NRNP 6540 Week 10 Knowledge Check; Musculoskeletal and Neurologic Disorders, Quizzes of Nursing

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QUESTION 1

Describe the difference between bursitis and tendinitis.

QUESTION 2

Your 68-year-old male complains of a hot, swollen, reddened MTP joint of the great toe. What is your primary diagnosis?

QUESTION 3

Restless legs syndrome (RLS) is a common neurological disorder characterized by an intense urge to move the legs (or sometimes the arms). Describe at least three symptoms or sensations of RLS.

QUESTION 4

Mary is a 79-year-old female who is post-menopausal and had refused to take hormone replacement therapy. Her vital signs are normal with slightly elevated BP today of 140/79, she states she is in pain 6/10. She is active around her home, and comes to the clinic complaining of back and hip pain after hanging new curtains and fell off her step ladder onto her kitchen floor. You suspect she has a fracture. What are the OLDCARTs questions you

NRNP 6540 Week 10 Knowledge Check

Bursitis is the inflammation of a bursa, a sac lined with synovial membranes that release synovial fluids. Tendinitis, on the other hand, is the inflammation of a tendon, which is the noncontractile portion of a muscle. The patient with a hot, swollen, reddened metatarsophalangeal joint of the great toe can have a primary diagnosis of gout. Those symptoms in the great toe, known as podagra, are the classic presentation of an acute gout attack. Three symptoms or sensations of restless leg syndrome include the following:

1. Symptoms are reported as a need to move due to sensations variously described as aching, burning, creeping, crawling, cramping, gnawing, pulling, painful, tense, throbbing, tingling, restless, itchy, tense, tearing, and tugging.
2. Movement of affected limbs provides relief, but discomfort recurs unless the movement continues.
3. Symptoms start or worsen during periods of inactivity like sitting or lying down.

In assessing Mary, who is suspected to have a fracture, the following

OLDCART questions will be asked:

1. Onset - When did the injury occur?

2. Location - What part of the body is hurting? Besides the back

and hip, any other related injury?

3. Characteristics - Describe the pain in the injured sites?

4. Duration - Is the pain constant or intermittent?

5. Aggravating Factors - What activity worsens the pain?

6. Relieving Factors - What activity helps relieve the pain.

QUESTION 5

Peripheral neuropathy (PN) can be a sequalae of stroke or diabetes. List three of the cardinal symptoms of PN.

QUESTION 6

Mrs. G arrives for her annual exam, and you note that her height is 5 foot 6 inches, down 1 inch from 2 years ago. Describe at least three of the changes in the muscular system that are a part of the normal aging process.

QUESTION 7

Edgar is a 72-year-old male and is in the clinic for his annual examination. His vital signs are normal, and he is stable on his blood pressure medications and daily Flonase for seasonal allergies. He has no other complaints. You want to assess his gait as part of the Medicare Annual examination. List four (4) methods by which you will evaluate Edgar’s gait.

7. Treatment -What did you do to alleviate the pain or discomfort

related to the fracture?

Three cardinal symptoms of peripheral neuropathy are:

1. Paresthesia and dysesthesias like numbness, tingling, prickling, pins, and needles sensations, band- like sensation on feeling and pressure.
2. Distal to proximal loss of various sensation, along with a predominant complaint of pain and thermal sensation, suggesting a small fiber neuropathy.
3. Autonomic nerve damage, which includes inability to control bowel and bladder function (constipation, diarrhea), orthostasis, arrhythmias, dry eyes, and dysphagia. In older adults, there are changes in the muscular system that are a part of the normal aging process. Examples are as follows:
4. Loss of subcutaneous fat due to aging causes bony prominences to become more noticeable.
5. Muscles stiffen and range of motion becomes impaired as people advance age.
6. Loss of muscle mass happens, some muscle diminishing, and others atrophying.

To evaluate Edgar's gait as part of his Medicare Annual Examination, the

following methods will be done:

1. Examine the lower extremities to include podiatric issues. Note

for any gait abnormality or problems in maintaining balance.

2. Evaluate the patient's stance. Note for any limping or asymmetrical leg movement

or deformities. An antalgic gait may be a result of chronic hip pain and muscle atrophy.

QUESTION 8

Ahmad is a 66-year-old male with a history of well controlled diabetes on metformin and takes ramipril for HTN. He also has a history of osteoarthritis for which he alternates Tylenol with Motrin daily. He states he was walking his dog, which he does every day, and the next day his right knee began to swell. Upon examination his knee is erythematous, swollen, and tender. List at least three differential diagnoses for Ahmad’s swollen knee.

3. Evaluate the patient's arm swing. If the patient is having difficulty in

shifting weight from one leg to the other and relies on shoulder

movement from side to side, the abnormality will be referred to as a

lurch.

4. Evaluate the patient's ability to sit in and rise from a chair. Quadriceps

weakness should be considered if the patient relies on a rocking motion

and/or arm strength to stand.

1. Osteoarthritis – Morning joint stiffness and usually affects weight

bearing joints such as knees and hips.

2. Gout – is a painful inflammatory arthritis that usually affects the big

toe but it can also develop in any joint, including one or both knees.

3. Septic Arthritis – Inflammation of joint due to bacterial infection

causing severe pain, swelling, warmth, redness, and limitation to

move the affected joint

4. Bursitis – Tenderness, erythema, and swelling maybe due to the

inflammation of its bursa.

an inflammation of a joint due to bacterial infection causing severe

pain swelling, warmth,redness,and inability to move the affected joint

5. Bursitis- apresence of pain,tenderness,eryt hema,and swelling of

the joint due to

6. theinflammation of its bursawith a risk factor to a patient

withRA, OA, gout, thyroid

QUESTION 10

Your 88-year-old patient has chronic gout. You know that gout is an inflammatory disease associated with malfunctioning metabolism of purine, leading to overproduction or underexcretion of uric acid, results in deposits of sodium urate crystals in the joints, periarticular tissues, subcutaneous tissues, and kidneys. List the

7. disease, chronic kidney disease, and diabetes

Bursitis- apresence of pain,tenderness,erythe ma,and swelling of the

joint due to theinflammation of its bursawith a risk factor to a patient

withRA,

OA, gout, thyroid

disease, chronic kidney disease, and diabetes

QUESTION 9

Describe a cognitive screening test that measures the status of a patient’s attention, concentration, executive function, memory, and orientation. The Montreal Cognitive Assessment (MoCA Version 7.1) is a screening tool created to measure the status of a patient's attention, concentration, executive functions, memory, and orientation. It has been trialed on patients with different neurodegenerative conditions and a history of substance abuse.

1. Age- Primary gout usually occurs between the ages forties to sixties. If occurring in older adults, it occurs around the sixties to seventies due to factors contributing to a cause of secondary gout. Prevalence increases with old age in men, with a peak of 75 to 84 years old.
2. Gender -Prevalence of gout in women is lower at all ages as compared to men, whose risk increases with age. Women’s risks are greater after meopause due to decreased hormone levels of estrogen, use of diuretics, increased renal insufficiency, and longer life span as compared to males.
3. There is a higher prevalence in Pacific Islanders, Filipinos and Samoans. There is higher incidence in African American than Caucasians. Africans that reside in Africa has very rare occurrence of gout. Meanwhile, gout affects 16.4 of every 1,000 men and 2.9 of every 1,000 women in England.