Question

NR304 Musculoskeletal Case Study Case Study N: A 74 ylo male client has come to the healthcare provider's office for a yearly examination. The nurse is conducting the initial health assessment and is ready to begin the musculoskeletal portion of the examination. 1. What questions should the nurse ask the client to detect common symptoms of bne and joint problems? (List at least three) 2. The nurse begins the focused assessment. What are the musculoskeletal age-related changes that are likely in this client? (List at least three) 3. The nurse is assessing the client's knee for ballottement. After having the client lie supine with leg in extension, the nurse should take which action? (Provide your rationale) Grasp the tibia and push fluid in the suprapatellar bursa to move between the tibia and the patella Grasp the tibia and push fluid in the suprapatellar bursa to move between the femur and the patella Grasp the tibia and push fluid in the suprapatellar bursa to move between the tibia and femur. Grasp the thigh above the knee and push fluid in the suprapatellar bursa to move between the femur and the patella a. b. c. d. Answer 4. The client reports a history of gouty arthritis and reports pain and swelling of the elbow. The nurse concludes that these manifestations are consistent with which disorder? (Explain what each condition is and provide the rationale for your answer) a. Osteoarthritis b. Olecranon bursitis c. Rheumatoid arthritis d. Carpal tunnel syndrome Answer

Answer 1

ANSWER

1. Questions to detect bone and joint problems.

                      * Do you felt pain in any joints of the body?

                      * Do you felt muscle cramps or aches ?

                      * Do you observe any swelling or edema around any joints in the body?

2. Musculoskeletal age related changes.

                     * Age related changes in posture and gait.

                     * Age related softening of bone due to loss of bone density.

                     * Less pronounced foot arches lead to slight loss of height.

3.d. Grasp the thigh above the knee and push fluid in the suprapatellar bursa to move between

        the femur and the patella. this test is useful to detect increased fluid in the suprapatellar

        pouch over the patella at the knee joint.

      * When doing the test bogginess around the joint shows test is positive for ballottement.

4.b. Olecranon bursitis.

       * Client has a history of gouty arthritis which is a possible cause for develop inflammation in bursa

          of the elbow joint and leads to clinical manifestations of bursitis like pain and swelling of the elbow.