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NURS 6521 Decision Tree for Neurological and Musculoskeletal Disorders Assignment Example
NURS 6521 Decision Tree for Neurological and Musculoskeletal Disorders Assignment
NURS 6521 Decision Tree for Neurological and Musculoskeletal Disorders Assignment Brief
Course: NURS 6521 – Advanced Pharmacology
Assignment Title: NURS 6521 Decision Tree for Neurological and Musculoskeletal Disorders Assignment
Assignment Instructions Overview
This assignment requires students to engage with an interactive media piece focusing on patient case studies involving neurological and musculoskeletal disorders. Each student will analyze the symptoms presented in the case study assigned by the instructor and develop a decision tree for diagnosis and treatment.
Understanding Assignment Objectives
The primary objective of this assignment is for students to demonstrate their ability to assess and treat patients presenting symptoms of neurological and musculoskeletal disorders. By engaging with interactive media resources, students will integrate theoretical knowledge with practical decision-making skills in clinical scenarios.
The Student’s Role
Students will critically analyze the patient case study provided through the assigned interactive media piece. They will formulate three key decisions regarding the diagnosis and treatment of the patient based on the symptoms and disorder presented. Each decision should be supported by evidence-based literature and consider potential co-morbidities and patient-specific factors.
Competencies Measured
This assignment measures students’ competencies in:
- Clinical reasoning and decision-making in neurology and musculoskeletal health.
- Application of evidence-based practice in patient assessment and treatment planning.
- Integration of theoretical knowledge with practical clinical scenarios.
- Communication of diagnostic and treatment strategies based on patient-centered care principles.
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NURS 6521 Decision Tree for Neurological and Musculoskeletal Disorders Assignment Example
Case Summary
A 43-year-old white male presents with chronic pain following a work-related fall seven years ago, resulting in hip injury. His pain is accompanied by ambulation difficulties necessitating crutches. Referred for psychiatric evaluation due to skepticism from his family doctor regarding the legitimacy of his pain, the patient denies depression but acknowledges significant life disruptions due to pain, including job loss and strained relationships. A diagnosis of complex regional pain syndrome (CRPS) has been previously made by a neurologist. Despite significant impact on his personal and professional life, he denies depression. Previous treatment attempts include unsuccessful pain management due to side effects.
Decision 1
Initiation of Savella (milnacipran) for pain management at 12.5 mg orally once daily, escalating to 50 mg twice daily over a one-week titration schedule was chosen. Savella, an SNRI and NMDA antagonist, is selected for its potential to modulate pain signaling by enhancing neurotransmitter availability, thereby alleviating pain hypersensitivity associated with CRPS (Stanton-Hicks, 2018). Alternative treatments like Amitriptyline were avoided due to potential side effects that could compromise patient compliance (Benzon, Liu & Buvanendran, 2016).
Expected Outcome
Anticipated outcomes included significant pain reduction (3/10), improved ambulation without crutches, and enhanced quality of life. These expectations were based on the analgesic properties of Savella documented in literature (Stanton-Hicks, 2018).
Difference between Expected Outcome and Actual Outcome
Following four weeks of treatment, the patient reported reduced pain intensity (4/10), but with persistence of morning exacerbations and nocturnal awakenings due to pain. Side effects such as sweating, sleep disturbances, and elevated blood pressure were noted, necessitating dosage adjustment (Finnerup et al., 2015).
Decision 2
Dosage reduction of Savella from 50 mg orally once daily to 25 mg twice daily was implemented to manage side effects while maintaining therapeutic efficacy. This decision aimed to balance pain management with minimizing adverse reactions, aligning with evidence suggesting dosage adjustments can mitigate drug-related symptoms (Stanton-Hicks, 2018).
Expected Outcome
Expected outcomes included continued pain relief, improved functional capacity, and resolution of drug-related side effects, fostering a return to normal activities and improved mood (Benzon, Liu & Buvanendran, 2016).
Difference between Expected Outcome and Actual Outcome
Despite dosage adjustment, the patient’s pain levels worsened, necessitating continued use of crutches and a reported pain intensity of 7 on a 10-point scale, indicating inadequate pain management. Although Savella-related side effects abated, functional improvement was limited (Murnion, 2018).
Decision 3
Transition to a split dosing regimen of Savella, 50 mg orally in the morning and 25 mg at bedtime, was chosen to capitalize on the observed diurnal pain pattern, aiming for enhanced pain control throughout the day. This decision was supported by literature suggesting optimized pain management through tailored dosing schedules (Finnerup et al., 2015).
Expected Outcome
Anticipated outcomes included further pain reduction (3/10), improved ambulation without aids, and stabilization of mood disturbances. Expected resolution of Savella-related side effects was also anticipated (Stanton-Hicks, 2018).
Difference between Expected Outcome and Actual Outcome
Following four weeks, the patient reported modest pain reduction, improved ambulation, and a pain intensity level of 4 on a 10-point scale. While mood and functional improvements were noted, complete pain resolution was not achieved, reinforcing the chronic nature of CRPS management (Benzon, Liu & Buvanendran, 2016). Comprehensive pain management strategies including adjunctive therapies were recommended to optimize outcomes (Murnion, 2018).
Conclusion
Effective management of complex regional pain syndrome (CRPS) necessitates a comprehensive approach that integrates tailored pharmacological interventions with non-pharmacological strategies. Pharmacotherapy, such as the use of medications like Savella, is pivotal in alleviating symptoms; however, adjustments must be personalized to achieve optimal balance between efficacy and tolerability. Concurrently, holistic care involving physical therapy, lifestyle modifications, and psychological support is indispensable for enhancing outcomes in chronic pain conditions like CRPS. By combining these approaches, healthcare providers can address the multifaceted nature of CRPS and improve overall patient well-being and functional outcomes.
References
Benzon, H. T., Liu, S. S., & Buvanendran, A. (2016). Evolving definitions and pharmacologic management of complex regional pain syndrome.
Finnerup, N. B., et al. (2015). Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. The Lancet Neurology, 14(2), 162-173.
Murnion, B. P. (2018). Neuropathic pain: current definition and review of drug treatment. Australian prescriber, 41(3), 60.
Stanton-Hicks, M. (2018). Complex regional pain syndrome. In Fundamentals of Pain Medicine (pp. 211-220). Springer, Cham.
Detailed Assessment Instructions for the NURS 6521 Decision Tree for Neurological and Musculoskeletal Disorders Assignment
Assignment: Decision Tree for Neurological and Musculoskeletal Disorders
For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders.
To Prepare
- Review the interactive media piece assigned by your Instructor.
- Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.
- Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.
- You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.
By Day 7 of Week 8
Write a 1- to 2-page summary paper that addresses the following:
- Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.
- Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
- What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
- Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.
You will submit this Assignment in Week 8.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK8Assgn+last name+first initial.(extension)” as the name.
- Click the Week 8 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 8 Assignment You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer Find the document you saved as “WK8Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submitbutton to complete your submission.
Submit Your Assignment by Day 7 of Week 8
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