed, narcotic analgesics are one of the most common, with over 238 million prescriptions prescribed in 2011 (IMS Health, 2012). This prevalence of prescribing narcotics has led to controversy among patients, providers, pharmacies, and lawmakers. Due to the short- and long-term effects of narcotic drugs, the controversy spans from overuse of narcotics to non-medical use of narcotics. For advanced practice nurses, it is essential to carefully observe and watch for signs of drug abuse during patient evaluations. Because not all musculoskeletal disorders require narcotics, a thorough patient evaluation will help to ensure the development of an appropriate treatment plan with patient safety in mind.
This week, you examine the process of evaluating and prescribing treatment to patients with musculoskeletal disorders. You also explore the ethical implications of prescribing narcotics for pain.
Learning Objectives
By the end of this week, students will:
•Assess differential diagnoses for patients with musculoskeletal disorders
•Analyze the role of patient information in differential diagnosis for musculoskeletal disorders
•Evaluate patient treatment options, including opioids, for patients with musculoskeletal disorders
•Understand and apply key terms, concepts, and principles related to musculoskeletal disorders and the opioid epidemic
•Analyze pattern recognition in patient diagnoses
Learning Resources
Required Readings
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2017). Primary care: A collaborative practice (5th ed.). St. Louis, MO: Elsevier.
•Part 19, “Evaluation and Management of Multisystem Disorders”
•Chapter 222, “Chronic Pain” (pp. 1186-1188)
•Part 15, “Evaluation and Management of Musculoskeletal and Arthritic Disorders” (pp. 897-998)
This part covers the pathophysiology, clinical manifestations, and management of musculoskeletal disorders. It also explores diagnostic tests for diagnosing these disorders.
•Part 18, “Evaluation and Management of Rheumatic Disorders” (pp. 1152-1180)
•This chapter examines the epidemiology, pathophysiology, clinical presentation, and evaluation of rheumatic disorders, including rheumatoid arthritis and systemic lupus E. It also provides a differential diagnosis for rheumatic disorders.
Centers for Disease Control and Prevention. (2017). Opioid overdose. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html
American Nurses Association. (2016). The Opioid epidemic: Addressing the growing drug overdose problem. Retrieved from http://nursingworld.org/DocumentVault/Health-Policy/Issue-Briefs/ANA-IssueBrief-Opioid-Epidemic.pdf
Centers for Disease Control and Prevention. (2017). What states need to know about PDMPs. Retrieved from https://www.cdc.gov/drugoverdose/pdmp/states.html
Document: Comprehensive SOAP Note Exemplar (Word document)
Document: Comprehensive SOAP Note Template (Word document)
Assignment 1: Practicum Experience – Comprehensive SOAP Note #3
After completing this week’s Practicum Experience, review the Comprehensive SOAP Note Exemplar and Template in this week’s Resources, and reflect on a patient who presented with musculoskeletal disorders or pain. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care.
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